scholarly journals Athletic Trainers' Perceptions of Advanced Clinical Practice: Defining Advanced Clinical Practice in Athletic Training

2020 ◽  
Vol 15 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Barton E. Anderson ◽  
Cailee E. Welch Bacon ◽  
Eric L. Sauers

Context Advanced clinical practice is inherent in contemporary athletic training education, such as residency programs and Doctor of Athletic Training programs; however, as a concept, advanced clinical practice in athletic training has been poorly studied to date. Objective To explore athletic trainers' perceptions of advanced clinical practice. Design Cross-sectional. Setting Online survey with open-ended questions. Patients or Other Participants Three hundred fifty of 1992 athletic trainers accessed the survey (17.6% access rate); 321 respondents completed at least 1 open-ended question; and 196 completed the survey in its entirety (61.1% completion rate). Intervention(s) We used a 13-item survey including demographic items (9 items) and open-ended response questions (4 items). Main Outcome Measure(s) Guided by the consensual qualitative research approach, a 3-person data analysis team coded the open-ended responses. Each member coded 50 responses and a consensus codebook was developed. Two members of the team coded the remaining responses, which were confirmed by the third member. Emergent data were organized into themes and categories, and frequency counts were determined for each category. Results Athletic trainers' definitions of advanced clinical practice were categorized into 4 emergent categories: (1) formal training and education; (2) informal training and education; (3) knowledge, skills, and behaviors; and (4) experience and uncertainty. Conclusions The categories of formal and informal training and education focused on athletic trainers acquiring additional knowledge and skills through mechanisms such as postprofessional degree programs, residency programs, or other areas of study. The knowledge, skills, and behaviors category included areas related to specialized skills and the core competencies. These 3 categories aligned with one another to provide both the types of knowledge, skills, and behaviors that define advanced clinical practice, and the specific mechanisms through which an athletic trainer can achieve advanced clinical practice.

2020 ◽  
Vol 15 (1) ◽  
pp. 35-40
Author(s):  
Barton E. Anderson ◽  
Cailee E. Welch Bacon ◽  
Eric L. Sauers

Context The “Strategic Priorities for Athletic Training Education” promote the development of clinical specialists and advanced practice leaders; however, little is known about the characteristics of advanced practice athletic trainers. Peer health professions have formal education and training programs and specialized credentials to denote advanced practice clinicians; however, such mechanisms are only now emerging in athletic training. As training and credentialing programs advance, it is important to understand the perceived characteristics of clinicians engaged in advanced clinical practice. Objective To explore how athletic trainers perceive the characteristics of clinicians advanced practice clinicians. Design Cross-sectional. Setting Self-reported online survey. Participants Of 1992 athletic trainers invited to participate, 350 accessed the survey (17.6% access rate); 321 respondents completed at least 1 open-ended question, and 196 completed the entire survey (61.1% completion rate). Main Outcome Measures Consensual qualitative research approach consisting of a 3-person team was used to analyze the open-ended responses. Members individually coded the initial set of responses and then met to develop a consensus codebook. Remaining responses were coded by 2 team members and were confirmed by the third member. Data were organized into themes and categories, and frequency counts were used for each category. Results Four categories of characteristics associated with advanced practice clinicians emerged: (1) intrapersonal skills, (2) interpersonal skills, (3) discipline specific knowledge and skills, and (4) experience. Conclusions Intrapersonal skills including lifelong learning, critical thinking, and willingness to mentor others were identified, in addition to strong communication and leadership skills. Discipline-specific knowledge and skills were also associated with advanced clinical practice, including specialized skills and advanced integration of the core competencies. Accredited Athletic Training Residency programs and Doctor of Athletic Training programs should strive to foster these characteristics within their students to facilitate the development of advanced practice athletic trainers.


2021 ◽  
Vol 56 (9) ◽  
pp. 980-992
Author(s):  
Cynthia J. Wright ◽  
Mike T. Diede

Context As part of clinical practice, athletic trainers (ATs) provide immediate management of patients with acute joint dislocations. Management techniques may include on-site closed joint reduction of the dislocated joint. Although joint reduction is part of the 2020 educational standards, currently practicing ATs may have various levels of exposure, knowledge, and skills. Objective To capture AT self-reported knowledge and practice patterns concerning closed joint reductions. Design Cohort study. Setting Online survey (Qualtrics). Patients or Other Participants The survey link was emailed to 5000 certified ATs. A total of 772 responses were completed by certified ATs with clinical practice experience (15.4% response rate). Main Outcome Measure(s) Participants were asked to complete a survey about their practice patterns concerning patients with closed joint reductions, which included questions about the types of closed reductions ATs performed most commonly, the frequency of on-site reduction by ATs, and participants' demographic information. Additionally, the survey addressed the ATs' training and comfort level in performing closed reductions and knowledge of standing orders and the state practice act. Results Ninety percent (n = 694) of ATs reported ever performing a closed reduction (either with or without a physician present), with 10% (n = 78) stating they had never performed a joint reduction. The interphalangeal joint of the finger (73.2% of ATs), shoulder (63.3%), and patella (48.2%) were cited as the 3 most common reductions performed without a physician present. Only 46.5% (n = 359) of ATs indicated receiving training in joint-reduction techniques as part of their precertification athletic training curriculum or program; a greater percentage (64%) said they learned directly from a physician. Fewer than 60% of ATs reported having standing orders related to joint reductions. Conclusions Considering the high percentage of ATs who reported performing closed joint reductions and the low percentage with formal training, further development of joint-reduction training and standing orders is warranted.


2021 ◽  
Vol 16 (4) ◽  
pp. 300-306
Author(s):  
Sarah A. Manspeaker ◽  
Alison N. Wix

Context Athletic trainers must develop the knowledge and skills to recognize signs and symptoms of dermatologic conditions in the physically active population. Objective To present an overview of an educational technique aimed at promoting the development of skills related to dermatological care that meets clinical practice needs and accreditation requirements for athletic training programs at all levels. Background Curricular content standards in athletic training education require learners to obtain the skills necessary to perform an evaluation, formulate a diagnosis, and establish a plan of care relevant to the integumentary system, including dermatological conditions. Cognitive Learning Theory uses specific sequencing of content and learning sessions to promote student engagement in the learning process. Description Within an evaluation course for nonorthopaedic conditions, a 3–class session learning module was developed to target instruction, application, and assessment of dermatological conditions. This article describes the development, overview of content, delivery methods, outcomes to date, and connection to the instructional standards in athletic training. Clinical Advantage(s) Integrating evaluation of dermatological conditions into athletic training curricula enhances clinical decision-making skills and direct application of these skills to clinical practice. Conclusion(s) Athletic trainers should be able to effectively identify, manage, and potentially refer patients with dermatological conditions. Educating future athletic trainers to be able to prevent the spread of infection, decrease disease transmission, and enhance their ability to recognize and manage dermatological conditions is vital to their development toward independent clinical practice.


2013 ◽  
Vol 48 (3) ◽  
pp. 405-415 ◽  
Author(s):  
Cailee W. McCarty ◽  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Eric J. Newton ◽  
Bonnie L. Van Lunen

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students. Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training educators (n = 24) and postprofessional students (n = 71). Main Outcome Measure(s): Likert-scale items (1 = strongly disagree, 4 = strongly agree) assessed attitudes and beliefs and perceived barriers, whereas multipart questions assessed accessibility to resources. Kruskal-Wallis H tests (P ≤ .05) and Mann-Whitney U tests with a Bonferroni adjustment (P ≤ .01) were used to determine differences among groups. Results: Athletic trainers agreed (3.27 ± 0.39 out of 4.0) that EBP has various benefits to clinical practice and disagreed (2.23 ± 0.42 out of 4.0) that negative perceptions are associated with EBP. Benefits to practice scores (P = .002) and negative perception scores (P < .001) differed among groups. With respect to perceived barriers, athletic trainers disagreed that personal skills and attributes (2.29 ± 0.52 out of 4.0) as well as support and accessibility to resources (2.40 ± 0.40 out of 4.0) were barriers to EBP implementation. Differences were found among groups for personal skills and attributes scores (P < .001) and support and accessibility to resources scores (P < .001). Time (76.6%) and availability of EBP mentors (69.6%) were the 2 most prevalent barriers reported. Of the resources assessed, participants were most unfamiliar with clinical prediction rules (37.6%) and Cochrane databases (52.5%); direct access to these 2 resources varied among participants. Conclusions: Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.


2010 ◽  
Vol 19 (3) ◽  
pp. 249-267 ◽  
Author(s):  
Megan D. Granquist ◽  
Diane L. Gill ◽  
Renee N. Appaneal

Context:Rehabilitation adherence is accepted as a critical component for attaining optimal outcomes. Poor adherence is recognized as a problem in the athletic training setting. Measurement has been inconsistent, and no measure has been developed for athletic training settings.Objective:To identify indicators of sportinjury rehabilitation adherence relevant to athletic training and develop a Rehabilitation Adherence Measure for Athletic Training (RAdMAT) based on these indicators.Design:Mixed methods, 3 steps.Setting:College athletic training facility.Participants:Practicing certified athletic trainers (ATCs; n = 7) generated items, experts (n = 12) reviewed them, and practicing ATCs (n = 164) completed the RAdMAT for their most, average, and least adherent athlete.Main Outcome Measure:RAdMAT.Results:The RAdMAT is 16 items with 3 subscales. Subscales and total have good internal consistency and clearly discriminate among adherence levels.Conclusions:The RAdMAT is based on scholarly literature and clinical practice, making it particularly appropriate for use in athletic training clinical practice or for research purposes.


2019 ◽  
Vol 14 (4) ◽  
pp. 305-314
Author(s):  
Hideyuki “E” Izumi ◽  
Yuri Hosokawa

Context Each country has a unique history in the development of its athletic training professionals and education and credentialing systems. In Japan, the majority of athletic trainers hold a domestic credential (JSPO-AT) obtained from the Japan Sport Association (JSPO) or a US-based credential from the Board of Certification (BOC-AT). Objective To determine whether differences in demographic, professional, and educational characteristics exist between Japanese BOC-ATs and JSPO-ATs who currently practice athletic training services in Japan. Design Cross-sectional study. Setting Online survey. Patients or Other Participants Eight hundred twenty-nine Japanese athletic trainers in Japan (BOC-AT, n = 64; JSPO-AT, n = 765). Main Outcome Measure(s) Pearson's χ2 test and Fisher's exact test were used to determine differences in demographic, professional, and educational characteristics between BOC-ATs and JSPO-ATs. Results The proportion of female respondents was greater for BOC-ATs (29.7%) than for JSPO-ATs (18.7%; χ2 [1] = 4.5, P = .03). A greater proportion of BOC-ATs reported having master's degrees or higher (χ2 [3] = 81.6, P < .01). The percentage of respondents with at least 1 therapist or medical practitioner license in Japan was greater for JSPO-ATs (73.1%) than for BOC-ATs (20.3%; P < .01). The percentage of respondents with at least 1 credential in exercise, nutrition, or teaching was greater for BOC-ATs (62.5%) than for JSPO-ATs (45.2%; P < .01). A large difference was observed in the proportion of individuals who identified as therapists (JSPO-ATs = 29.8%, BOC-ATs = 6.3%; χ2 [5] = 18.9, P < .01). The median income for BOC-ATs was 401–600 million yen (US$36 500–$54 500), whereas the median income for JSPO-ATs was 0–200 million yen (US$0–$18 200). Conclusions BOC-ATs in Japan were more established than JSPO-ATs as athletic training professionals with higher educational backgrounds, while more JSPO-ATs tended to be therapists. Findings from the current study may serve as benchmark data for the athletic training profession and service characteristics in Japan.


2018 ◽  
Vol 13 (4) ◽  
pp. 309-323 ◽  
Author(s):  
Cailee E. Welch Bacon ◽  
Bonnie L. Van Lunen ◽  
Dorice A. Hankemeier

Context: Over a decade ago, the Institute of Medicine indicated that all health care professionals should be educated in several health care competency areas (quality improvement, health care informatics, interprofessional education and collaborative practice, evidence-based practice, and patient-centered care). Despite this initiative, athletic training has only recently incorporated these competencies throughout education. Objective: To assess postprofessional athletic training students' perceived abilities and importance regarding 6 core competencies. Design: Cross-sectional. Setting: Self-reported paper survey. Patients or Other Participants: A total of 221 from a convenience sample of 258 postprofessional athletic training students (85.7%) completed the survey (82 males, 138 females; age = 23.29 ± 2.05 years). Main Outcome Measure(s): The survey consisted of several concept statements for each competency, and perceptions were collected via Likert-scale items (range 1–4). Composite perceived ability and importance Likert-scale scores were achieved by tabulating all values and then averaging the scores back to the Likert scale. Higher scores indicated that participants perceived themselves to have greater ability and that the concepts were more important for implementation in clinical practice. Results: Overall, postprofessional athletic training students perceived they were able to implement the concepts of the competencies into their daily practice and perceived all of the competencies to be moderately to extremely important for implementation. However, while participants globally perceived they were able to implement the competencies, they disagreed or strongly disagreed they were able to implement some concepts, particularly within health care informatics and patient-centered care, as a part of their clinical practice. Conclusions: Postprofessional athletic training students recognize the importance of the core competencies and perceive they are able to implement these competencies throughout clinical practice. However, as postprofessional athletic training students continue to advance their skills as clinicians, the benefits of health care informatics and incorporating real-time electronic patient data to support their clinical decisions should be emphasized.


2016 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
W. David Carr ◽  
Spencer Thomas ◽  
Jenica Paulsen ◽  
Jennifer Chiu

Context: Athletic training students acquire clinical hours under the direct supervision of athletic training preceptors. Objective: The purpose of this project was to explore what characteristics preceptors desire in their athletic training students. Design and Setting: Online survey instrument. Patients or Other Participants: A total of 286 certified athletic trainers (128 male, 158 female; average years experience 10.58 ± 8.48). Participants were required to be current preceptors and have 1 or more years of preceptor experience. Main Outcome Measure(s): An instrument of 21 questions, including 7 demographics, 13 Likert-scale (1 = not important; 10 = strongly important), and 1 rank order item was developed. Validity of the instrument was established by a review of experts. An analysis of internal consistency revealed an α of .834. Data was analyzed with SPSS (version 20.0; IBM Inc, Chicago, IL). Basic descriptive statistics were calculated, and an analysis of variance was conducted to determine differences. Results: Top 3 characteristics seen amongst all settings were initiative (mean = 9.091 ± 1.166), communication skills (mean = 8.769 ± 1.241), and intelligence (mean = 8.723 ± 1.247). Gender differences were observed in 4 of the 13 characteristics. Conclusions: Findings demonstrated initiative, communication skills, and intelligence to be perceived as the most important athletic training student characteristics. These findings differ with previous literature and the preliminary focus group findings, where emotional intelligence and communication skills were reported to be of greater importance.


2014 ◽  
Vol 49 (2) ◽  
pp. 220-233 ◽  
Author(s):  
Cailee E. Welch ◽  
Bonnie L. Van Lunen ◽  
Dorice A. Hankemeier ◽  
Aimee L. Wyant ◽  
Jessica M. Mutchler ◽  
...  

Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial. Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: We conducted 1 individual telephone interview with each participant. After transcription, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants perceived the EBP Web-based modules to produce numerous outcomes regarding education and clinical practice. These outcomes included perceived knowledge gain among participants, an increase in the importance and scope of EBP, a positive effect on educators' didactic instruction patterns and on instilling value and practice of EBP among students, and an enhanced ability among clinicians to implement EBP within clinical practice. However, some clinicians reported the Web-based modules had no current effect on clinical practice. Conclusions: Although the EBP Web-based modules were successful at enhancing knowledge among ATs, translation of knowledge into the classroom and clinical practice remains limited. Researchers should aim to identify effective strategies to help ATs implement EBP concepts into didactic education and clinical practice.


2013 ◽  
Vol 48 (3) ◽  
pp. 394-404 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Cailee W. McCarty ◽  
Eric J. Newton ◽  
Stacy E. Walker ◽  
...  

Context: Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown. Objective: To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%. Main Outcome Measure(s): Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables. Results: Athletic trainers demonstrated low knowledge scores (64.2% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P < .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P < .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P < .001). Conclusions: Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.


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