COMMUNITY IMPACT FOR CLINICALLY INTEGRATED ATC PROGRAM IN A SPORTSMEDICINE PRACTICE

Background: Health Systems routinely make investments in clinically driven outreach programs to build for future community needs, improve health outcomes, and serve their community mission. Many community sports programs have limited access to sports medicine care, including access to athletic trainers. Hypothesis/Purpose: The primary purpose of this study was to evaluate the impact of a clinically integrated Certified Athletic Trainer (ATC) Community Sports Outreach Program, by evaluating the outreach into the community, sports clubs, schools, covered events. Methods: The ATC Community Outreach Program monitored key metrics over a 3 and 1/2-year period. Metrics included the partnerships developed with local clubs and schools, number of athletes covered in each organization, games covered and hours spent supporting organizations. Categories were divided into fiscal years (FY) running from September to August. Fiscal Year 2016 was calculated from January – August, as it was the first year of the program. The percentage of growth of the amount of games covered was calculated from the adjacent FY. Results: Over the first 3 and 1/2 years (FY2016-FY2019), the number clubs, schools, programs covered grew from 10, 19, 25, to 31 from FY2016 - FY2019. Number of athletes from 7,363, 12,552, 15,104, to 19,794 from FY2016 - FY2019. The number of community outreach events grew from 6, 11, 57, to 190 from FY2016 - FY2019 (Table/Figure 1.1). The percentage of growth of games covered grew from 183%, 518% to 333% between FY2016 and FY2019. Discussion/Conclusion: Building, maintaining a sports medicine practice is a complex undertaking, and represents a significant investment for the health system and community. In many communities, access to sports medicine care for athletes is very limited. A clinically integrated ATC program can generate a significant impact on the community by building relationships with local sports clubs/schools and improving sports medicine care access to young athletes. Tables/Figures: [Table: see text][Figure: see text]

Injuries and Referral Patterns During Basic Combat Training: An Examination of Data From the Certified Athletic Trainer-Forward Program

ABSTRACT Introduction Injuries sustained during basic combat training (BCT) result in large economic costs to the U.S. Army. The inclusion of athletic trainers (ATs) in other military branches has reduced Troop Medical Clinic (TMC) referrals. However, the inclusion of ATs during BCT has yet to be studied. The purpose of this study was to describe the frequency and nature of sick call visits during BCT and determine how the presence of an AT affects referrals to the TMC. Materials and Methods A prospective cohort study was conducted at the Fort Jackson Army Training Center for one calendar year. Soldiers in BCT, aged 18–42, who reported to sick call were included. Independent variables collected included: Soldier demographics (sex and age), visit reason, and provider impression. Training battalions were placed in three conditions: control (CON), full-time medic (FTM), and part-time athletic trainer (PAT). The dependent variable was disposition (referred or returned to duty [RTD]). Frequencies and proportions were calculated. Logistic regression compared conditions while considering the other independent variables. Return on investment was calculated. Results Fourteen thousand three hundred and four visits were documented. Most soldiers were female (n = 7,650; 53.5%) and under 20 years old (n = 5,328; 37.2%). Visits were most commonly due to physical injury (n = 7,926; 55.4%), injuries affecting the knee (n = 2,264; 15.8%) and chronic/overuse conditions (n = 2,031; 14.2%). By condition, the FTM and PAT conditions resulted in 1.303 (95%CI: 1.187, 1.430; P < .001) and 1.219 (95%CI: 1.103, 1.348; P < .001), or 30.3% and 21.9% higher, odds of being RTD compared to the CON condition, respectively. Return on investment was $23,363,596 overall and $2,423,306 for musculoskeletal-related cases. Conclusions Injuries were common in BCT, particularly in females. Soldiers in both the PAT and FTM conditions were more likely to be RTD compared to those in the CON condition. Athletic trainers (ATs) are effective at reducing potentially unnecessary referrals, demonstrating their value as healthcare providers in the BCT environment. Understanding variables associated with recruit disposition may aid medics and ATs in the development of triage protocols and further reduction of potentially unnecessary soldier referrals. The Certified Athletic Trainer-Forward Program resulted in significant return on investment, further supporting the inclusion of ATs in BCT.

Engaging Athletic Trainers in Concussion Detection: Overview of the National Football League ATC Spotter Program, 2011–2017

Objective To assist sideline medical staff and to augment detection of concussion in National Football League (NFL) players during preseason and regular season games via the use of certified athletic trainer (ATC) spotters. Background Detecting concussive injuries in contact-sport athletes can be a challenging task for health care providers on the sideline. Over the past 8 years, professional sport leagues have begun to use additional sets of eyes (medical spotters along with video review) to help identify athletes with possible concussive injuries. Description The NFL first began a program using spotters in 2011, and the ATC Spotter Program has undergone systematic enhancements each year. This article describes the evolution of the ATC Spotter Program, the requirements and training of its participants, and the program data available to date. Directions for future improvement and research are addressed. Clinical Advantages The use of ATC spotters stationed in the broadcast booth has enhanced the real-time detection of concussed players in the NFL.

A Qualitative Exploration of the Professional Commitment of Athletic Trainers Employed in the Professional Sports Setting

Professional commitment has been studied in multiple settings, yet little is known about the professional sport setting. A total of 27 male athletic trainers, employed full time in the professional sport setting, participated in this study. Our participants were 34 years old (range 30–58), with 21 ± 7 years of experience as a certified athletic trainer, and more than 17 ± 7 years of experience in the professional setting. We conducted online asynchronous interviews. All data were analyzed following an interpretative approach. Data saturation was met, and we used a peer review and researcher triangulation. Barriers to professional commitment included time away from family/home and negative work environment. The facilitators to professional commitment were competition, positive work environment, and off-season professional development. The professional sport setting is unique, much like the collegiate setting, and thus our findings highlight that time away and a negative workplace atmosphere can reduce an athletic trainer’s commitment. Commitment to the profession, however, is enhanced within this setting because of the chance to be around the high level of competition, as well as the chance to have time for professional development.

National Athletic Trainers' Association Position Statement: Management of Acute Skin Trauma

Objective: To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients. Background: Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications. Recommendations: These guidelines are intended to provide the certified athletic trainer and others participating in athletic health care with specific knowledge about and recommendations for the management of acute skin trauma.

High School Athletes' Parents' Perceptions and Knowledge of the Skills and Job Requirements of the Certified Athletic Trainer

Context Parents play a crucial role in determining medical services for their children, and it is important they understand the scope of practice and skills of the athletic trainer (AT). Objective To understand parents' perceptions and knowledge of the skills and job requirements of the secondary school AT. Design Cross-sectional study. Setting Sport meetings and banquets at 5 high schools in southwest Michigan during the fall, winter, and spring seasons. Patients or Other Participants A total of 539 parents whose children competed in at least 1 high school sport participated. Data Collection and Analysis A Parents' Perceptions and Knowledge of Certified Athletic Trainers Survey consisting of 32 questions, divided into 3 sections (demographics, perceptions, and knowledge), was developed and given to parents of high school athletes. One-way analyses of variance were used to determine significance among 3 categories of experience and perception and knowledge of ATs. Results Of the 539 parents who responded, 28% responded yes, and 72% responded no to having experience with an AT for their own injuries. When asked if they had experience with an AT due to their child's injuries, 60% responded yes. We found a difference among the 3 categories of experience for perception scores (P = .002) and knowledge scores (P < .001). Conclusions In the absence of past experience with an AT, parents' perceptions and knowledge of the skills and job requirements of the secondary school AT are limited. Athletic trainers should educate parents on their professional roles, which may enhance their ability to provide better health care.

Characteristics and Program Decisions of Master's-Level Professional Athletic Training Students

Context The number of master's-level professional athletic training programs (MLPATPs) has grown by over 400% in the past 10 years; however, little is known about the characteristics of the students who enroll in these programs or why they select this route to certification. Objective To describe, by exploring the characteristics of MLPATP students, the profile of students who enroll in MLPATPs, and to aid in recruitment of students by developing a greater understanding of why students select the MLPATP route to athletic training certification. Design Cross-sectional design involving online survey research. MLPATP directors were asked to forward the survey link to students enrolled in their programs. Participants Seventy-nine students enrolled in MLPATPs accredited by the Commission on Accreditation of Athletic Training (CAATE). Data Collection and Analysis Survey data were collected by Formstack.com. Open-ended questions were categorized based on common themes and then coded. Descriptive statistics and nonparametric correlations were calculated. Results MLPATP students were, on average, 24.7 years old; 68% were women, 85% were Caucasian. Forty-two percent earned their bachelor's degree in exercise/sports science. Nearly 80% of students decided they wanted to be an athletic trainer either prior to or during their undergraduate studies, and students enrolled in their MLPATP an average of 1.2 years after completing their bachelor's degree. The geographical area and an institution's reputation were the primary contributing factors in choosing an MLPATP. Following graduation, 93.5% plan to seek employment using their certified athletic trainer credential. Conclusions Understanding the characteristics of MLPATP students can help in the recruitment of students for MLPATPs as well as develop a greater understanding of the needs of these students. Additional lines of research would contribute to discussions regarding the future of athletic training education.

National Athletic Trainers' Association Position Statement: Lightning Safety for Athletics and Recreation

Objective: To present recommendations for the education, prevention, and management of lightning injuries for those involved in athletics or recreation. Background: Lightning is the most common severe-storm activity encountered annually in the United States. The majority of lightning injuries can be prevented through an aggressive educational campaign, vacating outdoor activities before the lightning threat, and an understanding of the attributes of a safe place from the hazard. Recommendations: This position statement is focused on supplying information specific to lightning safety and prevention and treatment of lightning injury and providing lightning-safety recommendations for the certified athletic trainer and those who are involved in athletics and recreation.

Characterizations of a Quality Certified Athletic Trainer

Context: Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits. Objective: To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT). Design: Delphi study. Setting: Interviews in conference rooms or business offices and by telephone. Patients or Other Participants: Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers' Association (2, 3, 4, 9). Data Collection and Analysis: Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives. Results: We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits). Conclusions: According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting.