Promoting Soft Skill Development in Preprofessional Athletic Training Students
Athletic training programs are required to incorporate the development of many foundational skills and behaviors into the curriculum. Athletic training students must develop soft skills such as effective communication, exhibiting empathy, dependability, and integrity, which are all associated with quality athletic trainers. To describe a novel approach to promoting the awareness of values and development of the characteristics and soft skills associated with being a successful student and health care professional for students before they enter their clinical experiences. Graduate and undergraduate programs typically offer an introductory course to students before their first clinical assignment. The main emphasis of introductory courses is often on learning foundational knowledge and technical skills. However, early adoption of professional values and development of soft skills may benefit students as they start their clinical experiences. A course was designed using 11 main themes to guide student learning in values and behaviors important to academics and a career in health care. This article describes how the 11 themes were selected and developed, how the course was delivered, and how various pedagogical strategies were incorporated. Development of soft skills may benefit athletic training students as they enter the professional phase of an athletic training program. As athletic training education shifts to the master's level, fostering soft skills and necessary preclinical skills for students from varied backgrounds is becoming ever more important so students are all equitably prepared for their first clinical experiences.Context
Objective
Background
Description
Clinical Advantage(s)
Conclusion(s)
KEY POINTS
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Soft skill development is an imperative component of the education of future athletic trainers, and overt attention to its development should be addressed in athletic training curriculum.
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Professional socialization and soft skill development can begin prior to students engaging in patient care.
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Methods for the development of soft skills to prepare students for clinical experience are described and should continue to be explored.
Success as an athletic trainer in any professional setting is dependent on several factors, including specific content or task knowledge and skills as well as interpersonal and professional abilities.1 As athletic training educators, we look for ways to introduce students to the professional behaviors we value, develop appropriate soft skills, and encourage students to embrace and pursue the characteristics we associate with success. As students enter their first clinical experience, it is important that they demonstrate professionalism2; thus, it is important for athletic training educators and clinical preceptors to teach students what it means to be professional and to help them develop the associated soft skills. Although both the didactic and clinical portions of athletic training education should include a focus on soft skill development, the primary focus of the current article is the integration of soft skill development in the classroom setting.
Many definitions of the term soft skills exist. The most general definition from Collins English Dictionary depicts soft skills as “desirable qualities for certain forms of employment that do not depend on acquired knowledge: they include common sense, the ability to deal with people, and a positive flexible attitude.”3 Many disciplines such as occupational and physical therapy require graduates to demonstrate proficiency in certain soft skills. The American Physical Therapy Association's4 document outlining the minimum required skills for PT graduates includes several soft skills such as accountability, integrity, compassion/caring, altruism, communication, and cultural competence. In the Accreditation Council for Occupational Therapy Education5 standards, graduates from accredited occupational therapy programs are expected to professionally and effectively interact through written, oral, and nonverbal communication. Similarly, the 2020 Standards for Accreditation of Professional Athletic Training Programs2 include competencies related to professionalism that must be incorporated into each professional athletic training curriculum. Soft skills such as patience, accountability, reliability, honesty, self-control, and a respectful demeanor towards all persons are used in their definition of professionalism.
Graduate and undergraduate programs often have introductory coursework that students complete before entering their first clinical experiences. Traditionally, the focus is on hard skills such as foundational knowledge and technical or psychomotor skills. However, once participating in clinical experiences, students must quickly learn to effectively communicate with and gain the trust of patients, preceptors, and other health care and setting-specific professionals with whom they interact. Given the frequency and duration of interactions among students, patients, preceptors, and other members of the sports medicine team, the acquisition and improvement of soft skills should be a priority. In a recent study, Carr et al6 found that preceptors want to mentor athletic training students who are actively engaged, demonstrate initiative, and have good communication skills. Thus, early development of soft skills may benefit athletic training students as they begin their clinical experiences.
Although some important soft skills may be fully developed only through experience once a person is employed,7 researchers have found some educational strategies can assist the development of soft skills in students in health-related fields.8–10 For example, Lau and Wang8 found that nursing students benefited from participating in experiential learning games designed to allow application of soft skills. Cavanaugh and Konrad9 found that communication and interviewing skills improved in master of social work and doctor of physical therapy students who participated in reflection, simulated role modeling, and context-specific practice. Additionally, Maloney and Griffith10 found that service-learning experiences could improve interpersonal skill development in occupational therapy students. The educational strategies for which these authors advocate include either simulated or real patient interactions with a chance to engage in feedback or reflection after the experiences. However, these strategies are not ideally suited for students who are not yet participating in hands-on experiences and do not yet have the clinical skill sets to engage in simulated patient interactions, which brought the instructors of the described course to the outlined process of course design.
In addition to soft skills development, athletic training educators also seek to acquaint students with the personality traits and professional behaviors we value, such as honesty and integrity, respect, accountability, and exhibiting compassion and empathy.11,12 This is an important component in the process of professional socialization. Merton et al defined socialization as the “process by which people selectively acquire the values and attitudes, the interests, skills and knowledge—in short, the culture—current in the groups of which they are, or seek to become a member.”13(p287) Researchers14,15 have found that athletic training programs use several strategies to promote socialization. These include formal processes such as orientation sessions and introductory courses and informal processes such as social gatherings and mentoring.14,15 Students may benefit from formal strategies that allow clear articulation of program expectations and outline strategies for success14 as well as informal strategies that provide students with a realistic view of the profession and help create a sense of belonging in the community.14,15
The purpose of this article is to introduce a unique approach for developing soft skills and promoting the awareness and development of characteristics associated with being a successful student and health care professional for students before their first athletic training clinical assignment. This article will describe how the course was developed, provide a rationale for the topics that were highlighted, and present a brief synopsis of each main topic presented in the course.
COURSE DEVELOPMENT/OVERVIEW
Qualities and factors of strong athletic trainers identified in the research were used to plan this unique course. Eleven main themes from research studies16,17 and Web articles18,19 and the 5th edition of the Athletic Training Education Competencies12 were identified (see Table). A Web article by Ray18 inspired 3 themes: decisive and confident, listen and lead, and observant and exact. Ray18 noted the importance of staying calm in a crisis, communicating effectively, and paying attention to details. Three themes (dependability and responsibility, prepared and adaptable, and good character and trustworthy) were inspired by the work of Henry et al16 that noted that trustworthiness, honesty, high ethical standards, dependability, adaptability, and communication ability were viewed as essential to the success of athletic trainers at the National Collegiate Athletic Association Division III level. Two themes (knowledgeable and curious and good character and trustworthy) were inspired by the work of Raab et al,17 who determined that quality athletic trainers possessed the following characteristics: demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others. The 5th edition of the education competencies12 contributed to the choices of several of the above themes, most notably listen and lead, which focused on effective communication, and good character and trustworthy. The remaining themes (positive attitude and perseverance, masters of time and energy conscious, growth mindset and action oriented, and givers and takers) were inspired by a blog19 that discussed the qualities that make ordinary people extraordinary. These themes were also chosen as topics based on their close connection to success in academics and their relationship to institutional goals for early student academic integration and retention.20–22
In the course design, there was a clear weekly focus (Table), using each of the described themes. Students understood the aim of the course by seeing each of the qualities described and outlined in the course sequence. Each quality was accompanied by an in-class activity and a guided reflection. Activities included guest speakers, in-class group work, attendance at a local metro area athletic trainers' association quarterly meeting, and other educational opportunities through various offices in the university. The course culminated in interviews with athletic training students in the professional phase of the program and reflective presentations in class.
Throughout the course, the instructors used student-centered, active learning strategies. Class activities were designed to engage students in their own learning process, so as to increase the relevance of the lesson and help them create personal connections to the material.23 Although many active learning strategies were used during the course, the most consistent was the implementation of reflective written assignments after each class meeting. Journaling with targeted prompting and feedback was used to enhance the engagement of students in the soft skills focus for each week. As outlined in previous literature, journaling is personal and can be powerful for learning on an individual basis, which is an important characteristic of the millennial students currently enrolled in athletic training programs.24,25 As soft skills are also exceptionally individualized in application and interpretation, the individual approach of reflective written journals was selected as the best method of application and assessment. Students earned points for assignments that added up to their total grade in the course. Assignments were graded using a rubric that awarded points for answering questions thoughtfully and fully, using good grammar and spelling, and submitting the assignment on time. Students had access to these rubrics at the time the assignments were distributed.
In addition to using active learning strategies, we planned the class to incorporate professional socialization strategies and to foster a community of learners. Student-to-student and instructor-to-student interactions were used to help create a sense of fellowship in the classroom, which the authors wanted to encourage. Several times during the semester, certified athletic trainers from 3 different settings and upper-level athletic training students spoke on their values and how they interact with patients and other health care professionals. Also, students in this course were assigned an upper-level peer mentor. Mentoring from certified athletic trainers and peers has been identified as beneficial to the socialization process of students.14,15 Peer mentors provided a valuable resource for these students who were beginning to learn what their role would be in the program and in the profession. For the goals of the course, the combination of active learning strategies, socialization strategies, and building the classroom community laid the groundwork for students to progress in developing soft skills valuable for academics and a future in athletic training.
SOFT SKILL THEMES
The described course was designed for the students to interact with professionals in athletic training, and each week focused around qualities and behaviors important in the field. The themes were based in soft skills, personal attributes, and habits of successful people derived from the resources highlighted in the previous section. Students were asked to engage in specific activities each week and reflect on them based on the theme focus of that week.
Masters of Time and Energy Conscious
The focus of this class was on time and energy management. Students were given tools to promote time management and learned techniques to combat procrastination. Students also learned about the importance of sleep and nutrition. Students were provided with infographics illustrating the impact of sleep on mood, judgment, memory, and grades, after which they worked in small groups to come up with solutions for how to get adequate sleep.26,27 Lastly, the class discussed how nutrition choices could affect energy levels. Although the focus of this class was mainly on academics, the instructors stressed how quality athletic trainers must possess good time management skills and maintain their energy throughout the day.
Listen and Lead
Athletic trainers must be skillful in both verbal and nonverbal communication skills. Good communication often requires people to be flexible in their method of communication. In order for students to learn how to adapt their communication style, the instructors first sought to help them learn more about their own preferences and talents, and then how they could identify talents in others. This was facilitated by having the students complete the Clifton StrengthsQuest28 program. The strengths perspective has its foundation in positive psychology. It is based on the idea that each individual has specific talents that can be used for empowerment and promotion of success. The Clifton StrengthsFinder online assessment is a tool designed to identify the top 5 talents specific to each student. Each student completed the online assessment at the beginning of the course. The Clifton StrengthsQuest program helps students integrate the identified talents into their self-view as well as develop and apply their talents in the learning process. In this course, the Clifton StrengthsQuest program provided a framework for discussing individual differences, empathy, and communication. Along with learning to see themselves more clearly, they also learned how to see others more clearly through recognition of talents that may be the same or different from their own. Additionally, students learned how misunderstandings and conflict could result from differences in talent. Students then had the opportunity to reflect on the relationships in their lives, and how they could use their signature themes to strengthen those relationships through improved empathy, understanding, and adapting how they communicate.
Knowledgeable and Curious
The focus of this theme was on motivating students to adopt the value of lifelong learning and to appreciate how each skill they learn and each piece of knowledge they master will enable them to better help their patients. Three upper-class athletic training students came to the class and spoke about not just their experiences of applying what they learned in class, but also how they continuously seek out additional knowledge related to patients they encounter or special interests they have. Students were asked to write what it meant to them to be a lifelong learner. There were also asked to determine ways they could extend themselves and improve as they persist in something in which they have continued interest.
Decisive and Confident
This theme built upon the knowledgeable and curious theme, stressing that hard work will result in improved confidence in the students' skills and knowledge, which will help them be decisive when needed and remain calm in challenging situations. In this section students learned strategies on how to use their StrengthQuest talents to be more effective and efficient at learning new material. Strengths-based interventions that promote awareness of talents/strengths and how to use them has been found in the research to promote student success by improving perceived academic control and engagement in college.29 As such, students were asked to choose new study techniques that aligned with their talents and use those techniques for 1 week. Students outlined their plans to experiment with the new techniques and reflected on the effectiveness of the new study techniques they implemented. The instructors intended to guide the students toward decisive and confident change as the students were encouraged to try something new and reflect on it regardless of its success.
Dependability and Responsibility
This section focused on the importance of being reliable, accountable, consistent, diligent, and honest. A certified athletic trainer who works in the high school setting spoke to the students about how he demonstrates dependability and responsibility every day to the people he works with. Students also had an opportunity to learn about the daily life of an athletic trainer working in a high school setting. Students were asked to write a reflection as to how they model dependability and responsibility in their classes. They were also asked for strategies on how they could improve their behavior to be more dependable and responsible. Finally, they were asked to reflect on the lessons they learned from the guest speaker.
Positive Attitude and Perseverance
Studies have shown that happiness and positive emotions can lead to successful outcomes.30,31 In Shawn Achor's21 2010 book The Happiness Advantage, which is based on research in the field of positive psychology, he tells readers that when we are happier, we are more motivated and more likely to work towards our goals. Additionally, when we become more positive, our brain becomes more engaged, creative, motivated, energetic, healthy, resilient, and productive.21 Students in this course watched a TED talk that Achor gave in 2011 that provided an overview of the topic.32 A presentation and discussion followed that highlighted the key elements of Achor's book. Students were also introduced to several strategies to improve overall happiness, including meditation, finding something to look forward to, completing conscious acts of kindness, infusing positivity into their surroundings, exercising, practicing gratitude, and practicing a positive focus. Students created a plan to incorporate a few of the suggested strategies into their week. Once the tasks were completed, students wrote a reflection on their experiences.
Prepared and Adaptable
This section focused on the need to be prepared well ahead of time and the importance of being organized and flexible so that one can adapt to unforeseen circumstances. A certified athletic trainer from a National Collegiate Athletic Association Division I program spoke to the students. He discussed how he prepares for practices and events. He also spoke about mentally rehearsing various emergency scenarios so that he can react appropriately if and when the need arises. Students then reflected on the strategies they use in their life to prepare and why those strategies are successful or unsuccessful. Students shared their thoughts with their classmates in small groups. The assignment for the prepared and adaptable theme included describing a strategy discussed in their group and explaining why they thought that strategy might help them to be more successful.
Growth Mindset and Action Oriented
Dr Carol Dweck22 published Mindset: The New Psychology of Success in 2006. Dweck's research focused on conditions that promote effort, motivation, and persistence. Her research showed that believing that intelligence is changeable directly affects achievement. People with a growth mindset believe that intelligence can grow with focused practice and constructive feedback. These students are more willing to work hard and to risk mistakes because they know it will lead to improvement. Conversely, students with a fixed mindset believe that intelligence is an unchangeable innate trait and therefore are more likely to see difficulty as a personal shortfall.22 Thus, the type of mindset that students adopt has important implications.
Students were introduced to Dweck's work and then watched a video of a talk by Eduardo Briceno33 at TEDx Manhattan Beach titled “The Power of Belief—Mindset and Success.” Students were then asked to reflect on this information and to write about their approaches to specific classes and to outside activities in the context of mindset. Students were also asked to strategize on how they might move towards having more of a growth mindset in an identified area(s) where they tend to have a fixed mindset.
Observant and Exact
There are several skills that are imperative to being a successful student and athletic trainer. Accuracy and attention to detail were highlighted in this theme during the course. A preceptor from a local high school was invited to class to speak about being “in the trenches” and maintaining focus, even through challenges. At the time of this course, the guest speaker had recently implemented a new electronic medical record, which was used as the basis for discussing the importance of accuracy in record keeping.
Good Character and Trustworthy
Prior research in athletic training by Henry et al16 revealed that among athletic trainers surveyed, trustworthiness was the most important personal attribute of a successful athletic trainer, followed by honesty and having high ethical standards. These personal attributes formed the good character and trustworthy theme and were explored through the use of a guest speaker who works in the performing arts setting and serves as a preceptor of the athletic training program. The speaker used many examples of how she displayed her trustworthiness and character in order to build relationships with a diverse group of performers within a professional dance company. Through reflection, we asked the students to apply concepts from the guest speaker's discussion to their lives, interactions with others, and the person they imagined they wanted to become.
Givers and Takers
Current students in the athletic training program were invited to discuss how they collaborate and support each other in order to succeed as a group. According to Chen,19 the key to becoming exceptional in any role is to give more of oneself without expectation of reward, knowing that it will come back. The current athletic training students who spoke in class during this theme discussed how they try to support each other, their preceptors, and their patients, knowing someone else will do the same when they need it as a “taker.” They also discussed the struggles they endured to realize the balance of giving and taking, shedding some light on the process for the students in the described course. Students in the class were encouraged to reflect on when they have given to others and received help from others in the past.
CONCLUSION
The instructors of the designed course set out to construct an opportunity for students to develop soft skills and recognize personal attributes of successful athletic trainers before their clinical immersion in the program. It has been the experience of the instructors that students before entering their clinical experiences have had primarily coursework founded in hard skills. With the transition of professional-level athletic training education to the masters' level, the pressure to prepare students to be successful in all facets early in their clinical practice is increasing considerably. Therefore, the instructors theorized that there might be some benefit if students gained overt exposure to soft skill concepts before entering their clinical experiences.
Athletic training and similar programs all have the task of developing professionals in the field into good stewards of the respective profession. Fields such as physical therapy and occupational therapy also describe a need to grow students with soft skills and personal attributes that will make them better clinicians when they enter the workforce.4,5 Although there are strategies in the literature for developing soft skills in students who already have some clinical skills developed and are in the professional phase of a health care program, the instructors of the current course realized there might be an opportunity to start the soft skills conversation earlier.
The methods used in the 1-credit course were strategically chosen to actively engage students in the many soft skills that contribute to success in athletic training and academics. Student reflections attached to the in-class activities indicated that students understood and made an attempt to internalize the key themes in the course. Although this course was implemented with first-year students, there is an opportunity to use this concept as we ready students for their first clinical experiences at the masters' level as well. This approach could be used to successfully introduce students to valued professional behaviors and to facilitate the development of soft skills either in preprofessional programs or in introductory professional-level coursework. Future research efforts should examine the use of these methods with students considering careers in health care and with entry-level athletic training students starting master's degree programs. Student perceptions in this type of coursework should be examined, as well as educator perceptions of the instruction and assessment of soft skills during athletic training education.
Contributor Notes