Professional master's athletic training students are at high risk for changes in mood state and an increase in burnout levels during an academic semester due to stressors including academic workload, clinical expectations, and/or research projects, among other factors. To determine mood states and burnout levels among professional master's students during the middle and end of an academic semester. Cross-sectional study. Online survey. The sample consisted of first and second year professional master's students (males = 11, females = 30, age = 23.39 ± 1.44 years) who attended Commission on Accreditation of Athletic Training Education accredited athletic training programs. The independent variable was time (midsemester and end of semester). We sent the link to the online survey via e-mail to program directors and asked them to forward it to all students in the professional master's programs they led. The dependent variables were the subsets of burnout (depersonalization [DP], personal accomplishment, and emotional exhaustion [EE]) along with the overall mood state score. We used the modified 22 item Maslach Burnout Inventory and the modified 40 item Profile of Mood States. Burnout scores from the personal accomplishment subscale of the Maslach Burnout Inventory were statistically different between the 2 time points ({\rm{\chi }}_1^2 = 5.765, P = .016) in comparison to DP ({\rm{\chi }}_1^2 = 0.027, P = .869) and EE ({\rm{\chi }}_1^2 = 1.256, P = .262). For Profile of Mood States scores, the composite total mood disturbance score was not statistically different between the 2 time points ({\rm{\chi }}_1^2 = 0.200, P = .655). Our findings indicated that, as a whole, high level stressors were reported from lack of personal accomplishment. Clinically, mood states were reported to not change from midsemester to end of the semester.Context
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As professional athletic training programs transition to the graduate level, administrators will need to prepare preceptors to teach advanced learners. Currently, preceptor development is variable among programs and ideal content has yet to be identified. Exploring the development of preceptors teaching graduate learners can lead to an understanding of effective preceptorships. To explore graduate professional athletic training program administrators' (ie, program directors', clinical education coordinators') experiences preparing and implementing preceptor development. Consensual qualitative research. Individual phone interviews. Eighteen program administrators (11 women, 7 men; 5.92 ± 4.19 years of experience; 17 clinical education coordinators, 1 program director). Participants were recruited and interviewed until data saturation was achieved. Interviews were conducted using a semistructured interview guide, and were recorded and transcribed verbatim. Data were analyzed by a 4-person research team and coded into themes and categories based on a consensus process. Credibility was established by using multiple researchers, an external auditor, and member checks. Participants reported the delivery of preceptor development occurs formally (eg, in person, online) and informally (eg, phone calls, e-mail). The content typically included programmatic policies, expectations of preceptors, clinical teaching methods, and new clinical skills that had been added to the curriculum. Adaptations to content were made depending on several factors, including experience level of preceptors, years precepting with a specific program, and geographical location of the program. The process of determining content involved obtaining feedback from program stakeholders when planning future preceptor development. Complex decision making occurs during planning of preceptor development. Preceptor development is modified based on programmatic needs, stakeholder feedback, and the evolution of professional education. Future research should explore the challenges associated with developing preceptors, and which aspects of preceptor development are effective at facilitating student learning and readiness for clinical practice.Context
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Newly credentialed athletic trainers are expected to be independent practitioners capable of making their own clinical decisions. Transition to practice can be stressful and present challenges for graduates who are not accustomed to practicing independently. Explore the perceptions of professional master's students as they prepare to experience role transition from students to autonomous clinical practitioners. Qualitative study. Nine higher education institutions. Fourteen athletic training students (7 male, 7 female, age = 25.6 ± 3.7 years) participated. Participants completed a semistructured interview over the phone which focused on the perception of preparedness to enter clinical practice. All transcribed interviews were analyzed using a general inductive approach. Multiple-analyst triangulation and peer review were used to ensure trustworthiness. We found themes for facilitators and challenges to transition to autonomous clinical practice. Students felt prepared for independent practice due to (1) mentoring networks they had developed, (2) exposure to the breadth of clinical practice, and (3) autonomy allotted during clinical education. Potential challenges included (1) apprehension with decision making and (2) a lack of confidence. Our findings suggest graduates from professional master's programs, although ready for clinical practice, may require more time and exposure to autonomous practice to build confidence. Professional master's program administrators should work to provide clinical education experiences that expose students to a wide variety of clinical situations (patients, settings, preceptors) with appropriate professional role models while providing decision making autonomy within accreditation standards.Context
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Mentorship has been identified as a primary organizational socialization tactic and has been directly associated with transition to practice. Understand how the mentoring relationship develops for the newly credentialed athletic trainer during the first year of clinical practice. Grounded theory. Athletic training practice settings. Thirteen athletic trainers, who graduated from a professional master's program, certified between February and July of 2016, and obtained employment between July to August of 2016, participated in this study (6 female, 7 male, 26 ± 3 years; work settings included professional sports, college, secondary and middle school, and clinic). Data saturation was met. Semistructured phone interviews were conducted with all participants during 3 specific time points (3, 8, and 12 months posthire). All interviews were transcribed verbatim and coded following the steps of a grounded theory study. Credibility strategies included researcher triangulation and peer review. All 13 participants recognized a mentor, someone who they believed serve in a mentoring capacity during their transition into clinical practice as a newly credentialed athletic trainer. The development of the mentoring relationship for the newly credentialed athletic trainer appeared to be characterized by (1) identification of a mentor who had experience and knowledge, (2) a recognition of the need to have support and continued avenues for growth as a health care professional, (3) an informal initiation of the relationship through a professional relationship by the mentee, and (4) communication that overtime was reduced in frequency. Mentors provide career support and professional growth. Newly credentialed athletic trainers should seek out mentors who can support their continued development. The informal relationship appears to be of the greatest importance during the first few months of practice, and then once comfort and self-confidence improves, the frequency of communication is reduced.Context
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Athletic trainers (ATs) who serve as preceptors for athletic training students must model, facilitate, and guide professional skills and behaviors, including medical documentation. Preceptors have the unique ability to combine skill practice with real-time patient encounters for athletic training students. To describe the frequency of preceptors who allow athletic training students to complete medical documentation and rationale for their decisions. Cross-sectional. Qualitative study. Of 9578 ATs, 1150 responded to an electronic survey (access rate = 12.0%), and 385 of 1150 respondents who completed an electronic survey (33.5%) indicated being a preceptor for a professional athletic training program. Respondents (age = 34 ± 11 years, clinical practice experience = 11 ± 10 years) were predominantly female (53.8%, n = 207) and held a master's degree (67.3%, n = 259). A 3-member data analysis team coded the open-ended responses following the consensual qualitative research approach. Each member coded 50 responses and a consensus codebook was created. The principal investigator coded the remaining responses, and the data analysis team confirmed the findings. Data were organized into emergent domains and categories. Frequency counts were calculated for each category. A majority of preceptors (81.8%, n = 315) allowed their athletic training students to document patient care. Respondents indicated an intention for student involvement (domain 1), whereby they wanted students to engage in learning and develop knowledge (43.4%, n = 167) or practice and gain experience (41.3%, n = 159). However, others discussed deterrents (20.0%, n = 77) working against the preceptor's intentions. Respondents also indicated a need to mentor (domain 2). Specifically, they reported needing to manage the logistics of documentation (63.6%, n = 245) and the degree of oversight (48.8%, n = 188) needed during practice (either direct [79.8%, n = 150 of 188] or indirect [20.2%, n = 38 of 188]). Although preceptors intend to integrate students into medical documentation, they may benefit from formal guidance from the academic program on how to best integrate athletic training students into documenting day-to-day patient care.Context
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A broad range of knowledge, skills, and abilities related to leadership has been suggested as essential for development during the athletic training education process. Though the importance of these characteristics has been established, researchers have not yet evaluated the self-perceived proficiency levels of new-to-practice athletic trainers (ATs). To determine the level of self-perceived proficiency attained on key leadership competencies by new-to-practice ATs and to determine which factors relate to increased levels of self-perceived proficiency. Quantitative survey research. Online questionnaire. One hundred seventy-three ATs within their first 5 years of practice participated in the study. Participants completed a Web-based questionnaire developed by the researchers to determine the self-perceived level of proficiency attained by the new-to-practice AT on 5 key leadership competencies. One open-ended response item allowed participants to suggest educational experience changes that could lead to increased proficiency in the 5 key leadership competencies. Athletic trainers who completed their professional education at the master's level selected higher self-perceived proficiency levels for the competency knowledgeable than those who completed bachelor's degrees to complete their professional athletic training requirements. As years of practice increased, ATs perceived higher levels of proficiency in the competencies of knowledgeable, ethical practice, and credible. Level of self-perceived proficiency ratings for adaptable and resilient were significantly lower than those for other competencies, regardless of demographic variables. Completion of professional education at the master's degree level resulted in increased self-perceived levels of knowledge in new-to-practice ATs. Self-perceived proficiency in the characteristic of adaptability and resilience lags behind other key competencies even as years of practice increase. Instructors could use pedagogical and curricular strategies from other health care professions to increase adaptability and resilience in athletic training students.Context
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Tenure-earning faculty are evaluated in 3 primary areas including teaching, research and scholarship, and service. Struggles regarding earning tenure are not unique to the academe, but within the athletic training discipline concerns do exist. We examined the organizational socialization process for junior athletic training faculty members as they learned about the tenure and promotion expectations at their institutions. Interpretative phenomenological approach. Higher education institutions with an athletic training program. Nineteen junior faculty members (13 women, 6 men) addressed their understanding of tenure guidelines. Our participants were 32 ± 3 years of age, averaged 2 ± 2 years as a full-time faculty member, and were all at the assistant rank. All participants completed one-on-one phone interviews. We followed a stepwise approach to evaluating the data, which is described by the interpretative phenomenological approach. To ensure credibility of the interview protocol and to bracket some of our possible biases, a peer review and pilot study were conducted. There were 3 findings regarding the faculty members' understanding of the tenure process at their institutions: (1) vague expectations, (2) change in leadership, and (3) differing expectations in departments and college levels. The faculty believe improving understanding of promotion and tenure should include (1) formal, ongoing annual feedback, (2) informal communication with administrators, (3) informal institutional mentorship, and (4) instructional scaffolding. Athletic training junior faculty experience challenges with understanding tenure and promotion expectations at their institutions, mainly due to changes in leadership and a dichotomy between departmental and institutional expectations. The vagueness is often overcome when the faculty member receives support and guidance from colleagues and supervisors who not only share past experiences in knowledge but also provide feedback for understanding.Context
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Core competencies (CCs) are now a required component of educational content in all types of Commission on Accreditation of Athletic Training Education-accredited athletic training programs. There is limited evidence demonstrating which procedures included during patient encounters (PEs) occurring in clinical education allow for implementation of CCs. To determine the relationship between procedures performed by athletic training students during PEs on CC implementation. Panel design. Undergraduate, professional athletic training program, National Collegiate Athletic Association Division I institution. We purposefully recruited 1 athletic training program that used E*Value (Medhub) software; 40 participants (31 female, 9 male) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. Participants viewed a 20 minute recorded CC education module followed by educational handouts, which were available online for reference throughout the semester. E*Value was used to track procedures (prevention, evaluation, manual therapy, rehabilitation, treatment, diagnostic, surgical, or other) performed during PEs and an added block of questions indicating which, if any, of the CCs were implemented during the PE. Independent variables included procedures performed during PEs and whether any of the 6 CCs were implemented (yes/no). Binary logistic regression models determined how the type of procedure performed related to the implementation of each CC. Regression models were significant for 5 of the 6 CCs: patient-centered care (PCC; {\rm{\chi }}_7^2 = 62.949, P < .001), interprofessional education and collaborative practice (IPECP; {\rm{\chi }}_6^2 = 41.172, P < .001), health care informatics ({\rm{\chi }}_7^2 = 186.487, P < .001), evidence-based practice (EBP) ({\rm{\chi }}_8^2 = 54.712, P < .001), and quality improvement ({\rm{\chi }}_7^2 = 67.967, P < .001). Participants including evaluation procedures during PE were 3.6 and 1.3 times more likely to implement PCC and IPECP, respectively. Participants including a diagnostic procedure were 4.2 and 2.9 times more likely to implement EBP and IPECP, respectively, and 0.2 times less likely to implement health care informatics. Participants incorporating a manual therapy procedure were 2.6, 1.7, and 2.1 times more likely to implement PCC, EBP, and quality improvement, respectively. Athletic training program administrators should identify clinical sites that allow for PEs and procedural opportunities that align with priorities for greater CC implementation.Context
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Competency-based education (CBE) has been in existence in the landscape of educating health professionals since the 1970s. Despite this, there is significant variability in how CBE is defined in publication, practice, and conversation. This variability has likely contributed to common misconceptions about what it means for an educational system to be competency based, how such a system would operate, and the prevalence of these systems in current practices. To define CBE through a discussion of its evolution in health professions education and discuss considerations for its role in the education of athletic trainers (ATs). The CBE framework has solidified its place in medical education to address the need for health care professionals to provide care that is safe, effective, and responsive to patient beliefs, values, and circumstances. These same necessities exist in athletic training practice. However, CBE does not yet have a solid place in the preparation of ATs, nor does it seem to be well understood by educators in the field. Athletic training educators should be familiar with CBE as an educational framework that is fundamentally flexible and outcome oriented. Flexible practices allow for progression based on learner capability, opportunistic content delivery, and variable timing for assessments. Components of CBE that are outcome centric emphasize preparedness to practice and purposeful location selection for formative assessments. Further, it is important to avoid misusing the phrase CBE as a means to describe any aspect of learning that pertains to competence, competency, or competencies. To hold and maintain a place in the larger context of health care, athletic training educators should have a firm grasp on the concepts and practices of CBE. Future areas of scholarship should identify strategies to incorporate CBE into athletic training education and determine its effect on patient care.Context
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Athletic training programs blend didactic experiences with clinical practice opportunities with varied patient populations. Traditionally, clinical education relies heavily on the preceptor to supervise, instruct, and mentor the professional athletic training student (P-ATS) during clinical education. To describe a preceptor-led educational technique focused on creating meaningful clinical experiences that guide the P-ATS to self-reflect and improve clinical decision-making. Preceptors are expected to create an effective learning environment at their clinical site that prepares the P-ATS for independent clinical practice, yet some authentic patient encounters and administrative tasks may not be possible because of the nature of the clinical site. By implementing novel clinical education techniques that mimic clinical practice, the P-ATS can engage in meaningful clinical experiences in a safe environment, which aids in professional readiness for independent clinical practice that address learner goals and deficiencies in areas with minimal opportunities for real-time encounters. The preceptor designed educational techniques to cultivate meaningful clinical experiences that included incognito standardized patient encounters, structured debriefing, and reflective journaling. A 3-fold benefit exists. First, the P-ATS engages in meaningful clinical experiences to enhance professional readiness for replication of independent clinical practice. Second, the P-ATS develops soft skills, such as metacognitive reflection and quality improvement strategies, after completing the debrief sessions and reflective journaling. Lastly, the preceptor shares contemporary expertise through designing and implementing instructional strategies that mentor the P-ATS through difficult conversations and unique patient presentations. Implementation of novel instructional strategies within clinical education demonstrates the ability for the P-ATS to engage in real-time clinical experiences in a safe environment and under the guidance of the preceptor.Context
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Reliability and Validity of the Functional Assessment of Neurocognition in Sport (FANS): A Paradigm Shift in Post-Concussion Return-to-Sport Decision-Making
Driving After Concussion: Clinical Measures Associated with Post-concussion
The role of shoulder posture in pitching mechanics and injury risk in high school baseball pitchers
Corticospinal Excitability during Standing and Its Association with Postural Control Following Acute Lateral Ankle Sprain.
The socio-economic cost of anterior cruciate ligament injuries and lateral ankle sprains in amateur football and basketball.
JAT eISSN: 1938-162X
JAT ISSN: 1062-6050
ATEJ ISSN: 1947-380X