The Globalization of Athletic Training and Athletic Therapy Education: Editor-in-Chief Welcome

INTRODUCTION

As the Editor-in-Chief of the Athletic Training Education Journal, I am very proud and excited to introduce to our readership our 2019 special issue on the globalization of athletic training and athletic therapy education. This special issue has been in development for 18 months to foster a dialogue among athletic training and athletic therapy educators across the globe. When the journal began 15 years ago, opportunities to exchange athletic training and athletic therapy education ideas across international borders were almost nonexistent. Even before this issue, only a handful of articles had been published in the Athletic Training Education Journal related to the concept of globalization of athletic training and athletic therapy education.^1–3

Fast-forward 15 years and we now have a mutual recognition arrangement between the Board of Certification (BOC) and the Athletic Rehabilitation Therapy Ireland (ARTI) that allows BOC–certified athletic trainers and ARTI–certified athletic therapists to challenge each other's certification exams. This arrangement also allows certified clinicians access to professional requirements for employment in both countries. The mutual recognition arrangement among the BOC and ARTI also recognizes each other's education and certification standards.^4,5 This mutual recognition arrangements suggest that the educational processes of each organization share mutual knowledge, skills, and attitudes and are something that should be embraced by educators around the globe.

In August 2019 the Commission on Accreditation of Athletic Training Education (CAATE) accredited the first professional graduate athletic training program outside the United States.⁴ During CAATE's August 13, 2019, meeting, the board voted to grant the master's in athletic training and therapy to the Universidad Camilo José Cela, in Madrid, Spain.⁴ According to the CAATE, athletic training programs housed outside of the United States must demonstrate compliance with all CAATE standards in the same manner as US-sponsored programs.⁴ The CAATE notes that 9 of the standards for program housed outside of the United States can be achieved through “substantial equivalence.” These standards relate to the sponsoring institution, the name of the degree awarded, the type of personnel teaching within the program, and specific training pertaining to the protection of health and student data.

NATIONAL ATHLETIC TRAINERS' ASSOCIATION'S INTERNATIONAL COMMITTEE

The establishment of the National Athletic Trainers' Association's (NATA's) International Committee has assisted in the development of athletic training and athletic therapy in many regions of the world, including countries in Europe, Asia, and the Pacific.⁶ The NATA's international speaker program provides funding support to athletic training scientists, clinicians, and educators wishing to present their research or intellectual content at conferences or symposia outside of the United States. The NATA's International Committee also provides a wealth of information for international academic programming. Whether a student group, educators, or clinicians are interested in studying abroad to expand international opportunities, it can be hard to know where to start. The NATA International Committee has compiled helpful tool kits to start a global experience, including an academic program development tool kit, a study abroad tool kit, and tips for avoiding culture-shocking experiences.

International opportunities are not limited to the dissemination of research or intellectual content at conferences, symposia, or study abroad. Athletic trainers and therapists can also participate in international service and learning ventures open to students and athletic trainers outside of those university settings. International service learning offers students and clinicians practical experiences, interactions, and cross-cultural dialogues, often using a multidisciplinary approach, in many developing communities. Experiences may include options to perform health services in the field to patients (following appropriate laws), building a fence, or offering training and education. Several international volunteer or service-learning programs can be found in the Table.

Table International Volunteer or Service Learning Programs^a

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EFFECT OF INTERNATIONAL VOLUNTEER OR SERVICE-LEARNING PROGRAMS OR STUDY ABROAD

The effect of international volunteer or service-learning programs or study abroad on students, faculty, and clinicians is often impactful for all involved parties. This is especially true for those traveling to the country in question, where the student experience impacts and improves one's cultural competency and awareness,^6,12,13 as well as collaboration, communication, clinical skills, knowledge, adaptability, compassion, confidence, and personal growth.^13–15 Furthermore, Kokko¹² suggests that service-learning experience would theoretically be able to offer employers a resource through preparedness for culturally competent nursing, making them more marketable.

Abe-Hiraishi et al² remind us in their 2018 paper, “Increasing Cultural Competence: Implementation of Study Away/Abroad in an Athletic Training Program,” that cultural competence is a component of professional preparation programs, but is often challenging to implement. Moreover, although study abroad experience may help to address the educational requirement, traditional athletic training programs use a cohort model into which it is often difficult to integrate a study away/abroad program or international experiences. In their commentary, Abe-Hiraishi et al² offer strategies for embedding an international study component into the curriculum, assuming that cultural competence, diversity, and international experiences constitute a programmatic goal. As professional athletic training programs begin to shift to the master's level, given the benefits of study away/abroad, faculty should consider integrating international experiences into the athletic training curriculum and offer both didactic and clinical experiences internationally.

PERSONAL PERSPECTIVE

My own personal and professional experiences have allowed me the opportunity to oversee 3 interprofessional study abroad opportunities to Guangzhou, China; one athletic training–specific study abroad to Puerto Rico; and speaking engagements with the Japanese Athletic Trainers' Organization and the World Federation of Athletic Training and Athletic Therapy. Each of the experiences offered insight into how athletic training and athletic trainers are perceived, used, and engaged. The interprofessional study abroad opportunities to Guangzhou, China, offered the athletic training students not only an understanding of health care in China, but an opportunity to engage nursing students, occupational therapy graduate students, and exercise science students from their college. During our first trip to China in 2013, we worked with the host institution to see “athletic training.” We soon learned that in 2013, “athletic training” was interpreted differently. We ended up seeing different types of physical education courses at the university. Of interest to the students (which became a talking point during our nightly debriefing) was the fact that male and female students were primarily taught separately. And, although we did not see “athletic training,” the students did participate in the physical education course and learned about the Dragon Dance.

The Puerto Rico athletic training–specific study abroad trip combined athletic training and service learning. Time was spent learning about athletic training in general, the difference in educational preparation between an athletic trainer educated in Puerto Rico and one educated in the United States, athletic health care coverage for the winter league baseball teams sponsored in Puerto Rico, and finally strength and conditioning. For this trip, we offered credit for our required athletic therapy course. The 14 students from 2 cohorts completed didactic coursework before the trip. Once on the trip, time was blocked for students to complete their oral presentations and demonstrate aquatic skills on the beach. Admittingly, we never completed the water component of the course because of high water swells, a very rocky beach (which we never asked about), and the fact that the students were so tired at night, they just wanted to relax. However, the most impactful component of the trip was time spent helping prepare a Christian mission camp for the next season. One of the projects involved repairing and painting a gazebo. When we finished, the gazebo was a multicolored piece of artwork that all the students had personalized with something that represented who they were, where they came from, and what the experience meant to them—very powerful!

GLOBALIZATION OF ATHLETIC TRAINING AND ATHLETIC THERAPY EDUCATION

It is these opportunities, experiences, and possibilities the journal wanted to bring to our readership. The world, which at one time was thought to be unnavigable, is getting smaller and smaller, while athletic training is expanding across multiple continents. Therefore, as a journal we sought to solicit works that introduced the concepts of globalization of athletic training and therapy education and its effects on the preparation of athletic trainers and athletic therapists worldwide. We strove to value and demonstrate the effectiveness of study-abroad programs within athletic training and therapy professional education programs. We tried to demonstrate pedagogical strategies used globally to preparation to prepare athletic trainer and athletic therapist to be better clinicians as well as more culturally competent.

Please enjoy and let us keep striving to globalize the preparation of athletic training and athletic therapy students.