Athletic trainers (ATs) possess moderate levels of cultural knowledge and awareness but a lower capacity to demonstrate culturally competent clinical behaviors. Proven educational strategies for improving culturally responsive care have yet to emerge. Intergroup dialogue is a pedagogical approach that may bridge the knowledge-to-practice gap, promote equity, and enhance culturally competent patient care. To determine the impact of an intergroup dialogue workshop on cultural knowledge and awareness and on clinical behaviors associated with cultural competence. Mixed-methods cross-sectional cohort. In-person workshop and survey with web-based survey follow-up. Sixteen practicing ATs. ATs participated in an intergroup dialogue workshop designed to improve cultural competence. Cultural awareness and sensitivity (CAS) and culturally competent behavioral intentions (CCB) were measured quantitatively using a modified Cultural Competence Assessment. Written survey responses recorded participants' workshop experiences and patterns of culturally competent clinical behaviors. A 2 × 3 analysis of variance with Tukey post hoc (P < .05) calculated differences in the CAS and CCB measurements over time (preworkshop, immediately postworkshop, 6 weeks postworkshop). Written responses were coded to identify common themes, type and frequency of behavior modifications. The CAS scores were greater postworkshop when compared to preworkshop values (P = .010), with no further change 6 weeks postworkshop (P = 1.00). The CCB was significantly higher postworkshop (P < .001), and then returned to baseline values 6 weeks postworkshop. Qualitatively, however, there was evidence of sustained behavioral change 6 weeks postworkshop, with a majority (11, 69%) of participants reporting clinical behavior changes. Our results offer initial support for the efficacy of an intergroup dialogue workshop to promote culturally responsive clinical behaviors among ATs. This method may be used by AT educators, coordinators of clinical education, and practitioners to prepare current and future ATs with knowledge and skills to be culturally competent practitioners.Context
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Interprofessional and collaborative practice (IPCP) is thought to improve comprehensive patient care but is often hindered by a lack of knowledge about the scope of training of other providers, inadequate communication, and structural barriers. The secondary school setting may pose unique challenges to IPCP. To investigate the perceptions and practices of secondary school athletic trainers (SSATs) regarding IPCP. Cross-sectional, Web-based survey. Secondary school athletic trainers (N = 379, age = 35 ± 11 years, experience = 12 ± 10 years). We used a modified version of the Clinician Perspectives of Interprofessional Collaborative Practice Survey, a validated survey consisting of 6 sections representing 6 different constructs (48 items) and 4 open-ended response questions focused on perceived challenges, resources, drawbacks, and benefits relative to IPCP. We calculated descriptive statistics, including a composite mean, to characterize the scores on each construct. We analyzed the open-ended, qualitative data using general inductive coding and used multiple analysts and auditing to establish trustworthiness. We contacted 4666 SSATs to complete the survey. We had 507 (10.9%) SSATs respond, and 379 (74.8%) completed the survey in its entirety. Secondary school athletic trainers agreed with or marked that statements were either always true or sometimes true for all constructs. Three main themes emerged from the open-ended data: (1) communication, (2) infrastructure, and (3) learning. Communication was deemed critical, and having access to shared information improved collaboration. Secondary school athletic trainers were often responsible for initiating communication. A strong infrastructure that enhanced access to other providers, incorporated parents, and improved efficiency helped support IPCP. Interprofessional and collaborative practice resulted in learning between providers, including roles and responsibilities, which yielded stronger trust and respect. Interprofessional and collaborative practice resulted in idea sharing and potentially improved patient outcomes. Although SSATs described regular use of IPCP in practice, barriers exist that diminish IPCP including communication, infrastructure, and learning between professions.Context
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Athletic training students (ATSs) have reported increased levels of stress due to balancing a myriad of responsibilities, both as students and with personal life roles. Coping mechanisms to manage their stress are multifactorial. The COVID-19 pandemic has added additional stressors not yet fully understood. Although some understanding of stress and coping of ATSs exists, little is known about how they coped during the COVID-19 pandemic. Therefore, our purpose was to better understand the coping response to stress for ATSs during the COVID-19 pandemic. Phenomenological qualitative study. Web-based (Zoom) interviews. Fourteen Professional Master of Athletic Training students (9 female, 5 male) from 14 colleges and universities completed semistructured Web-based interviews. On average, the participants were 26 ± 4 years old. All interviews were recorded via the Zoom platform and then transcribed by Otter. Basic member checks to ensure accuracy of the transcription process were completed with all participants before analyzing the data. Peer review was also completed. Three major themes emerged from the data: (1) the importance of flexibility and adaptability, (2) the need for empathy toward others and self, and (3) various stress management strategies. All themes transcended stress reduction, and each had potential implications for their future roles as athletic trainers. Students enrolled in professional master's programs experienced increased stress, not only due to COVID-19 but in general due to the demands of the role of students in health care professional programs. Learning to be effective time and stress managers will be important for professional longevity as other stressful events are likely.Context
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Burnout is a common concern in the field of athletic training that may affect athletic training students. They may experience burnout because of stressors related to their clinical education responsibilities and course load. Various buffers have been suggested to reduce burnout in other health care settings; however, there is a limited body of research examining the effect of locus of control and optimism as buffers against burnout in athletic training populations. To investigate whether a perceived internal locus of control and/or optimism can provide a buffer against burnout in athletic training students. A cross-sectional observational research design via Qualtrics survey. A total of 48 professional master's athletic training students enrolled in Commission on Accrediting Athletic Training Education–accredited programs. Participants were sent a survey link that included demographic questions, the Copenhagen Burnout Inventory, Life Orientation Test–Revised, and the Rotter Internal/External Locus of Control Scale. Three multiple regression analyses were conducted to examine the relationships of personal burnout, work-related burnout, and client-related burnout with optimism and locus of control. A Pearson correlation was conducted on the significant findings to determine the strength of relationship among variables. Copenhagen Burnout Inventory, Life Orientation Test–Revised, Rotter Internal/External Locus of Control Scale. Significant relationships were identified between optimism and personal burnout (t = −3.30, P = .002) and between optimism and work-related burnout. (t = −2.48, P = .02). No significant relationships were identified between locus of control and any of the burnout-related variables (P > .05). Optimism could be an effective buffer against student burnout in professional master's athletic training programs. Athletic training programs should implement various strategies to promote student optimism including proper social support strategies, time management, and stress management to help reduce the onset of burnout in students.Context
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In athletic training education, the first-time Board of Certification (BOC) pass rate is a significant marker of a program's success, and the Commission on Accreditation of Athletic Training Education (CAATE) and requires programs to maintain a first-time 3-year aggregate BOC examination pass rate over 70% (Standard 11). Published research on BOC pass rates on professional master's (PM) programs is limited. Therefore, it is essential to identify modifiable factors that have a relationship with first-time pass rates. The aim of this study aim was to investigate the relationships between programmatic factors and the first-time BOC pass rate for PM athletic training students while controlling for student and institutional factors. This study is necessary to fill the literature gap and identify PM programmatic factors that may be significant in predicting student success in PM athletic training programs. Cross-section study. A multiple regression analysis of program-level data that captured student, programmatic, and institutional factors obtained from the deidentified CAATE data was conducted on 77 PM athletic training programs in the 2018–2019 reporting year. Independent variables included in the study were institutional type, admissions selectivity, cohort diversity, clinical immersion hours per week, students per core faculty member, students per lab faculty member, percent doctoral faculty, and total spending on professional development. The dependent variable was the programmatic 1-year, first-time BOC pass rate. A significant positive relationship was found between admissions selectivity, clinical immersion hours per week, percentage of doctoral faculty, and total amount spent on professional development and 1-year, first-time BOC program pass rates. These results suggest that increased programmatic investments into development of faculty and the evaluation of the clinical immersive experience may help programs increase their first-time BOC pass rate.Context
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Transition to clinical practice is a topic receiving substantial attention. Many reports have focused on the educational program's role and have stopped short of identifying the impact of the initial year of employment on desire to persist and future career goals. To examine the career aspirations of athletic trainers in their first year of employment who graduated from professional master's programs. Qualitative. Nine professional master's athletic training programs, variety of employment settings. Seven men and 7 women (age = 25.6 ± 3.7 years). A general inductive approach was used to analyze data from individual interviews conducted 6 and 12 months into the first year of clinical practice. Multiple-analyst triangulation and peer review ensured credibility. Graduates of professional master's programs in athletic training plan to stay in the profession. However, newly credentialed athletic trainers do not plan to remain with their initial employer beyond 2 years; 11 of 14 participants (79%) stated their first job was transitional. The first year of employment did not change participants' perceptions, as the graduates knew upon taking their first job that it would be temporary. Though participants planned to change jobs, most (79%) planned to continue to engage in clinical practice as athletic trainers. Understanding newly credentialed athletic trainers' perceptions of the impact of the first year of employment can provide educators and employers important insight to assist in retention and persistence of young professionals. Graduates regard their first years of employment as impermanent. However, the majority do not wish to leave clinical practice. Participants viewed their first job as a way to gain valuable experience that did not dissuade them from continuing in the field. Recent graduates demonstrated ambitions to experience different work settings and higher-level positions with greater responsibilities.Context
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As athletic training education transitions to a professional master's degree, understanding the perceptions professional master's athletic training students have of athletic training is important. To examine second-year professional master's students' perceptions of the athletic training profession, a career in the profession, and identify the factors that influence their perceptions. Convergent mixed methods. Online surveys and individual phone interviews. A total of 80 second-year professional master's students (63 female, 13 male, 4 no response, age = 24.63 ± 2.29 years), who were enrolled in the final semester of their program in the spring of 2019, completed the online survey. Ten survey respondents completed the follow-up phone interviews. A survey instrument and a semistructured interview guide were developed to answer the research questions. Both were validated externally by 3 independent researchers using a content-validity indexing tool. The data from the survey and interviews were woven together and merged to provide 1 comprehensive results section. Trustworthiness was established using triangulation, member checks, memos, and peer debriefing. Three higher-order themes emerged from the data: (1) perceptions of the athletic training profession: lack of appreciation and awareness for the profession from others, rewarding profession, and dynamic profession; (2) perceptions of a career in athletic training: low pay, long hours and inconsistent schedules, and inability to have work-life balance; (3) factors influencing perceptions: clinical experiences and interactions with athletic trainers. Second-year professional master's athletic training students developed positive and negative perceptions about the profession and a career in the profession during their professional education experiences. The factors identified were professional socializing agents and should be considered when designing clinical education experiences.Context
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As athletic training education continues to evolve to a professional master's degree, understanding the career intentions of students preparing to graduate from professional master's programs is essential. To examine the career intentions of second-year professional master's athletic training students and identify the factors that influence their intentions. Convergent mixed methods. Online surveys and individual phone interviews. A total of 80 second-year professional master's students (63 women, 13 men, 4 no response, age = 24.63 ± 2.29 years) who were enrolled in the final semester of their program in spring 2019 participated in the online survey. Ten survey respondents participated in follow-up phone interviews. An online survey was designed and administered to answer the research questions. Semistructured phone interviews were conducted as a follow-up to the survey to gain further insight into the research questions. The data from the survey and interviews were woven together and merged to provide a comprehensive display of results. Triangulation, member checks, memos, and peer debriefing were completed for trustworthiness. Two higher-order themes emerged from the data: career progression and factors influencing career intentions. We identified 3 lower-order themes for career progression: short-term career plans, concerns over lack of experience, and long-term career plans. Two lower-order themes were identified for factors influencing career intentions: clinical experience and mentorship. Second-year professional master's athletic training students have short-term and long-term career plans. Their career intentions were influenced by past clinical experiences and the mentorship received from their clinical preceptors and faculty members during their professional education. Unfortunately, many students were having difficulty obtaining positions after graduation due to a lack of professional experience. As a result, some turned to internship or residency positions to gain experience.Context
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It is assumed that after the transition to practice, athletic trainers will have developed stronger decision-making strategies, will have become comfortable within their role, and will be able to reflect on how their employer assisted them through the transition-to-practice process. The goal of this study was to gain an understanding of how athletic trainers have gone through the transition-to-practice process and what resources they relied on during and after the transition. Qualitative study, phenomenological design. Semistructured interviews. Twelve athletic trainers (10 women, 2 men; 4.0 ± 2 years certified) agreed to participate. Data saturation guided the total number of participants for this study. Videoconference interviews were recorded and transcribed verbatim using Zoom. Credibility of the study was maintained using several mechanisms, including expert/peer review, member checks, and researcher triangulation. Two themes emerged as different points in time of the athletic trainer's transition to practice. The first theme was pre–entrance into the workforce, and within this theme, athletic trainers were able to reflect on the strategies and resources that were provided to them by their professional master of athletic training program. Within the second theme, post–entrance into the workforce, athletic trainers were able to recall the resources that were provided to them by their employers and those additional resources that were sought out individually. Athletic trainers recognized how their master of athletic training programs prepared them for the transition-to-practice process based on the didactic coursework and intentional clinical education experiences. Athletic trainers also recognized the resources that were and were not provided to them to assist them in fulfilling their roles and responsibilities, as well as realizing the additional resources they needed to enhance their own clinical practice.Context
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Within the athletic training profession, Doctor of Athletic Training (DAT) programs are expected to develop advanced practice leaders; however, little is known about whether this is achieved. Assess DAT graduates' perceived importance and confidence in performing personal leadership competencies as well as the level of influence a DAT program had on the development of these competencies. Cross-sectional design. A 73-item Web-based survey. Seventy-seven DAT graduates, from a possible 205 graduates responded to the survey. Forty-five respondents completed the survey (21.9%) and were included in this study (age = 31.5 ± 6.1 years; years since graduating from DAT = 1.13 ± 0.90; years of experience = 8.69 ± 5.6; years employed at current job = 3.00 ± 4.04). Each participant completed a questionnaire with 7 demographic items and 66 items to assess perceived importance, confidence, and influence of the DAT on 22 personal leadership competencies. The questionnaire was adapted from the Leadership Development in Athletic Training instrument. Descriptive statistics were used to characterize participant demographics and assess the perceived importance, confidence, and influence of the DAT program on leadership competencies. Partial data were included in the analysis. All competencies were rated as important or higher with critical thinking (mean = 4.84 ± 0.37) rated very important (mode = 5, n = 37/45, 82.2%). Graduates were moderately confident or higher on all competencies with being credible (mean = 4.5 ± 0.55) rated extremely confident (mode = 5, n = 23/45, 51.1%). Graduates indicated that the DAT was extremely influential on their being future minded (mean = 4.63 ± 0.58; mode = 5, n = 29/45, 64.4%). Doctor of Athletic Training graduates' perceptions suggest that programs may be meeting the goal of developing advanced practice leaders. Respondents indicated higher perceptions of confidence in competencies they deemed as important. Respondents also indicated that DAT programs were influential in shaping their perceptions about certain leadership competencies. Other factors may influence graduates' perceptions outside of the DAT, such as previous education and experience.Context
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Clinical reasoning is an inferential process of collecting and evaluating data in patient cases, necessary in all care. Athletic training residency programs are emerging rapidly as the industry standard for developing clinical specialists who possess advanced clinical reasoning needed for complex cases. The purpose of this study was to explore current practices of advanced clinical reasoning development and assessment in athletic training residency programs. Inductive qualitative research. Web-based teleconferencing platform (Zoom Video Communications). Seven of 10 Commission on Accreditation of Athletic Training Education–accredited residency program directors (RPDs) (age = 46 ± 9 years, years as RPD = 5 ± 6). We used qualitative, semistructured interviews. Audio files were transcribed verbatim, checked for accuracy, deidentified, and member checked before analysis. We used a 2-person data analysis team and an inductive coding approach. The researchers reviewed the transcripts independently, met to develop a codebook, applied the codes, and conducted internal auditing. Trustworthiness was established through member checking, multiple-analyst coding, and auditing. Three themes emerged from the RPDs about developing advanced clinical reasoning: (1) defining clinical reasoning, (2) instructional tactics, and (3) assessment tactics. RPDs defined clinical reasoning as the process of the resident justifying their decision-making and the accuracy of their decisions. RPDs described both clinical and didactic instructional tactics, including mentoring, lectures and discussions, case presentations, and journal club. RPDs described assessing advanced clinical reasoning through patient and preceptor feedback in structured and unstructured formats, self-reflection, and knowledge testing to measure clinical reasoning. RPDs highly relied on preceptors and clinical mentoring, but also described a singular reliance on residents to appraise the clinical reasoning capacity of their own preceptors. RPDs define clinical reasoning as rationalization and accuracy of decisions. Although the programs are engaged in effective clinical and didactic approaches to teach advanced clinical reasoning, they rely heavily on the subjectivity of preceptors and residents to assess these outcomes.Context
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Athletic training programs have autonomy to select preceptors based on program objectives. Due to a lack of empirical evidence outlining best practices for graduate programs, program administrators must appraise this themselves. Gaining information on what stakeholders believe is most appropriate when considering clinicians for the role of preceptor may help administrators choose preceptors who are well suited to teach. The purpose of this study was to explore stakeholders (ie, preceptors, program directors, clinical education coordinators) beliefs of the ideal qualities of athletic training preceptors. Hermeneutic phenomenological approach. Individual phone interviews. Nineteen individuals (10 clinical education coordinators, 7 preceptors, 1 program director, 1 dual-role program administrator; 7.74 ± 6.30 years of experience). Data saturation guided the total number of participants. A semistructured interview guide was used to conduct interviews, which were recorded and transcribed verbatim. Data were analyzed by the primary investigator and coded into themes using the interpretative phenomenological analysis approach. Peer reviews and narrative-accuracy member checks established credibility. Participants discussed their desire for preceptors to prioritize their role as educator by being committed to teaching and creating abundant experiences for learners. In addition, participants described ideal preceptors as those who practice with professionalism by setting a good example, meeting administrative expectations, and having autonomous experiences beyond their professional degree. Finally, participants discussed preceptors should have the qualities of leaders by possessing a growth mindset, utilizing best practices as they relate to recent literature and evolving clinical skills, and embracing educational advancement. To promote the best learning environment, preceptors should possess the qualities of an educator, professional, and leader. The findings of this study help inform decisions regarding who may be best suited to serve as preceptor. Future research should investigate what stakeholders believe are ideal components of preceptor development.Context
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Athletic training students have identified clinical education as the most important aspect of their education when transitioning to practice. However, athletic training students have been frustrated with a lack of engagement, mentorship, and diversity within their clinical education experiences. As such, the selection and deselection of clinical sites is critical to creating effective learning experiences. To explore how clinical education coordinators (CECs) select and deselect clinical education experiences (sites and preceptors) for clinical integration and immersion. Consensual qualitative research. Individual teleconference interviews. Thirteen CECs (age = 42 ± 8 years, experience in current role = 8 ± 8 years) from accredited professional master's programs who were in their position for at least 1 year and had at least 1 immersive rotation. All interviews were audio recorded and transcribed. A 3-person data analysis team used a multiphase process to identify the emerging domains and categories. Trustworthiness was established through member checking, multiple researcher triangulation, and auditing. Two themes emerged from the participant responses: accreditation compliance and strategic choices. We found participants expressed the theme of accreditation compliance as a major facilitator when selecting or deselecting clinical education placements. Strategic choices, such as student aspirations and focus on the quantity over the quality, were used by CECs to select clinical education placements which develop student autonomy and provide diverse experiences. However, the CECs engaged in convenient preceptor selection based on geographical location and previous relationships. Our findings suggest CECs leverage convenient clinical education opportunities that comply with accreditation expectations. CECs should be strategically selecting clinical education opportunities that move beyond accreditation minimum standards and focus on high-quality experiential learning, which leads to autonomous practice and embraces the diversity of the profession.Context
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As a part of the Commission on Accreditation of Athletic Training Education (CAATE) 2020 Standards for Accreditation of Professional Athletic Training Programs, all preceptors affiliated with accredited programs must identify an area of contemporary expertise in a routine area of athletic training practice. However, little is known regarding preceptors' perceptions of contemporary expertise. To explore preceptors' perceptions of the characteristics of contemporary expertise. Cross-sectional. Online survey with open-ended questions. A total of 277 preceptors affiliated with 80 CAATE-accredited professional programs accessed the survey; 259 respondents completed at least 1 open-ended question, and 201 completed the survey in its entirety (77.6% completion rate). We used a 16-item survey including demographic (10 items), Likert-scale (1 item), and open-ended (5 items) questions. Descriptive statistics were conducted to characterize respondent demographics and familiarity with contemporary expertise. Guided by consensual qualitative research, a 3-person data analysis team coded responses from the open-ended questions following a structured, 4-phase progression. An external auditor confirmed accuracy and representation of the findings. Approximately 36% of preceptors reported they were not at all familiar with contemporary expertise. Preceptors identified several defining characteristics (eg, knowledge or skills possessed, clinical practice experience, intentional continuing education, evidence-based practice [EBP]) and parameters (eg, CAATE curricular content standards, Board of Certification domains of practice, areas of specific interest) of contemporary expertise. Additionally, 85% of preceptors discussed how identifying areas of contemporary expertise would improve their practice, while the remaining 15% discussed how it would not. Preceptors affiliated with CAATE-accredited professional programs appear to be largely in favor of developing an area of contemporary expertise and believe it will improve their own clinical practice. More education is needed to acquaint preceptors who are not yet familiar with the notion of contemporary expertise.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