Athletic trainers provide care to diverse patients, many of whom exist in a culture different from that of the athletic trainer. As health care providers it is imperative to provide patient-centered care while practicing the empathy needed to perform services best for the patient. To provide a brief historical view of the need for health care provider to demonstrate cultural competence and ethnocultural empathy when caring for patients. Cultural competence—understanding other's beliefs, values, and differences—is one piece to quality health care. Ethnocultural empathy is the ability to not only understand but also to relate to others in these areas. Both must be practiced for complete patient-centered care. By teaching ethnocultural empathy, students will demonstrate an empathetic response to diverse clients, deepening their quality of relationship. There is limited description of ethnocultural empathy in the athletic training literature, but for many clinicians, it is an innate characteristic that can be improved. Athletic training educators should consider ways to incorporate ethnocultural empathy into how cultural competency is being addressed to produce more culturally aware and enriched students. Integrating ethnocultural empathy into an athletic training curriculum provides deeper levels of cultural competence by moving beyond understanding and toward actionable improvement of patient relationships.Context
Objective
Background
Data Synthesis
Results
Recommendation(s)
Conclusion(s)
The 2020 Standards for the Accreditation of Professional Athletic Training Programs from the Commission on Accreditation of Athletic Training Education require programs to include at least one immersive clinical experience (ICE) in their clinical education curricula. Yet, it is unknown whether ICEs provide more opportunities and benefits than nonimmersive clinical experiences (N-ICEs). The purpose of this study was to compare characteristics of patient encounters (PEs) that occurred during ICEs and N-ICEs. Multisite panel design. Twelve professional programs (5 undergraduate, 7 graduate). Three hundred thirty-eight athletic training students logged PEs in the E*Value system. For each PE, students reported clinical experience type (ICE, N-ICE), clinical site type, student role (observed, assisted, performed), diagnoses reported, and procedure(s) performed. Descriptive statistics were used to summarize PE characteristics. Generalized estimating equations were used to compare student role and clinical site type during PEs in ICEs and N-ICEs (P < .05). A total of 10 999 PEs occurred at ICEs and 18 228 PEs occurred at N-ICEs. Sixty-four percent of ICEs and 67.2% of N-ICEs occurred at collegiate settings. Students performed 70.6% of reported PEs during ICEs, and 72% of PEs at N-ICEs. Participants averaged 0.80 ± 0.64 diagnoses and 1.35 ± 1.12 procedures per PE during ICEs, compared with 0.82 ± 0.63 diagnoses and 1.33 ± 1.04 procedures per PE during N-ICEs. No significant differences between ICEs and N-ICEs were found in either student role (P = .50) or clinical site type (P = .71). Programs may intend to use ICEs later in their curricula to demonstrate progressive clinical autonomy; however, we found no statistically significant differences in student role for ICEs versus N-ICEs. The ICEs examined in this study may have been implemented without specific objectives, which may explain the lack of characteristic differences between the clinical experience types.Context
Design
Setting
Patients or Other Participants
Main Outcome Measures
Results
Conclusion(s)
Research suggests that athletic training students lack knowledge and experience providing care to transgender patients. Additionally, research has identified a lack of comfort with sexual health screening in peer health professions. To assess how a curriculum, including a standardized patient (SP) encounter, influenced attitudes and skills in working with sexual health and gender minorities. Prospective observational study. Simulation lab. Twenty cisgender postbaccalaureate professional athletic training students (females = 16, males = 4; age = 23 ± 2 years). The intervention included a focused curriculum on transgender health care and sexual health. In a culminating SP encounter, one group (n = 10) interacted with a cisgender woman and the second group (n = 10) with a transgender woman. The students completed a postintervention survey. Instruments included the Attitudes Towards Transgender Patients tool, which is divided into 3 subscales: clinician education, transgender sport participation, and clinician comfort; and the the Sexual Health Knowledge and Attitudes and Sexual History–Taking instruments, which evaluated the effectiveness of the sexual health curriculum on knowledge, attitudes, and comfort. The investigator and SP actor evaluated the SP encounters. Data were analyzed using descriptive statistics, nonparametric Mann-Whitney U, and 1-way analyses of variance. We identified a significant difference between those completing a transgender SP encounter (mean = 5.30 ± 2.11) and those completing the cisgender SP encounter (mean = 3.50 ± 0.97) on the clinician education subscale (P = .035). There were no differences between groups on the transgender sport participation (P = .70) and clinician comfort (P = .32) subscales. On the SP actor evaluation, we found no significant differences (P = .08). The curriculum and SP encounter influenced knowledge, attitudes, and comfort when working with gender minorities and screening for sexual health.Context
Objective
Design
Setting
Patients or Other Participants
Intervention(s)
Main Outcome Measure(s)
Results
Conclusions
Secondary school athletic trainers (ATs) may not be aware of health care delivery strategies for the social determinants of health (SDOH). Specifically, secondary school ATs have demonstrated the lowest knowledge and practice of the SDOH. The purpose of this study was to determine whether infographics as a continuing professional development method changed patient-centered–care screening considerations and familiarities with the SDOH. Randomized controlled trial. Online survey with infographic intervention. In total, 34 participants in the intervention group and 46 participants in the control group were included for the analysis. The intervention group received a different SDOH infographic weekly for 12 weeks. The control group did not receive any infographics. The survey asked participants to rate their patient-centered–care tasks, screening consideration, and familiarity with the SDOH. A significant change-score improvement was identified for the intervention group relative to providing whole-person health care (P = .024) and recognizing the SDOH (P ≤ .001). No statistical differences were noted for screening and practices between the groups. However, familiarity with screening for 4 SDOH areas improved for the intervention group, including access to primary care (P = .007), poverty (P = .048), environmental conditions (P = .036), and social cohesion (P = .025). The ATs improved their familiarity with screening for some SDOH after engaging in professional development using infographics, but screening practices and considerations did not change over the course of the study.Context
Objective
Design
Setting
Patient or Other Participants
Intervention(s)
Main Outcome Measure(s)
Results
Conclusion
Sexual harassment is a concern in health care professions and on college campuses nationwide. Athletic trainers are health care professionals who work in close conjunction with athletes, coaches, officials, and other stakeholders, predisposing them to potential sexual harassment occurrences. To examine the experiences of sexual harassment of professional master's ATSs during their clinical education experiences. Mixed-method study. Online questionnaire. Eighty-seven athletic training students (68 women, 19 males; age = 23.40 ± 1.85 years; 44 first-year students, 43 second-year students) currently enrolled in Commission on Accreditation of Athletic Training Education (CAATE)–accredited professional master's athletic training programs. We sent an online questionnaire to CAATE-accredited professional master's athletic training program directors, along with a recruitment email encouraging program directors to send the questionnaire to students currently enrolled in the programs they lead. We validated the questionnaire using expert and peer review. We used a general inductive approach to analyze the results and used multi-analyst triangulation and peer review to ensure credibility. Our study revealed that 28.70% of participants reported they felt as though they were subjected to sexual harassment behaviors during clinical education. Themes reported through recipients' accounts of sexual harassment defined a timeline that started when sexual harassment most commonly manifested through inappropriate comments, followed by ATSs having to adjust after incidents instead of the perpetrators, and finally ended with insufficient resolution in which victims felt the situations should have been handled differently. Sexual harassment affects some professional master's ATSs in clinical education settings. Athletic training program administrators should educate students on clearly defined policies and procedures that will lead to resolution when sexual harassment occurs during athletic training clinical education.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
The COVID-19 pandemic affected the delivery of higher education during the 2020 spring semester. Specifically, various components of the anticipatory socialization process for professional master of athletic training students, such as in-person and hands-on learning, were abruptly halted as a result of the COVID-19 pandemic. Develop an understanding of the effects of the COVID-19 pandemic on the educational experiences and mental health of entry-level master of athletic training students. Qualitative phenomenological study Higher education institutions with professional master of athletic training programs Fourteen students (9 female, 5 male; average age = 26 ± 4 years) who were enrolled in a professional master of athletic training program during the 2020 spring semester participated in our study. One-on-one virtual Zoom interviews were conducted using a semistructured interview guide. Interviews were recorded and transcribed after their conclusion, and transcripts were analyzed using a phenomenological approach. Credibility was achieved through peer review, data saturation, and multiple-analyst triangulation. Three themes emerged from the data, showing the effects of the COVID-19 pandemic on clinical education, participant learning environment, and delivery of classroom instruction. Specifically, a loss of clinical experience resulted in decreased clinical confidence, the distance learning environment allowed for increased distractions and decreased motivation and flipped-classroom–style instruction proved to be beneficial for information synthesis and mental health, according to students. Distance learning presented challenges for students, such as communication barriers, decreased motivation, and work-life balance guilt. It also highlighted the potential benefits of providing breaks in education for student wellness and success. These findings should be considered as programs continue to transition to entry-level master's programs that use clinical immersion and distance learning.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
Racial microaggressions can be comments or actions that are often unconsciously or unintentionally directed toward members of marginalized groups. Athletic trainers have been found to be prone to organizational conflict and harassment; however, no studies have investigated whether racial microaggressions occur during athletic training student (ATS) clinical education experiences. To examine the existence of racial microaggressions directed toward ATSs during clinical education, specifically identifying the resources that existed for students who perceived they were encountering racial microaggressions. Qualitative study. Commission on Accreditation of Athletic Training Education–accredited professional master's programs. One hundred fifteen second-year master's students (80 female, 33 male, 1 nonbinary/third gender, 1 wished to not disclose; age = 23.67 ± 3.41 years). We created a questionnaire based on the purpose of the study and the current literature that we validated via peer and expert review before initiation of the study. We used peer review and multiple-analyst triangulation to provide credibility and analyzed the data with a phenomenological qualitative approach. Three main themes emerged: (1) participants experienced forms of microaggression including, but not limited to, microassaults, microinsults, microinvalidations, and stereotypes; (2) participants experienced a lack of action after racial microaggressions; and (3) participants experienced a period of career reconsideration during which they questioned entering the profession because of feeling uncomfortable and discriminated against. To reduce the number of racial microaggressions that students face, athletic training education program administrators and preceptors should be educated on racial microaggressions, validate athletic training student emotions, encourage brave spaces where students can openly communicate about what is transpiring at clinical sites, safely identify aggressors, and remove students from harmful environments.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
Coordinators of Clinical Education (CCEs) play an important role in clinical education, yet they often receive little to no formal training in the role. The experiences of the CCE and preparation for their role is unknown; therefore, the purpose of this study was to explore the professional socialization of CCEs into their roles. A total of 36 CCEs with a minimum of 1-year experience as a CCE (31 women, 5 men; 5.2 ± 4.7 years of experience as CCE) participated in this qualitative study. Data saturation guided the number of participants. Seven focus-group interviews were completed following a semistructured interview guide developed based on previous socialization research. Data were analyzed through consensual qualitative review, with data coded for common themes and subthemes. Trustworthiness was established via peer review and multianalyte triangulation. Two themes emerged: role and socialization. Role is described as responsibilities, collaboration, and challenges. Participants described responsibilities including complete oversight of clinical education, preceptor development, evaluation and assessment of clinical skills, and administrative duties. CCEs described the importance of collaboration, both internally and externally. CCEs faced challenges such as time management, conflict management, and navigating institutional policies. Socialization described preparation, integration into the role, resources, and needs. CCEs described minimal preparation, and most did not feel prepared to take on all aspects of the role. CCEs described role integration, which included meeting with the program director, reviewing the job description and the Commission on Accreditation of Athletic Training Education (CAATE) Standards, and trial and error. During socialization, they described a variety of resources such as conferences and the CAATE Standards to provide guidance. Last, participants identified needs including specific job description, a timeline for tasks, and professional development. Overall, participants felt adequately prepared for some aspects of their roles, but less prepared for others. Additional professional development is necessary to make CCEs more successful.Context
Methods
Results
Conclusions
Residency training in athletic training is an educational priority for specialist development; however, little is known about what motivates athletic trainers (ATs) to pursue this training. To identify the motivating factors that influence ATs to pursue postprofessional athletic training residencies. Qualitative study. Individual telephone interviews. Twelve postprofessional athletic training residency candidates (8 females, 4 males; age = 26 ± 3 years; years of experience as a practicing AT = 4 ± 3 years) participated. Each teleconference interview was transcribed verbatim. All information was retrieved, coded, and categorized under domains, subdomains, and categories. Three members of the research team coded and compared transcripts using multiple-analyst triangulation and peer review to confirm their findings. An external auditor was used to verify the accuracy of the codebook. We identified 4 emergent domains: (1) support to pursue, (2) personal influencers, (3) professional influencers, and (4) future recruitment considerations. Web resources, direct residency contacts, and mentors with knowledge of residencies provided potential residents with information about residency programs. Personal influencers included financial considerations, work/life balance, and increased respect. Professional influencers included practice setting, working in teams, developing a specialization, and self-improvement. Professional influencers also included a subdomain, by which potential residents acknowledged what is gained from postprofessional learning in terms of advanced practice clinical, scholarship, and leadership skill development. Participants suggested residencies should use social media and conference presentations to clarify the central message around the purpose of residencies and specialization. The purpose of this study was to identify the motivating factors that influence ATs to pursue residency training. Participants applied to residencies for several different reasons, but all wanted to advance their practice and improve their ability to perform their job functions through both additional clinical and didactic education.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
The Commission on Accreditation of Athletic Training Education Professional and Residency and Fellowship Standards indicate athletic training students, residents, and fellows must be trained in diversity, equity, inclusion, and social justice (DEI&SJ). Diversity, equity, inclusion, and social justice is a broad, complicated subject. Stereotyping and bias training are 2 topics within DEI&SJ that are important for providing culturally competent health care. To detail a strategy for implementing concepts of DEI&SJ into athletic training education programs. As part of the health care team, athletic trainers are at the forefront of access to the medical system. Athletic trainers need to be prepared to service a growing diverse population. This learning activity enables athletic training educators to creatively engage students in discussion using graphic novels. This article describes the preparation and delivery methods for using graphic novels to teach stereotyping and bias concepts. Integrating graphic novels into a classroom activity allows students the opportunity for open communication with classmates. Interpreting graphic novels may increase patient-centered care by increasing empathy in athletic training students. The inclusion of graphic novels into athletic training education using interpretation and open discussion techniques can expose students to complicated topics related to DEI&SJ.Context
Objective
Background
Description
Clinical Advantage(s)
Conclusion(s)
Diversity, equity, and inclusion training in academic programming has evolved in recent years to address racial minority and lesbian, gay, bisexual, transgender, and queer populations; an additional special population that merits inclusion in this type of programming is the military-affiliated population. Introduce the Campus Green Zone training workshop as an option to incorporate cultural competency for the military-affiliated patient or client population in athletic training programs. Commission on Accreditation of Athletic Training Education standards identify the need for students to engage with clients or patients who participate in nonsport activities such as those in the military. The Campus Green Zone training program focuses on educating individuals about military-affiliated culture. One athletic training program requested a tailored version of the training for graduate students to prepare them for interacting with military-affiliated patients. Staff from the institution's Office of Military Affairs presented the training to 2 classes of athletic training graduate students, working in collaboration with the athletic training program's clinical education coordinator, to develop a version of the Campus Green Zone training that would help students reflect on the potential for interaction with clients representing the military-affiliated communities. By importing a training workshop that is already in use on campus, the instructor saved time researching and deploying cultural sensitivity materials related to the military-affiliated population. By collaborating closely with the staff of the Office of Military Affairs, the training was improved and expanded upon to better serve the needs of the athletic training students. Athletic training instructors may meet the standard of cultural awareness in part by incorporating Campus Green Zone workshops and materials into their curriculum for graduate-level preservice students.Context
Objective
Background
Description
Clinical Advantage(s)
Conclusion(s)
With the rise of athletic trainers (ATs) providing care to more nontraditional sports such as skiing, motor sports, rodeo, and X Games, the potential for dealing with traumatic pelvic injuries has increased from the traditional setting. The prehospital care provided by the AT can greatly reduce the potential complications seen in these patients. Application of a pelvic binder should be integrated into the athletic training education curriculum. To provide the presentation of traumatic pelvic fractures, various types of pelvic binders available in the prehospital setting, and integration and teaching of this skill to professional level athletic training students. Students should be able to recognize and assess traumatic pelvic injuries. Proper treatment of these injuries is presented with a step-by-step process of how to manage these injuries in the prehospital setting. Equipment needs and how to teach this within the athletic training setting are discussed. Integrating the application of the pelvic binder into current athletic training curricula helps provide ATs another tool to use in helping to prevent blood loss, shock, or death in patients with a possible traumatic pelvic fracture. Traumatic pelvic fractures are an important critical injury that must be assessed and addressed promptly to avoid hemorrhage and other sequela.Context
Objective
Description
Clinical Advantage(s)
Conclusion(s)
The Commission on Accreditation of Athletic Training Education has an educational standard to address the need for competence in health literacy. The purpose of this paper is to introduce foundational health literacy knowledge and evidence-based tools to apply in athletic training and present examples of assignments to instruct and assess health literacy from a model professional athletic training program. Health literacy is “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”1 Most patients will experience moments of poor health literacy; therefore, clinicians should use health literacy universal precautions to improve patient decisions and outcomes. These health decisions range from practicing health promotion behaviors, understanding when and how to use health services, and participating in shared decision-making about treatments or procedures. These same health decisions apply to athletic training patient populations. Athletic trainers (ATs) should demonstrate effective health literacy skills; therefore, professional athletic training programs must instruct athletic training students on essential concepts and tools. Examples of how one professional athletic training program instructs and assesses health literacy across the curriculum are discussed; including didactic lessons, rubric criteria development, a comprehensive health literacy project, and learning objectives for simulation-based experiences. Education drives clinical practice. Incorporating health literacy through didactic presentation and assessment of application may develop health literacy competence and prepare athletic training students to provide optimal care when transitioning to practice. Health literacy universal precautions are recommended for all health care professionals to provide quality care. Introducing and assessing these concepts during education will prepare future ATs for successful integration of health literacy into clinical practice. Furthermore, these concepts and tools should be shared with preceptors to reinforce during student clinical experiences.Context
Objective
Background
Description
Clinical Advantage
Conclusion
Many topics related to diversity, equity, and inclusion are receiving attention in the popular media and in literature. However, religious, spiritual, and secular identities and how these relate to culturally competent patient-centered care have received considerably less attention. Encourage athletic training educators to enhance their curriculum related to providing culturally competent patient-centered care by including content on interfaith patient care and offer guidance on foundational concepts and practical strategies. This paper provides a framework for providing education on quality patient care with respect to patients' religious, spiritual, and secular identities: (1) create a foundation of understanding, (2) establish a rationale for content inclusion, and (3) provide practical strategies for teaching and the provision of quality patient-centered care with respect to religious, spiritual, and secular identities. Religious, spiritual, and secular identities are often an important part of a patient's self-concept, and thus need to be considered when providing culturally competent patient-centered care. The Board of Certification Standards of Professional Practice and the Commission on the Accreditation of Athletic Training Education standards for professional athletic training programs both address patient care with specific language related to cultural competence. Although athletic trainers recognize the importance of considering religious, spiritual, and secular identities of patients, many athletic trainers may not feel equipped to address these identities when providing culturally competent patient-centered care. Students should be better prepared to provide a more complete holistic approach to culturally competent patient-centered care. A framework for addressing this content in an athletic training curriculum includes providing foundational concepts and a rationale for the inclusion of this content and then offering practical strategies for considering religious, spiritual, and secular identities in patient-centered care. Athletic training educational programs should include education on religious, spiritual, and secular identities for culturally competent patient-centered care.Context
Objective
Background
Description
Educational Advantage
Conclusion(s)
Immersive clinical education is an integral component of athletic training curricula. The flexibility in the requirements allows programs to be innovative in their curricular design and to meet the needs of their learners. The purpose of this educational technique is to describe the process for empowering students to choose preceptors and clinical sites that meet their needs. Traditionally, program administrators assign students to preceptors and clinical sites based on proximity and availability of clinicians surrounding the institution. However, this may limit the options for students to find preceptors and mentors who are best suited to prepare them for future clinical practice. In our program, we empower students to pursue their immersive clinical education experience with a preceptor and/or clinical site that will meet their personal and professional needs as a learner and future clinician. Preceptors and alumni have noted increased engagement when students are invested in the selection process. Students are encouraged to advocate for their needs personally and professionally, to place themselves in the best environment for their future success. More specifically, historically marginalized students have the opportunity to identify a preceptor with similar demographic characteristics, who may be better suited to mentor them as a future professional, when geographic proximity has been a challenge in the past. Students and program administrators partner to select preceptors who provide opportunities for a successful immersive clinical experience, who align with the student's future career goals, and who provide mentorship. Historically marginalized students in less diverse regions may benefit the most from this model because they can overcome geographic proximity challenges to identifying effective preceptors and mentors.Context
Objective
Background
Description
Advantages
Conclusions
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