Interprofessional education and collaborative practice (IPECP) is a priority in health care. Collaborative care that includes clinicians across disciplines has been shown across health care to ensure quality patient outcomes. In athletic training, a team approach to clinical practice has been promoted for nearly a decade and continues to gain attention. Interprofessional education (IPE) is a core curricular content standard that requires programs to teach students to practice in collaboration with other health care professionals. Interprofessional education and collaborative practice necessitates students have opportunities to practice before being expected to demonstrate skills clinically. To effectively demonstrate IPECP, athletic trainers need exposure to and training in IPECP core competencies during education. Simulation-enhanced IPE (Sim-IPE) is one strategy to integrate these experiences. Between classroom learning and clinical practice, simulation provides an opportunity for students to apply knowledge in a realistic but low-stakes clinical environment. This article will detail strategies to identify and develop Sim-IPE experiences that support achieving educational standards and prepare students for effective IPECP. Healthcare Simulation Standards of Best Practice™ and the Association of Standardized Patient Educators best practices were established to guide the design of quality Sim-IPE. This manuscript will provide a roadmap for these best practices, including conducting a needs assessment, coordinating event logistics, designing prebrief sessions, and selecting debrief models. Students can gain valuable experience during Sim-IPE. Participation in Sim-IPE improves student understanding of the roles and responsibilities, communication techniques, and teamwork. These factors combine to achieve improved patient outcomes. Athletic training programs implementing Sim-IPE should use simulation best practices to provide quality IPECP opportunities.Context
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Athletic trainers (ATs) collaborate with other professionals to improve the health and well-being of their patients. To prepare ATs to care for individuals, communities, and populations, it is important for athletic training students to experience interprofessional (IP) education, social determinants of health (SDOH), and varying health conditions, in a variety of practice settings. To describe an educational technique that provides athletic training students with an IP experience at a student-led clinic. Athletic trainers care for clients/patients who have limited resources for health care and personal needs. To care for these individuals, ATs must have collaborative practices that engage them with parents/guardians, school-based social workers, and nurses through a variety of settings, including free/low-cost clinics and social services. A purposeful educational strategy that provides direct clinical experiences using IP education and IP practice to address SDOH in multiple settings is important in preparing future health care providers. Student-led IP clinics provide community-based teaching and learning to prepare students for clinical practice. First-year graduate-level athletic training students enrolled in clinical courses participated in this educational technique. A clinical experience provided students the unique opportunity to learn and apply IP practice with students and faculty in multiple academic programs (undergraduate and graduate nursing, undergraduate public health, undergraduate and graduate social work) while caring for underserved individuals and communities in the rural Midwest region. This educational strategy positively impacts the community, students, faculty, academic programs, and the university. Participation in community-based IP student-led clinics prepares athletic training students to care for a variety of individuals, populations, and health conditions through a collaborative approach. This approach also addresses gaps in health care delivery, particularly among underserved groups with varying SDOH, while introducing students to practice settings they may not have considered previously. Incorporating the athletic training student into an IP student-led clinic provides unique learning opportunities for students to care for underserved individuals, populations, and communities, preparing them to provide whole-person care as clinicians.Context
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Although interprofessional education (IPE) is not a new concept in health profession programs, the integration of this collaborative approach into athletic training education is still relatively new. Interprofessional education learning experiences can be embedded in a current course, presented in a stand-alone course, or integrated into service learning, simulation, or clinical education. Regardless of implementation strategy, IPE learning experiences should be adapted to each institution in response to program needs and resources available. To describe the development of an IP course that includes 10 health profession programs. Although athletic training programs are required to implement IP collaborative practices, some institutions may experience challenges in developing strategies to meet this goal. Opportunities to engage in IPE initiatives may be present within your own college, institution, and community. We will describe the implementation of an IP course that included 10 health profession programs. The paper will outline the course design, course delivery, outcomes/data, and lessons learned along the way to support the continued advancement of IPE in athletic training programs. This course, through revisions, also included foundational understanding for concepts of cultural humility and the competence continuum along with strategies for respectful and effective team building in a diverse and IP environment. Through this course, athletic training students are able to interact and collaborate with students from varied health profession programs, which leads to an increased level of rapport among students as well as discussions and integration of diversity, equity, and inclusion. The course also provides athletic training students with opportunities to educate future health professionals about athletic training. When contemplating implementing an IPE course, administrators should consider other health programming and students in their respective colleges, campuses, and communities. Other considerations for successful course development include administrative support and buy-in.Context
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Due to the complexity of concussion evaluation and management and the growing demand for interprofessional collaborative practice in health care, the need for interprofessional education (IPE) among professional health care programs has become increasingly important. This IPE technique provides athletic training and nursing students with an opportunity to apply knowledge of professional roles and uses collective clinical reasoning to navigate a multifaceted case scenario with a patient who sustained a concussion. With the emphasis of IPE in professional health care programs, both athletic training and nursing programs accrediting bodies have adopted standards that require the implementation of IPE within the curriculum. This IPE event uses a modular and scaffolding teaching approach to gradually introduce new developments into the patient case in a sequential manner to increase fidelity. By using this approach, students will have the opportunity to meet the objectives for each module before moving on to the next. Additionally, students will develop professional relationships over time within the collaboration of professional groups. Use of this IPE technique affords athletic training and nursing students the opportunity to develop the professional skills required to engage in interprofessional collaborative practice and improve patient outcomes.Context
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Unlearning is a critical component of evidence-based practice, yet research related to its role in athletic training practice is limited. To explore athletic trainers’ (ATs’) perceptions of and experiences with unlearning. Cross-sectional. Online survey with open-ended questions. Seven hundred fifteen of 6925 ATs accessed the survey (access rate = 10.3%) with 640 ATs completing it (completion rate = 94%). We distributed a survey consisting of 8 to 10 demographic questions, 1 Likert-scale item on familiarity with unlearning, and 4 to 5 open-ended questions. Descriptive statistics summarize demographic information. Open-ended data were analyzed using the consensual qualitative research approach. Respondents who self-reported familiarity with unlearning were asked to described its meaning. To ensure data quality, these responses were compared with definitions of unlearning by 2 research team members. If consensus was reached that a participant’s understanding of unlearning aligned with the definitions, the remaining responses from that participant were included in the qualitative data analyses reported in this manuscript. Most respondents were minimally or not at all familiar with unlearning (n = 505/652, 77%). Approximately 46% (n = 181/391; 120 clinicians, 61 educators) accurately described the meaning of unlearning. Analysis of open-ended responses yielded 2 themes: barriers to unlearning and facilitators of unlearning. Reported barriers were intrinsic and extrinsic in nature and involved key stakeholders that frequently interact with ATs. Facilitators of unlearning included continued education, mentorship and team mindset, resources and evidence, and stakeholder education. Respondents were largely unfamiliar with unlearning despite its role in promoting evidence-based practice. Continued education for ATs and relevant stakeholders is needed and may be accomplished through the creation and dissemination of accessible resources that highlight knowledge and skills that should be unlearned. These educational efforts may help to normalize unlearning in athletic training practice to continually improve the delivery of patient care.Context
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In this study, we sought to assess the changes in the knowledge, attitudes, and practices (KAP) of athletic training program (ATP) and nurse practitioner (NP) graduate students before and after an acute care interprofessional education (IPE) workshop. This was a descriptive KAP survey to be taken by participants before and after the IPE event. This survey was administered using a QR code that participants scanned. The study occurred at the University of Central Florida College of Nursing before and after acute care skills were taught and practiced by each program’s students. A total of 35 students from a professional master’s ATP and an adult gerontology acute care NP program were present at the workshop. Thirty-two students took the preworkshop survey, while 30 students completed the postworkshop survey. In this study, we aimed to measure the change in perceptions about the knowledge, skills, teaching, and IPE understanding of each respective program after the educational workshop. Surveys were distributed before the IPE workshop and then again after the workshop concluded. The survey responses were scored on a 5-point Likert scale. Scores for each section were averaged, and statistical analysis was done using repeated measures analyses of variance for total and subsection scores for both programs. A significant increase was found for each group in IPE understanding, knowledge, skills, and teaching scoring (P < .05) with moderate to large effect sizes. Participating in this acute care IPE workshop showed significant increases in perceptions of the KAP among ATP and NP students.Objective
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The U.S. News & World Report college ranking system is used to describe the best graduate programs in the country. Rankings of graduate programs are based solely on perceived ratings of quality by directors and/or deans. Athletic training is not listed by U.S. News & World Report; however, the Commission on Accreditation of Athletic Training Education (CAATE) reports key metrics such as the Board of Certification pass rate and program graduation rate, which could be helpful to create rankings. To evaluate and rank CAATE-accredited professional athletic training (PAT) programs using 2 models: (1) perceived rating of academic quality by program directors (PDs) and (2) CAATE outcome data. Cross-sectional with survey and retrospective data. Web-based survey. One hundred fifty-five PDs and 230 CAATE-accredited PAT programs. The perceived rating survey for the PDs resembled the U.S. News & World Report system using a 5-point Likert scale to assess the academic quality of each program. For the CAATE outcome data, we used publicly available information for each PAT program on the CAATE website. We ranked all PAT programs using the data from each model. A Cohen κ was performed to explore the agreement between the PDs’ perceived ranking and the CAATE outcome data rankings. No agreement was found between the perceived peer assessment and CAATE outcome data rankings (κ = −0.003, P = .401). Perception by PDs did not align with objective data reported by CAATE. The lack of agreement between the 2 ranking systems highlights concerns about using the U.S. News & World Report system for graduate health programs. We suggest exploring a more robust and comprehensive formula including overall pass rate and graduation rate to identify top-ranked programs in athletic training.Context
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Screening for social determinants of health (SDOH) factors is fundamental to addressing barriers to health outcomes and identifying resources needed to provide patient-centered care. However, SDOH can be a difficult area of patient care to navigate without a screening tool. To explore athletic training students’ abilities to screen for SDOH factors via standardized patient (SP) encounters and to describe the experience of screening for SDOH factors. Prospective, mixed-methods cohort study. Simulation laboratory. Fifty-four postbaccalaureate professional athletic training students (women = 43, men = 11; age = 23 ± 1 years). The same SP encounter was completed with 2 cohorts of athletic training students, with 1 intervention cohort (n = 29) screening for the SDOH without an aide and the control cohort (n = 25) screening with the mandatory use of a validated SDOH focused history script. The SP encounters were evaluated using a tool containing an SDOH evaluation by domain and Athletic Training Milestone competencies. Following the SP encounter, each learner completed a postlearning survey. Data were analyzed using descriptive statistics, Mann-Whitney U tests, and thematic qualitative analysis. We identified a significant difference (P ≤ .001) for the overall screening for the SDOH, with the intervention cohort that was required to use the focused history script scoring significantly higher than the control cohort. The intervention cohort scored significantly higher (P ≤ .001) on the Athletic Training Milestones than the control cohort, but the intervention cohort self-rated their performance as lower during the reflection. The use of the focused history script during the SP encounter highlighted the need for a screening tool to be present during the evaluation to facilitate a conversation about the SDOH. When health care students were not required to use the focused history script to screen for the SDOH, most failed to elicit information about the SDOH factors or performed poorly during the screening.Context
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The increased prevalence of mental health conditions and athletic training education’s heightened focus on behavioral and mental health necessitate an examination of teaching techniques for this material. This study explores the impact of virtual pedagogical strategies on athletic training students’ knowledge and confidence with mental health recognition and referral to help educators determine best practices for content delivery. This study examined the effect of Mental Health First Aid (MHFA) training on students’ knowledge and confidence in mental health recognition and referral. The impact of group allocation (standardized patient [SP] encounters, case-based learning [CBL], and control) on these outcomes was also assessed. Randomized controllled trial portion from a sequential, explanatory mixed-methods design. Online learning environment. Convenience sample of 70 students (25 men, 44 women, 1 nonbinary; aged 23.38 ± 2.27 years) from Commission on Accreditation of Athletic Training Education-accredited graduate-level professional athletic training programs. All participants completed MHFA training followed by either no intervention, an SP encounter, or CBL activity. Mental health recognition and referral skills as measured by an electronic knowledge assessment and self-reported confidence scale whose content validity were established by an expert panel. A mixed-model analysis of variance showed significant improvement from pretest to posttest for both knowledge and confidence [knowledge: F(1,67) = 70.31, P < .001; confidence: F(1,67) = 206.41, P < .001]. This relationship was similar among all 3 groups. No significant difference in knowledge or confidence was found between the control, SP, and CBL groups. With the increased need to care for patients’ behavioral and mental health, professional athletic training programs and continuing education should consider incorporating MHFA training to improve content knowledge and confidence in skills. While no numerical difference between the groups was shown by this study, supplementation with simulation through CBL or SP encounters provides an opportunity for application specific to athletic training practice, which may help reinforce concepts and enhance clinical readiness.Context
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The increased prevalence of mental health conditions and the use of telehealth for patient care have exposed gaps in athletic training professional and continuing education. Here, we explore athletic training students’ perceptions of virtual pedagogical strategies for the delivery and application of concepts related to mental health recognition and referral, which may help educators determine best practices. To examine students’ experiences and perceptions of Mental Health First Aid (MHFA) training, case-based learning, and standardized patient encounters. Qualitative portion of a sequential, explanatory mixed-methods design. Individual interviews via video conference. A convenience sample of graduate athletic training students from Commission on Accreditation of Athletic Training Education-accredited professional athletic training programs who participated in the MHFA training and secondary encounters were recruited. Twenty-two participants (11 from each intervention group; 45.5% male, 54.5% female; age = 24.59 ± 2.3) were interviewed. Interviews were recorded using Zoom and then transcribed. The Qualitative Analysis Guide of Leuven method was used to analyze the data to determine emergent themes. Strategies to enhance trustworthiness included an audit trail, member checks, and peer debriefing. Five higher order themes emerged from the interview data, as follows: (1) perceived value of MHFA training, (2) engaged learning and facilitated feedback, (3) capability, (4) comfort and confidence, and (5) authenticity. These themes were organized into the following 3 overarching dimensions: knowledge, skills, and pedagogy. Participants described how the opportunity to apply their knowledge and practice their skills with an athletic training-specific scenario helped them feel more equipped for future patient care. Regardless of simulation strategy, the opportunity to practice influenced participants’ knowledge and feelings of confidence and capability. The MHFA training and simulated encounters were engaging techniques that incorporated feedback and provided elements of authentic patient interaction.Context
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Musculoskeletal (MSK) diagnostic ultrasound (US) is increasingly being utilized by physicians to evaluate athletes in outpatient clinics, on the sidelines, and in athletic training facilities. Having a thorough understanding of MSK US will help athletic trainers (ATs) better assist physicians who perform MSK US. To determine if a longitudinal 6-month MSK anatomy and US course would increase ATs’ ability to acquire, label, and optimize US images of normal structures and improve their overall confidence in assisting with performing US and to determine if demographic factors, work-related factors, or higher self-reported confidence was associated with better performance. Prospective cohort study. Academic institution. Seventeen ATs working with sports medicine physicians at 3 institutions. Longitudinal 6-month MSK anatomy and US course. Ultrasound image scores (normal structures scored on a 5-point scale) were assessed precourse, during the course, and postcourse. Scores were compared across time points for the assessed body regions (knee, ankle/foot, shoulder, elbow/wrist/hand, and hip). Associations with demographic factors, US experience, and AT self-reported confidence were explored. Seventeen ATs completed the course. There was a significant difference among the average overall precourse (average: 1.34/5, range: 0/5 to 4.23/5), during-course (average = 3.53/5; range, 2.6/5 to 4.37/5), and postcourse (average = 3.83/5; range, 2.33/5 to 4.67/5) image scores [χ2(2) = 24.47, P < .001]. There was a significant positive correlation between the numbers of days (rs[17] = 0.62, P = .01) and hours (rs[17] = 0.55, P = .02) per week that the AT spent observing or performing US scanning and the postcourse overall image scores. The ATs’ confidence in identifying structures when they scan and postcourse overall image scores were marginally correlated but not significant (rs[17] = 0.47, P = .06). A comprehensive longitudinal MSK diagnostic US course may have resulted in significant improvements in an AT’s ability to acquire, label, and optimize US images of normal MSK structures that are commonly injured by active persons.Context
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The benefits of service-learning experiences have been reported throughout health care education, yet no recent empirical investigations have been made of the effect of service-learning experiences on athletic training students. Two commentaries, published over 10 years ago, promoted the benefits of and need for service-learning experiences in athletic training education, yet no studies have been published that measure the effect of service-learning in athletic training education. To assess athletic training students’ attitudes and perceptions of community service and civic engagement after participating in a service-learning experience involving underserved populations. Quasiexperimental. Free medical clinic in an urban location in the Midwest. Twenty-eight final year undergraduate athletic training students (18 females, 10 males, 21.3 ± 0.6 years old). Students participated in 4 hours of service-learning experience in the fall and spring semesters, for a total of 8 hours, in a free medical clinic. The Center for Healthy Communities Service-learning Survey (1999, with permission) was administered anonymously online (Qualtrics Inc) before and after the service-learning experience. Statistically significant changes were found in 3 of the 15 items: “I feel well prepared to practice my profession in a community similar to the community in which my placement is located” (U = 242, Z = −2.205, P = .027), “I believe students should volunteer their time helping people without resources” (U = 235.5, Z = −2.244, P = .025), and “I feel that I can have a positive impact on the community in which I work by volunteering my time” (U = 253, Z = −2.054, P = .040). Athletic training programs should consider incorporating service-learning into their curriculum to enhance their students’ preparation to serve diverse patient populations and become civically engaged professionals.Context
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Continuing education (CE) in health care, particularly in athletic training, often fails to meet the needs of its participants. Rapid increases in available information make it necessary for CE to be delivered as efficiently as possible. To explore whether an interactive teaching strategy and various characteristics of athletic trainers affected the perceived knowledge of emergency skills among certified athletic trainers. Quasiexperimental study with a single-group pretest-posttest design. Certified athletic trainers (N = 81) at the Great Lakes Athletic Trainers' Association Annual Meeting and Symposium. Emergency skills practice session for anaphylaxis, opioid overdose, diabetes, and asthma. Participants completed a preintervention perceived knowledge questionnaire (PKQ) that included background information questions and completed a postintervention PKQ. A statistically significant difference (P < .001) in PKQ scores from pretest to posttest was found with pretest scores being lower than posttest scores (89.59 and 103.02, respectively). Age and years of experience had a weak correlation with PKQ pretest scores (rs = .32 and rs = .33, respectively). Participant characteristics including additional certification (P = .012), anaphylaxis experience (P = .036), opioid overdose experience (P < .001), diabetes experience (P = .025), and combined emergency experience (P = .029) had significantly different pretest PKQ scores. The use of an interactive teaching strategy in CE and certain athletic trainer characteristics significantly affected athletic trainers' perceived knowledge of emergency skills.Context
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The Commission on Accreditation of Athletic Training Education (CAATE) implemented new accreditation standards for professional education in 2020, requiring educators and preceptors affiliated with CAATE-accredited professional programs to identify an area of contemporary expertise. Although this requirement is imperative to ensure that educators and preceptors are exposing students to the breadth and depth of content areas in athletic training practice, little is known about how an area of contemporary expertise is developed and maintained. To explore educators’ and preceptors’ experiences with developing and maintaining an area of contemporary expertise. Cross-sectional. Web-based survey. Of 449 athletic trainers (ATs), 347 (183 educators and 164 preceptors) indicated an identified area of contemporary expertise, completed the survey, and were included in the data analysis. A 16-item survey (10 demographic items, 1 Likert-scale item, and 5 open-ended questions) was used. Descriptive statistics were used to characterize participant demographics and familiarity with contemporary expertise. Data analysis of open-ended responses was guided by a 4-phase, consensual qualitative research process using a 3-person team. An external auditor confirmed data representation and accuracy. Familiarity with contemporary expertise and its impact on practice was shared, and participants identified various activities and resources accessible for ATs. However, challenges associated with developing and maintaining expertise and conflicts with current certification expectations were also identified. Program administrators and employers should consider how they can best support the endeavors of educators and preceptors for developing and maintaining areas of contemporary expertise. Program administrators should evaluate programmatic approaches to assist preceptors with maintaining contemporary expertise. Additionally, as educators and preceptors become more familiar with contemporary expertise, the Board of Certification and the CAATE should provide guidance regarding the intent of continuing education, how it relates to contemporary expertise, and how stakeholders can achieve the objectives set forth by regulatory groups.Context
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Many athletic training programs are not meeting accreditation standards involving measures of student success, causing programs to be noncompliant with these standards and showing current and prospective students that their program may not prepare them for a successful career. Studies have shown that psychosocial factors, including psychological needs and measures of student motivation, may be related to student success. To examine the relationships between psychological needs (autonomy, competence, and relatedness), measures of student motivation (controlled and autonomous motivation, self-efficacy, and academic and athletic trainer identity), and measures of student success (persistence, intention to leave, perceived academic performance, and grade point average [GPA]) in athletic training students. Cross-sectional. Entry-level master’s athletic training programs. Ninety-seven current entry-level master’s athletic training students who held a noncertified student National Athletic Trainers’ Association membership in 2020. Responses to surveys were estimated using a path model, in which 4 measures of student success were specified to be predicted by psychological needs directly and indirectly through measures of student motivation. Persistence was positively predicted by autonomy and autonomous motivation. Intention to leave was positively predicted by controlled motivation. Perceived academic performance was positively predicted by competence and autonomous motivation. Finally, GPA was predicted positively by academic identity and negatively by athletic trainer identity. Findings also showed an indirect relationship between competence and GPA through academic identity. Overall, findings showed that autonomy, competence, autonomous motivation, and academic identity were important predictors of student success. Athletic training students should be provided opportunities to practice athletic training skills and knowledge and to make choices regarding patient care in real-life situations and regarding their learning environment. These opportunities for independence may result in greater autonomy, competence, autonomous motivation, and academic identity, and, in turn, greater student success.Context
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Low salary is often cited as one of the primary motivations for professional attrition in athletic training. The employer usually determines the salary range; however, negotiation can also influence the final salary and benefits of a given position. It is unclear to what extent, if any, athletic training educators negotiate salary or other terms of employment during the hiring process. To explore the negotiation practices of athletic training educators during the hiring process. Cross-sectional. Web-based survey. A total of 174 athletic training educators who have held at least one full-time employed position. Demographic factors as well as the current salary range served as independent variables, and participants’ responses to questions about salary and terms of employment negotiation questions were the dependent variables. All variables were characterized using summary statistics, and multiple chi-square analyses (P < .05) were conducted to determine significant relationships between independent variables on negotiation practices. Most athletic training educators attempted to negotiate their salary (64.4%) and terms of employment (54%) during the hiring process. The most commonly negotiated terms of employment were moving expenses (58.5%), research-related start-up costs (45.7%), and continuing education funding/reimbursement (42.6%). The influence of demographic factors on the decision to negotiate salary or terms of employment and the relative success of that negotiation varied, with significant findings for previous employment, gender, race, relationship status, number of dependents, age, salary range, and highest degree earned. Lack of negotiation disproportionately occurred in those athletic training educators with less work experience, and women inexplicably had less success in negotiation attempts. Widespread training in negotiation strategies is warranted across the athletic training profession, including its educators, and our findings suggest that such training would specifically benefit early-career and women athletic training educators.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