International Clinical Immersion Experience: Opportunities and Challenges in Athletic Training Education
International clinical immersion experiences are pivotal in athletic training education, offering students a practice-intensive environment to engage comprehensively in global health care. As the athletic training professions extend across borders, clinical immersions foster cultural competence and adaptability, crucial for delivering high-quality patient care. In this editorial, we guide educators and students in understanding the opportunities, benefits, challenges, and best practices for securing international clinical immersion experiences and study abroad opportunities in athletic training education. We synthesize the role of international clinical immersions in enhancing cultural competency, clinical adaptability, interprofessional collaboration, and broadening clinical perspectives. Key benefits of diverse health care experiences include enhanced cultural competence, clinical skill development in various health settings, and the potential for improved employability. The challenges students may experience entail logistical planning, financial constraints, and concerns surrounding legal and personal safety. Incorporating international clinical immersion experiences for athletic training students fosters strong partnerships that can enhance student learning, strengthen global health competence, and boost the athletic training professions international visibility. Future researchers should focus on examining long-term outcomes and developing policies to optimize these experiences.Context
Objective
Methods
Results
Conclusion(s)
KEY POINTS
International clinical immersions enhance students’ cultural competence and adaptability, equipping them with critical thinking and problem-solving skills vital for diverse health care environments.
Strong institutional backing, including resources for global health, travel scholarships, and faculty mentorship, is crucial for navigating logistical challenges and enriching students’ immersion experiences.
Integrating international clinical immersions into athletic training curricula can boost the National Athletic Trainers’ Association’s brand recognition and growth, reinforcing its leadership in advancing the profession on a global scale.
Taking advantage of the available resources provided through the National Athletic Trainers’ Association International Committee (https://www.nata.org/professional-interests/international).
INTRODUCTION
Clinical immersion plays an important role in athletic training (and athletic therapy) education, offering students a “practice-intensive experience that allows them to engage with the full spectrum of health care provided by athletic trainers.”1 As athletic training progresses into extending across international borders, clinical education experiences become essential for cultivating cultural competence and adaptability with a more expansive understanding for patient care.2 These immersive experiences are especially important in the context of sports medicine, in which practices and cultural norms can vary.2 International clinical immersions and short-term study abroad opportunities allow students to engage with diverse health care systems, offering valuable insights into different approaches to patient care. This exposure not only enhances students’ clinical skills but also broadens their perspectives, fostering a global mindset when providing high-quality, culturally competent health care.2
In this editorial, we aim to provide a supportive guide for health care educators and athletic training students. Our focus is to outline the benefits of international clinical immersions, the challenges that students may encounter, and provide best practices for securing international clinical immersion and study abroad opportunities. By examining these aspects, in this paper, we aim to support the integration of international experiences into athletic training curricula, ultimately contributing to the development of well-rounded, culturally sensitive health care professionals.
International Clinical Immersion Experiences
In today’s rapidly evolving health care landscape, international clinical experiences are becoming increasingly important for athletic trainers. International experiences can play a crucial role in preparing athletic trainers to navigate globalized health care perspectives. With the expanding demands for athletic trainers, international clinical immersions offer an invaluable chance to develop contemporary perspectives in culturally competent care, clinical adaptability, interprofessional collaborations, an opportunity to broaden clinical perspectives while enhancing employment opportunities and gaining a deeper understanding of diverse health care practices.
While international clinical immersions broaden clinical skills, they also help establish an appreciation for the international norms and operational values embedded in health care systems. These experiences are essential to the growth of athletic training. By promoting and offering international opportunities to students, beyond study abroad, athletic trainers not only expand on their understanding but also position themselves to better serve diverse populations with culturally sensitive care. In an interconnected world, immersion in global health care settings is not just an added benefit; it is a necessary step for those who aspire to lead and innovate within the athletic training profession.
Here is a list of possible benefits of fostering international clinical immersive experiences:
(1) Culturally Competent Care.
Exposure to sports medicine in different cultural contexts enhances students’ abilities to provide culturally responsive care. International clinical immersions allow students to learn firsthand the values, norms, and expectations surrounding health care in diverse cultural settings, which is essential for improving patient-provider interactions.3
(2) Clinical Adaptability and Skill Development.
International clinical settings present unique challenges, which may entail limited resources to what one is accustomed to, varying health care protocols that do not align with Western medicine, and cultural differences in patient health care. International clinical experiences also provide opportunities for students to cultivate adaptability. An essential skill for athletic training students is for them to be able to immerse themselves in settings where they must apply innovative problem-solving techniques when faced with unfamiliar or resource-constrained situations. While in an international setting, however, students must do so in an environment in they are not normally accustomed to. Navigating these diverse health care environments can help build confidence in students so they can take on new challenges outside their comfort zones.
(3) International Interprofessional Collaboration.
Exposure to alternative forms of health care during international clinical immersions enhances athletic training students’ understanding of holistic health care. By learning other skills (eg, traditional acupuncture, herbal medicine, and mindfulness), students gain new problem-solving strategies. This integration promotes their clinical education and emphasizes the importance of collaboration across borders and health care paradigms. Students develop a broader perspective on patient care, combining diverse practices to provide a more comprehensive, well-rounded care in varied health care settings.
(4) Broadened Perspectives.
International immersions provide exposure to alternative treatment protocols, contributing to a holistic perspective on patient care and a global perspective of health care. Students learn how health care priorities and strategies vary internationally, enriching their ability to adapt therapeutic interventions to individual patient needs. Additionally, students will gain cultural perspectives that are nonclinical in nature. For example, international opportunities bring about learning cultural habits that surround food, family, transportation, and social engagements.
(5) Enhanced Employability.
International immersions may inspire students to pursue further education or seek out specialization. With this additional education, students may pursue advanced degrees in global health, public health, or health care policy. These opportunities can open additional career paths and enable them to have a broader effect on global health further supporting the athletic training profession. Additionally, employers will see this as a sign that the student is open to working in diverse environments and willing to adapt to new challenges. For athletic training students, having international clinical immersion experience can help them stand out in the job market, distinguishing them from their peers.
Recommendations for Securing an International Clinical Immersion
The following steps help students ensure their international clinical immersion is purposeful and academically rigorous. The 5 recommendations offer students a thorough framework to maximize the benefits of the international experience and grow both personally and professionally.
(1) Establish Clear Learning Goals and Outcomes.
Before embarking on international clinical immersion, students should define specific learning goals that align with both their academic and professional aspirations. This foundational step ensures that the experience will be purposeful and enriching, providing students with a clear direction for their immersion and helping them focus on what they aim to achieve.
(2) Research and Select Appropriate Clinical Immersion Sites.
After setting goals, the next step is to research and choose clinical immersion sites that resonate with the student’s academic interests and professional competencies. This choice is crucial because it determines how effectively immersion will complement or serve as a supplementary opportunity in their educational path. Students must also ensure that the sites adhere to Commission on Accreditation of Athletic Training Education (CAATE) standards, which require a supervising Board of Certification (BOC) certified athletic trainer or a physician. While this requirement might limit the number of available options, students are encouraged to be tenacious in their search, as many BOC-certified athletic trainers work in international schools in regions that may not initially be considered.
(3) Prepare for the Clinical Immersion.
Thorough preparation is essential to ensure immersion is both effective and seamless. This preparation should include cultural training, language study, and familiarization with local health care standards. Understanding the cultural and linguistic aspects of the new environment can make the experience more successful, while knowledge of local health care practices provides context for professional practices abroad. This preparation helps students navigate the new setting with confidence and ease.
(4) Collaborate With Institutions to Ensure Academic Alignment.
It is essential to collaborate closely with the student’s institution before and during immersion to ensure that the experience meets academic credit requirements. This includes making sure that immersion satisfies the necessary academic standards and that clinical hours and learning outcomes are meticulously documented. Proper documentation is key to aligning clinical immersion with academic benchmarks and ensuring the experience is recognized for credit.
(5) Engage in Reflective Activities to Maximize Learning Outcomes.
Reflecting on the clinical immersion experience is a critical step for reinforcing learning and enhancing professional development. Students should engage in activities like journaling, giving presentations, or participating in peer debriefing sessions. These reflective exercises help integrate the insights gained during immersion and allow students to connect their experiences to their future practice, fostering personal growth and a deeper understanding of the international health care environment.
Challenges of Securing and Participating in International Clinical Immersions
International clinical immersions come with a unique set of challenges that require careful planning and preparation. From logistical hurdles to financial concerns, legal complexities, and health and safety considerations, students must navigate a variety of factors to ensure their immersion is both successful and enriching. Additionally, the lack of professional recognition for athletic training in many countries can further complicate the experience. Below are 6 key recommendations to help students overcome these challenges and make the most of their international clinical immersion.
(1) Plan for Logistical Challenges.
International clinical immersions present a host of logistical challenges that require significant planning. Students must manage complex arrangements such as securing visas, arranging housing, and coordinating transportation. Additionally, students need to prepare for potential language barriers that could affect communication in the clinical setting. Given the substantial time and effort required to navigate these tasks, students should begin the planning process well in advance to ensure everything is properly organized before the immersion begins.
(2) Address Financial Considerations.
The costs associated with international clinical immersions can be substantial, including travel, accommodation, food, and program fees. Limited funding and scholarship options may deter students from pursuing these valuable opportunities. However, some institutions offer travel grants, though these funds are often limited. Therefore, students should be resourceful in exploring alternative funding options and carefully plan their budgets to cover the necessary expenses.
(3) Secure Institutional Support and Approval.
Institutional support and approval are crucial for ensuring that international clinical immersion meets specific academic requirements. Many academic programs require clinical immersions to adhere to certain criteria to be eligible for academic credit. Students must work closely with their academic institutions to ensure that international immersion aligns with accreditation standards and institutional policies.
(4) Navigate Legal Concerns.
Different countries have varying health care laws and clinical supervision requirements that students must be aware of before participating in international clinical immersion. Maintaining ethical standards is also a concern, as differing regulations may affect how care is provided and how students interact with patients. Being informed about these legal requirements is essential to ensuring that students’ clinical practice is safe, compliant, and professional in the international setting.
(5) Prioritize Health and Safety.
Health and safety are paramount when participating in international clinical immersions. Students must be prepared for the inherent risks of international travel, which may include exposure to infectious diseases, injuries, and environmental hazards not commonly encountered in the United States. To mitigate these risks, students should take necessary vaccinations, plan for emergencies, and familiarize themselves with local health care resources to ensure access to appropriate medical care when needed. Additionally, students should be aware of the political climate in their destination, including laws, anti-American sentiment, immigration policies, and human rights issues, such as treating patients who identify as LGBTQ+.
(6) Overcome the Lack of Professional Recognition for Athletic Training.
In many countries, athletic training may not be professionally recognized, which can pose a significant challenge for students seeking appropriate supervision and guidance during their clinical immersion. The lack of professional recognition can make it difficult for students to fully integrate into the local health care team. Students may need to spend time educating other health care professionals about the athletic training profession, which can affect their overall experience. Therefore, selecting clinical immersion sites that are open to the care an athletic trainer can provide is crucial to ensure a successful and enriching experience.
Faculty and Institutional Roles in Supporting International Clinical Immersions
Universities can significantly enhance the success of international clinical immersions by providing robust institutional support and resources. Dedicated offices for global or international health, along with travel scholarships and flexible academic credit policies, are essential components that can ease the logistical burdens students face when planning their immersions. Additionally, faculty involvement and mentorship are critical to this process; faculty members guide students through each stage, offering valuable support during predeparture preparation and facilitating postimmersion reflection. This mentorship not only enriches the students’ experiences but also helps them integrate their learning effectively into their academic and professional lives.
Furthermore, the sustainability of these international clinical immersion opportunities is greatly bolstered when institutions formalize them within their curricula. By creating structured pathways for future athletic training students, universities foster continuity in partnerships and ensure that these immersive experiences remain accessible and effective over time. This comprehensive approach, combining institutional support, faculty mentorship, and program sustainability, is key to cultivating meaningful and enriching international immersions that empower students in their academic and professional journeys.
Short-Term Study Abroad Clinical Experiences
Short-term study abroad clinical experience or medical mission trips, often referred to as short-term experiences in global health (STEGH), offer health care students with unique opportunities to gain hands-on clinical experiences while gaining a global clinical education.4,5 When assessing short-term opportunities, these typically range from approximatively 2 to 4 weeks as compared with full semester or yearlong clinical immersions. These shorter durations often focus on specific clinical skills in health care settings that are more suitable for students with limited time or those looking for a focused experience. Short-term also combines academic learning with clinical practice, immersing students in international health care environments. Students are typically placed in health care settings such as physiotherapy clinics, sports medicine clinics, athletic training (clinic) rooms, or with professional and amateur sports teams, where they can apply learned skills to real-world scenarios. Short-term study abroad opportunities not only enhance clinical proficiency in areas such as injury prevention, rehabilitation, and performance enhancement but also allow students to develop cultural competence like that of international clinical immersions in a shorter amount of time.6
Future Directions and Recommendations
Athletic training programs should consider integrating international clinical immersions into their core curricula to broaden access and ensure that students benefit from transformative global experiences. By doing so, programs not only enhance the educational journey for their students but also significantly increase the National Athletic Trainers’ Association’s (NATA’s) brand recognition and growth in the international arena. Further research assessing the long-term outcomes of clinical immersion experiences, particularly regarding their effect on athletic training student skills and cultural competence development, should be conducted. In addition, understanding these outcomes can help in refining clinical immersion programs and demonstrating their value to stakeholders.
Additionally, building a robust network of global clinical partners is essential for facilitating immersion placements for athletic training students. Such a network fosters a sustainable framework for future partnerships, enabling institutions to provide diverse opportunities that enhance students’ learning and professional development. Furthermore, guidance for policy development is crucial in establishing a foundation for standardized international clinical immersion experiences. Policies that address safety, legal, and academic recognition requirements will not only protect students but also lend credibility to these programs, enhancing NATA’s reputation as a leader in advancing athletic training globally. By embracing these strategies, athletic training programs can position themselves—and the NATA—for significant growth and recognition in the international space.
CONCLUSIONS
International clinical immersions present an invaluable opportunity for athletic training students to develop new and innovative skills that may not be provided in the United States. In addition, these experiences also bring about enhanced cultural competence, clinical adaptability, and a global perspective of health care delivery. Despite logistical, financial, and regulatory challenges, the benefits greatly overshadow the drawbacks. These experiences enrich students’ education and professional development. Through careful planning, institutional support, and best practices, athletic training programs can empower students to pursue transformative international experiences, preparing them to excel in a globalized health care landscape.
Contributor Notes