Injuries and Referral Patterns During Basic Combat Training: An Examination of Data From the Certified Athletic Trainer-Forward Program

ABSTRACT Introduction Injuries sustained during basic combat training (BCT) result in large economic costs to the U.S. Army. The inclusion of athletic trainers (ATs) in other military branches has reduced Troop Medical Clinic (TMC) referrals. However, the inclusion of ATs during BCT has yet to be studied. The purpose of this study was to describe the frequency and nature of sick call visits during BCT and determine how the presence of an AT affects referrals to the TMC. Materials and Methods A prospective cohort study was conducted at the Fort Jackson Army Training Center for one calendar year. Soldiers in BCT, aged 18–42, who reported to sick call were included. Independent variables collected included: Soldier demographics (sex and age), visit reason, and provider impression. Training battalions were placed in three conditions: control (CON), full-time medic (FTM), and part-time athletic trainer (PAT). The dependent variable was disposition (referred or returned to duty [RTD]). Frequencies and proportions were calculated. Logistic regression compared conditions while considering the other independent variables. Return on investment was calculated. Results Fourteen thousand three hundred and four visits were documented. Most soldiers were female (n = 7,650; 53.5%) and under 20 years old (n = 5,328; 37.2%). Visits were most commonly due to physical injury (n = 7,926; 55.4%), injuries affecting the knee (n = 2,264; 15.8%) and chronic/overuse conditions (n = 2,031; 14.2%). By condition, the FTM and PAT conditions resulted in 1.303 (95%CI: 1.187, 1.430; P < .001) and 1.219 (95%CI: 1.103, 1.348; P < .001), or 30.3% and 21.9% higher, odds of being RTD compared to the CON condition, respectively. Return on investment was $23,363,596 overall and $2,423,306 for musculoskeletal-related cases. Conclusions Injuries were common in BCT, particularly in females. Soldiers in both the PAT and FTM conditions were more likely to be RTD compared to those in the CON condition. Athletic trainers (ATs) are effective at reducing potentially unnecessary referrals, demonstrating their value as healthcare providers in the BCT environment. Understanding variables associated with recruit disposition may aid medics and ATs in the development of triage protocols and further reduction of potentially unnecessary soldier referrals. The Certified Athletic Trainer-Forward Program resulted in significant return on investment, further supporting the inclusion of ATs in BCT.

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A Qualitative Exploration of the Professional Commitment of Athletic Trainers Employed in the Professional Sports Setting

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2016-0078 ◽

2017 ◽

Vol 22 (2) ◽

pp. 40-47 ◽

Cited By ~ 2

Author(s):

Stephanie M. Mazerolle ◽

Chantel Hunter

Keyword(s):

Professional Development ◽

Work Environment ◽

Athletic Trainers ◽

Professional Sport ◽

Professional Commitment ◽

Full Time ◽

Years Of Experience ◽

Interpretative Approach ◽

Certified Athletic Trainer ◽

Time Away

Professional commitment has been studied in multiple settings, yet little is known about the professional sport setting. A total of 27 male athletic trainers, employed full time in the professional sport setting, participated in this study. Our participants were 34 years old (range 30–58), with 21 ± 7 years of experience as a certified athletic trainer, and more than 17 ± 7 years of experience in the professional setting. We conducted online asynchronous interviews. All data were analyzed following an interpretative approach. Data saturation was met, and we used a peer review and researcher triangulation. Barriers to professional commitment included time away from family/home and negative work environment. The facilitators to professional commitment were competition, positive work environment, and off-season professional development. The professional sport setting is unique, much like the collegiate setting, and thus our findings highlight that time away and a negative workplace atmosphere can reduce an athletic trainer’s commitment. Commitment to the profession, however, is enhanced within this setting because of the chance to be around the high level of competition, as well as the chance to have time for professional development.

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Athletic Trainer Services in the Secondary School Setting: The Athletic Training Locations and Services Project

Journal of Athletic Training ◽

10.4085/1062-6050-12-19 ◽

2019 ◽

Vol 54 (11) ◽

pp. 1129-1139 ◽

Cited By ~ 1

Author(s):

Robert A. Huggins ◽

Kelly A. Coleman ◽

Sarah M. Attanasio ◽

G. Larry Cooper ◽

Brad D. Endres ◽

...

Keyword(s):

School District ◽

Secondary School ◽

Secondary Schools ◽

Athletic Training ◽

Athletic Trainers ◽

Athletic Trainer ◽

Full Time ◽

Independent Contractor ◽

Public And Private ◽

National Athletic Trainers Association

Context Previous research from a sample of US secondary schools (n = 10 553) indicated that 67% of schools had access to an athletic trainer (AT; 35% full time [FT], 30% part time [PT], and 2% per diem). However, the population-based statistic in all secondary schools with athletic programs (n = approximately 20 000) is yet to be determined. Objective To determine the level of AT services and employment status in US secondary schools with athletics by National Athletic Trainers' Association district. Design Cross-sectional study. Setting Public and private secondary schools with athletics. Patients or Other Participants Data from all 20 272 US public and private secondary schools were obtained. Main Outcome Measure(s) Data were collected from September 2015 to April 2018 by phone or e-mail communication with school administrators or ATs and by online surveys of secondary school ATs. Employment categories were school district, school district with teaching, medical or university facility, and independent contractor. Data are presented as total number and percentage of ATs. Descriptive statistics were calculated for FT, PT, and no AT services data for public, private, public + private, and employment type by state and by National Athletic Trainers' Association district. Results Of the 20 272 secondary schools, 66% (n = 13 473) had access to AT services, while 34% (n = 6799) had no access. Of those schools with AT services, 53% (n = 7119) received FT services, while 47% (n = 6354) received PT services. Public schools (n = 16 076) received 37%, 32%, and 31%, whereas private schools (n = 4196) received 27%, 28%, and 45%, for FT, PT, and no AT services, respectively. Most of the Athletic Training Locations and Services Survey participants (n = 6754, 57%) were employed by a medical or university facility, followed by a school district, school district with teaching, and independent contractor. Combined, 38% of AT employment was via the school district. Conclusions The percentages of US schools with AT access and FT and PT services were similar to those noted in previous research. One-third of secondary schools had no access to AT services. The majority of AT employment was via medical or university facilities. These data depict the largest and most updated representation of AT services in secondary schools.

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Exploring Summer Medical Care Within the National Collegiate Athletic Association Division I Setting: A Perspective From the Athletic Trainer

Journal of Athletic Training ◽

10.4085/1062-6050-51.3.03 ◽

2016 ◽

Vol 51 (2) ◽

pp. 175-183 ◽

Cited By ~ 3

Author(s):

Stephanie M. Mazerolle ◽

Christianne M. Eason ◽

Ashley Goodman

Keyword(s):

Medical Care ◽

Athletic Training ◽

National Collegiate Athletic Association ◽

Athletic Trainers ◽

Negative Influence ◽

Division I ◽

Athletic Trainer ◽

Full Time ◽

Frequency Distributions ◽

Training Services

Over the last few decades, the National Collegiate Athletics Association (NCAA) has made changes related to the increase in sanctioned team activities during summer athletics. These changes may affect how athletic training services are provided.Context: To investigate the methods by which athletic training departments of NCAA institutions manage expectations regarding athletic training services during the summer.Objective: Mixed-methods qualitative and quantitative study.Design: The NCAA Division I.Setting: Twenty-two athletic trainers (13 men, 9 women) participated. All were employed full time within the NCAA Division I setting. Participants were 35 ± 8 years of age (range, 26−52 years), with 12 ± 7 years (range, 3−29 years) of athletic training experience.Patients or Other Participants: All participants completed a series of questions online that consisted of closed- (demographic and Likert-scale 5-point) and open-ended items that addressed the research questions. Descriptive statistics, frequency distributions, and phenomenologic analyses were completed with the data. Peer review and multiple-analyst triangulation established credibility.Data Collection and Analysis: Summer athletic training services included 3 primary mechanisms: individual medical care, shared medical care, or a combination of the 2. Participants reported working 40 ± 10 hours during the summer. Likert-item analysis showed that participants were moderately satisfied with their summer medical care structure (3.3 ± 1.0) and with the flexibility of summer schedules (3.0 ± 1.2). Yet the qualitative analysis revealed that perceptions of summer medical care were more positive for shared-care participants than for individual- or combination-care participants. The perceived effect on the athletic trainer included increased workload and expectations and a negative influence on work-life balance, particularly in terms of decreased schedule flexibility and opportunities for rejuvenation. For many, the summer season mimicked the hours, workload, and expectations of the nontraditional season.Results: The NCAA rule changes and medical care expectations affected the summer workload of athletic trainers, but job sharing seemed to help them manage conflict associated with providing summer athletic training services.Conclusions:

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High School Athletes' Parents' Perceptions and Knowledge of the Skills and Job Requirements of the Certified Athletic Trainer

Journal of Athletic Training ◽

10.4085/1062-6050-51.1.11 ◽

2015 ◽

Vol 50 (12) ◽

pp. 1286-1291 ◽

Cited By ~ 7

Author(s):

Rachel L. Weitzel ◽

Michael G. Miller ◽

Erin R. Giannotta ◽

Catherine J. Newman

Keyword(s):

High School ◽

Secondary School ◽

Athletic Trainers ◽

Cross Sectional Study ◽

Athletic Trainer ◽

High School Athletes ◽

Cross Sectional ◽

Certified Athletic Trainers ◽

Job Requirements ◽

Certified Athletic Trainer

Context Parents play a crucial role in determining medical services for their children, and it is important they understand the scope of practice and skills of the athletic trainer (AT). Objective To understand parents' perceptions and knowledge of the skills and job requirements of the secondary school AT. Design Cross-sectional study. Setting Sport meetings and banquets at 5 high schools in southwest Michigan during the fall, winter, and spring seasons. Patients or Other Participants A total of 539 parents whose children competed in at least 1 high school sport participated. Data Collection and Analysis A Parents' Perceptions and Knowledge of Certified Athletic Trainers Survey consisting of 32 questions, divided into 3 sections (demographics, perceptions, and knowledge), was developed and given to parents of high school athletes. One-way analyses of variance were used to determine significance among 3 categories of experience and perception and knowledge of ATs. Results Of the 539 parents who responded, 28% responded yes, and 72% responded no to having experience with an AT for their own injuries. When asked if they had experience with an AT due to their child's injuries, 60% responded yes. We found a difference among the 3 categories of experience for perception scores (P = .002) and knowledge scores (P < .001). Conclusions In the absence of past experience with an AT, parents' perceptions and knowledge of the skills and job requirements of the secondary school AT are limited. Athletic trainers should educate parents on their professional roles, which may enhance their ability to provide better health care.

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National Athletic Trainers' Association Position Statement: Management of Acute Skin Trauma

Journal of Athletic Training ◽

10.4085/1062-6050-51.7.01 ◽

2016 ◽

Vol 51 (12) ◽

pp. 1053-1070 ◽

Cited By ~ 3

Author(s):

Joel W. Beam ◽

Bernadette Buckley ◽

William R. Holcomb ◽

Mario Ciocca

Keyword(s):

Health Care ◽

Adverse Reactions ◽

Athletic Trainers ◽

Position Statement ◽

Athletic Trainer ◽

Medical Professionals ◽

Specific Knowledge ◽

Certified Athletic Trainers ◽

National Athletic Trainers Association ◽

Certified Athletic Trainer

Objective: To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients. Background: Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications. Recommendations: These guidelines are intended to provide the certified athletic trainer and others participating in athletic health care with specific knowledge about and recommendations for the management of acute skin trauma.

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Effects of Stress, Coping Style, and Confidence on Basic Combat

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/154193120705101404 ◽

2007 ◽

Vol 51 (14) ◽

pp. 855-859

Author(s):

Training Attrition ◽

Thomas W. Davis ◽

Thurmon E. Lockhart

Keyword(s):

South Carolina ◽

Transition Process ◽

Attrition Rate ◽

Disciplinary Action ◽

Combat Training ◽

Basic Combat Training ◽

Fort Jackson ◽

Relationship Of ◽

The Military ◽

To Receive

Each year the military loses hundreds of millions of dollars invested in enlistees whom never make it to their first duty station. Investigators have reported that the transition process from civilian to military in basic combat training tends to be very stressful and anxiety provoking for enlistees. However, little data have been gathered to assess the relationship of enlistees' stress levels and their attrition rate. A study was conducted of 155 Soldiers during their nine-week basic combat training at Fort Jackson, South Carolina. It was hypothesized that enlistees with higher levels of stress would also have a higher level of depression and hostility resulting in performance degradation. The results showed a statistically significant positive relationship among perceived stress, hostility and depression levels; furthermore, participants who were able to modify their coping mechanism tended to be more confident in successfully completing training and less likely to receive disciplinary action.

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Going Beyond the State Law: Investigating High School Sport-Related Concussion Protocols

Journal of Athletic Training ◽

10.4085/1062-6050-0505.20 ◽

2020 ◽

Author(s):

Erica Beidler ◽

Cailee E. Welch Bacon ◽

Nicholas Hattrup ◽

Cassidy Powers ◽

Lilly Saitz ◽

...

Keyword(s):

High School ◽

High Schools ◽

Sports Medicine ◽

Athletic Trainers ◽

The State ◽

Return To Play ◽

Athletic Trainer ◽

Full Time ◽

State Law ◽

Part Time

Context: State laws provide general guidelines for sport-related concussion (SRC) management, but do not comprehensively address the multiple layers of management for this complex injury. While high schools are encouraged to develop a SRC protocol that includes both state law tenets and additional management practices, the execution of this warrants examination. Objective: To investigate state law compliance and practice components included in high school SRC protocols, and determine whether the degree of sports medicine coverage influenced protocol quality. Design: Qualitative document analysis. Setting: High school athletics. Participants: In total, 184 Pennsylvania high schools [24.3% of schools statewide; full-time athletic trainer=149, part-time athletic trainer=13, missing=21] voluntarily provided copies of their protocol from the 2018–2019 academic year. Main Outcome Measures: Four athletic trainers conducted document analyses using a 67-item component analysis guide. Frequencies were computed for included protocol components related to the state law, preparticipation and prevention, recognition and assessment, and management. The difference in the total number of included components (max 60) by sports medicine coverage was assessed using a Mann-Whitney U test. Results: There was heterogeneity in components included in the submitted protocols. Only 23.4% included all mandatory state law tenets. Immediate removal from play was noted in 67.4% of protocols, while only 1.6% contained prevention strategies. Return-to-play was addressed more frequently than return-to-learn (74.5% versus 32.6%). The sample had a mean of 15.5±9.7 total components per protocol. Schools with full-time sports medicine coverage had significantly more protocol components than those with part-time athletic trainers (15 [8.5–22.5] versus 6 [3–10.5] median components; U = 377.5, p < .001) Conclusions: School-level written SRC protocols were often missing components of the state law and additional best practice recommendations. Full-time sports medicine coverage in high schools is recommended to increase SRC protocol and healthcare quality.

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