scholarly journals Feedback in Clinical Education, Part I: Characteristics of Feedback Provided by Approved Clinical Instructors

2014 ◽  
Vol 49 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Sara Nottingham ◽  
Jolene Henning
Keyword(s):  
Athletic Training ◽  
Clinical Education ◽  
National Collegiate Athletic Association ◽  
Athletic Training Education ◽  
Comparative Approach ◽  
Outpatient Rehabilitation ◽  
Clinical Instructors ◽  
Entry Level ◽  
Extensive Field ◽  
Approved Clinical Instructors

Context Providing students with feedback is an important component of athletic training clinical education; however, little information is known about the feedback that Approved Clinical Instructors (ACIs; now known as preceptors) currently provide to athletic training students (ATSs). Objective To characterize the feedback provided by ACIs to ATSs during clinical education experiences. Design Qualitative study. Setting One National Collegiate Athletic Association Division I athletic training facility and 1 outpatient rehabilitation clinic that were clinical sites for 1 entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants A total of 4 ACIs with various experience levels and 4 second-year ATSs. Data Collection and Analysis Extensive field observations were audio recorded, transcribed, and integrated with field notes for analysis. The constant comparative approach of open, axial, and selective coding was used to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. Results The ACIs gave 88 feedback statements in 45 hours and 10 minutes of observation. Characteristics of feedback categories included purpose, timing, specificity, content, form, and privacy. Conclusions Feedback that ACIs provided included several components that made each feedback exchange unique. The ACIs in our study provided feedback that is supported by the literature, suggesting that ACIs are using current recommendations for providing feedback. Feedback needs to be investigated across multiple athletic training education programs to gain more understanding of certain areas of feedback, including frequency, privacy, and form.

scholarly journals Feedback in Clinical Education, Part II: Approved Clinical Instructor and Student Perceptions of and Influences on Feedback

2014 ◽  
Vol 49 (1) ◽  
pp. 58-67 ◽  
Author(s):  
Sara Nottingham ◽  
Jolene Henning
Keyword(s):  
Student Perceptions ◽  
Athletic Training ◽  
Clinical Education ◽  
Athletic Training Education ◽  
Comparative Approach ◽  
Clinical Instructors ◽  
Entry Level ◽  
Approved Clinical Instructors ◽  
Field Notes ◽  
Current Characteristics

Context: Approved Clinical Instructors (ACIs; now known as preceptors) are expected to provide feedback to athletic training students (ATSs) during clinical education experiences. Researchers in other fields have found that clinical instructors and students often have different perceptions of actual and ideal feedback and that several factors may influence the feedback exchanges between instructors and students. However, understanding of these issues in athletic training education is minimal. Objective: To investigate the current characteristics and perceptions of and the influences on feedback exchanges between ATSs and ACIs. Design: Qualitative study. Setting: One entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants: Four ACIs and 4 second-year ATSs. Data Collection and Analysis: Individual, semistructured interviews were conducted with participants and integrated with field notes and observations for analysis. We used the constant comparative approach to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. Results: Participants described that feedback plays an important role in clinical education and has several purposes related to improving performance. The ACIs and ATSs also discussed several preferred characteristics of feedback. Participants identified 4 main influences on their feedback exchanges, including the ACI, the ATS, personalities, and the learning environment. Conclusions: The ACIs and ATSs had similar perceptions of ideal feedback in addition to the actual feedback that was provided during their clinical education experiences. Most of the preferences for feedback were aligned with recommendations in the literature, suggesting that existing research findings are applicable to athletic training clinical education. Several factors influenced the feedback exchanges between ACIs and ATSs, which clinical education coordinators should consider when selecting clinical sites and training ACIs.

scholarly journals Athletic Training Approved Clinical Instructors' Reports of Real-Time Opportunities for Evaluating Clinical Proficiencies

2009 ◽  
Vol 44 (6) ◽  
pp. 630-638 ◽  
Author(s):  
Kirk J. Armstrong ◽  
Thomas G. Weidner ◽  
Stacy E. Walker
Keyword(s):  
Real Time ◽  
Athletic Training ◽  
Clinical Experience ◽  
Athletic Trainers ◽  
Athletic Training Education ◽  
Demographic Characteristics ◽  
Clinical Instructors ◽  
Content Areas ◽  
Entry Level ◽  
Approved Clinical Instructors

Abstract Context: Appropriate methods for evaluating clinical proficiencies are essential to ensuring entry-level competence in athletic training. Objective: To identify the methods Approved Clinical Instructors (ACIs) use to evaluate student performance of clinical proficiencies. Design: Cross-sectional design. Setting: Public and private institutions in National Athletic Trainers' Association (NATA) District 4. Patients or Other Participants: Approved Clinical Instructors from accredited athletic training education programs in the Great Lakes Athletic Trainers' Association, which is NATA District 4 (N  =  135). Data Collection and Analysis: Participants completed a previously validated survey instrument, Methods of Clinical Proficiency Evaluation in Athletic Training, that consisted of 15 items, including demographic characteristics of the respondents and Likert-scale items (1  =  strongly disagree to 5  =  strongly agree) regarding methods of clinical proficiency evaluation, barriers, educational content areas, and clinical experience settings. We used analyses of variance and 2-tailed, independent-samples t tests to assess differences among ACI demographic characteristics and the methods, barriers, educational content areas, settings, and opportunities for feedback regarding clinical proficiency evaluation. Qualitative analysis of respondents' comments was completed. Results: The ACIs (n  =  106 of 133 respondents, 79.7%) most often used simulations to evaluate clinical proficiencies. Only 59 (55.1%) of the 107 ACIs responding to a follow-up question reported that they feel students engage in a sufficient number of real-time evaluations to prepare them for entry-level practice. An independent-samples t test revealed that no particular clinical experience setting provided more opportunities than another for real-time evaluations (t119 range, −0.909 to 1.796, P ≥ .05). The occurrence of injuries not coinciding with the clinical proficiency evaluation timetable (4.00 ± 0.832) was a barrier to real-time evaluations. Respondents' comments indicated much interest in opportunities and barriers regarding real-time clinical proficiency evaluations. Conclusions: Most clinical proficiencies are evaluated via simulations. The ACIs should maximize real-time situations to evaluate students' clinical proficiencies whenever feasible. Athletic training education program administrators should develop alternative methods of clinical proficiency evaluations.

scholarly journals Questioning Skills Demonstrated by Approved Clinical Instructors During Clinical Field Experiences

2008 ◽  
Vol 43 (3) ◽  
pp. 284-292 ◽  
Author(s):  
Mary G. Barnum
Keyword(s):  
Athletic Training ◽  
Clinical Education ◽  
Education Program ◽  
Athletic Training Education ◽  
Full Time ◽  
Field Observations ◽  
Clinical Instructors ◽  
Stimulated Recall ◽  
Approved Clinical Instructors ◽  
Stimulated Recall Interviews

Abstract Context: The current trend in athletic training clinical education places greater emphasis on the quality of interactions occurring between Approved Clinical Instructors (ACIs) and athletic training students (ATSs). Among other attributes, the ability of ACIs to facilitate and direct quality clinical learning experiences may be influenced by the skill with which the ACI is able to use selected teaching strategies. Objective: To gain insight into ACIs' use of questioning as a specific teaching strategy during the clinical education experiences of undergraduate ATSs. Design: Qualitative case study design involving initial and stimulated-recall interviews, prolonged field observations, and audio recording of ACI-ATS interactions. Setting: The primary athletic training facility at one athletic training education program accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants: The 8 ACI participants included 3 full-time athletic training education program faculty members and 5 graduate-level assistants. The 24 ATS participants included 1 senior, 17 juniors, and 6 sophomores. Data Collection and Analysis: Transcribed data collected from 8 initial interviews, 23 field observations, 23 audio-recorded ACI-ATS interactions and 54 stimulated-recall interviews were analyzed through microscopic, open, and axial coding, as well as coding for process. The cognition level of questions posed by ACIs was analyzed according to Sellappah and colleagues' Question Classification Framework. Results: The ACI participants posed 712 questions during the 23 observation periods. Of the total questions, 70.37% were classified as low-level cognitive questions and 17.00% as high-level cognitive questions. The remaining 12.64% were classified as other. Conclusions: Although all ACIs used questioning during clinical instruction, 2 distinct questioning patterns were identified: strategic questioning and nonstrategic questioning. The way ACIs sequenced questions (their questioning pattern) appeared to be more important than the number of specific cognitive-level questions posed. Nonstrategic questioning appears to support knowledge and comprehension, whereas strategic questioning appears to support critical thinking.

scholarly journals The Acquisition of Instructional Strategies through a Four-Session Athletic Trainer Clinical Instructor Workshop

2008 ◽  
Author(s):  
Pradeep Vanguri ◽  
Jeff Konin
Keyword(s):  
Instructional Strategies ◽  
Athletic Training ◽  
Clinical Education ◽  
Athletic Training Education ◽  
Control Group ◽  
Clinical Instructor ◽  
Delivery Mode ◽  
Clinical Instructors ◽  
Single Session ◽  
Experimental Group

Athletic training clinical education combines didactic education with practical experiences. Athletic training education programs facilitate the development of this instruction by preparing the clinical instructors affiliated with the program. Primarily through one-time workshops, this effort provides limited delivery of content to prepare these clinical instructors. In an attempt to identify which method of content delivery would most benefit clinical instructors, this research creates a unique methods to further investigate this issue. This study compared the acquisition of knowledge between the traditional single session clinical instructor workshop to a modified four-session workshop on athletic training clinical education instructional strategies. Method: A pre-post assessment was utilized to measure the acquisition of clinical instruction skills for a control and experimental group of clinical instructors within a single accredited athletic training education program. Eleven clinical instructors participated in the experimental group while fifteen clinical instructors participated in the control group (N=26). A standardized instrument for assessment compared control and experimental group participants’ acquisition of information delivered through the clinical workshop models. Results:Statistical analysis of the results from the testing instrument identified a statistical difference (p=.003) between the control and experimental groups implying an acquisition of knowledge from the clinical instructor workshop interventions.Conclusions: This study supports the implementation of multiple session clinical workshops for athletic training clinical instructor workshop training as an alternative method to the traditional single session workshop delivery mode. Nurturing clinical instructors through instructional develops a positive learning environment to ensure their success.

Delegation and Empowerment in CAATE Accredited Athletic Training Education Programs

2009 ◽  
Vol 4 (4) ◽  
pp. 139-143 ◽  
Author(s):  
Johanna Hoch ◽  
Kristi White ◽  
Chad Starkey ◽  
B. Andrew Krause
Keyword(s):  
Athletic Training ◽  
Clinical Education ◽  
Athletic Training Education ◽  
Validity And Reliability ◽  
Electronic Survey ◽  
Entry Level ◽  
Academic Role ◽  
Data Collection And Analysis ◽  
Survey Instruments ◽  
Administrative Tasks

Context: The use of delegation can potentially alleviate some of the stress with administering an athletic training education program (ATEP) and allow program directors (PDs) to focus on other aspects of their academic role. Objectives: To determine the reasons PDs delegate and do not delegate tasks to other faculty of ATEPs accredited by the Commission on Accreditation of Athletic Training Education (CAATE), and to determine if clinical education coordinators (CECs) of accredited ATEPs feel empowered when completing these tasks. Design and Setting: Survey of CECs and PDs of CAATE accredited entry-level ATEPs. Patients or other participants: At the time of this research there were 358 CAATE accredited entry-level ATEPs; 143 of these institutions had both CECs and PDs on staff resulting in 286 possible participants. Data Collection and Analysis: We developed two electronic survey instruments and established the validity and reliability. Descriptive statistics were used to analyze and rank administrative tasks. Results: We ranked five reasons PDs delegate and do not delegate administrative tasks to the other faculty of the ATEP. For over 80% (n=25) of the PDs surveyed, frequency statistics suggested that lack of confidence and lack of trust in others were the number one and number two reasons, respectively, for not delegating tasks to other faculty. Also, PDs ranked improving productivity as their primary reason to delegate tasks to other members of the ATEP. Finally, CECs felt empowered 59% of the time when completing assigned tasks. Conclusions: When used properly, delegation can alleviate some of the job stresses PDs face in accredited entry-level ATEPs. However, in order for delegation to improve the PDs and CECs job satisfaction, the CECs must feel empowered when completing these tasks to the level CAATE requires.

scholarly journals Approved Clinical Instructors' Perspectives on Implementation Strategies in Evidence-Based Practice for Athletic Training Students

2011 ◽  
Vol 46 (6) ◽  
pp. 655-664 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Bonnie L. Van Lunen
Keyword(s):  
Critical Thinking ◽  
Clinical Practice ◽  
Athletic Training ◽  
Evidence Based Practice ◽  
Implementation Strategies ◽  
Athletic Training Education ◽  
Evidence Based ◽  
Clinical Instructors ◽  
Approved Clinical Instructors ◽  
Ebp Implementation

Context: Understanding implementation strategies of Approved Clinical Instructors (ACIs) who use evidence-based practice (EBP) in clinical instruction will help promote the use of EBP in clinical practice. Objective: To examine the perspectives and experiences of ACIs using EBP concepts in undergraduate athletic training education programs to determine the importance of using these concepts in clinical practice, clinical EBP implementation strategies for students, and challenges of implementing EBP into clinical practice while mentoring and teaching their students. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as a certified athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.8 ± 3.9 years) were interviewed. Data Collection and Analysis: We interviewed each participant by telephone. Interview transcripts were analyzed and coded for common themes and subthemes regarding implementation strategies. Established themes were triangulated through peer review and member checking to verify the data. Results: The ACIs identified EBP implementation as important for validation of the profession, changing paradigm shift, improving patient care, and improving student educational experiences. They promoted 3 methods of implementing EBP concepts with their students: self-discovery, promoting critical thinking, and sharing information. They assisted students with the steps of EBP and often faced challenges in implementation of the first 3 steps of EBP: defining a clinical question, literature searching, and literature appraisal. Finally, ACIs indicated that modeling the behavior of making clinical decisions based on evidence was the best way to encourage students to continue using EBP. Conclusions: Athletic training education program directors should encourage and recommend specific techniques for EBP implementation in the clinical setting. The ACIs believed that role modeling is a strategy that can be used to promote the use of EBP with students. Training of ACIs should include methods by which to address the steps of the EBP process while still promoting critical thinking.

scholarly journals Clinical Instruction for Professional Practice

2009 ◽  
Vol 4 (1) ◽  
pp. 28-31 ◽  
Author(s):  
Greg Gardner ◽  
Patrick Sexton ◽  
M. Susan Guyer ◽  
K. Sean Willeford ◽  
Linda S. Levy ◽  
...  
Keyword(s):  
Adult Learning ◽  
Instructional Strategies ◽  
Athletic Training ◽  
Skill Acquisition ◽  
Clinical Education ◽  
Clinical Instructors ◽  
Clinical Experiences ◽  
Self Directed Learning ◽  
Entry Level ◽  
Directed Learning

Objective: To present the principles of adult learning and mentoring to help clinical instructors better educate athletic training students (ATSs) during their clinical experiences, with the end result being a better prepared, competent entry-level practitioner. Background: The principles of adult learning must be applied to ATS clinical education in order to develop more task mature and knowledgeable entry-level practitioners. Because clinical instructors are typically educated as clinicians rather than educators, they are generally not well-versed in the principles of adult learning, and generally do not spend a great deal of time designing learning experiences, appropriate supervision techniques, or mentoring strategies within the students' clinical experiences. Description: Concepts of adult learning, such as task maturity, self-concept, and self-directed learning, are keys to the development of competent practitioners. As espoused by Knowles, the Dreyfus five stage model of skill acquisition supports the concepts of adult learning and is easily applied to clinical education of the ATS. Modifications of this model and other adult learning models place students along a learning continuum where their progress can be enhanced or delayed depending on the instructional strategies employed by their clinical instructor (CI). Clinical Advantages: If instructional strategies are changed to correctly match the learner's progression, the learner will continue to move toward becoming a competent entry-level practitioner. These instructional adjustments will also allow the student to become more competent and self-confident in his or her clinical and decision-making skills.

scholarly journals Dynamic Paired-Behaviors in Effective Clinical Instruction

2010 ◽  
Vol 5 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Philip D. Ford ◽  
Benito Velasquez
Keyword(s):  
Athletic Training ◽  
Clinical Education ◽  
Clinical Setting ◽  
Relevant Literature ◽  
Athletic Training Education ◽  
Clinical Instructor ◽  
Clinical Instructors ◽  
Clinical Instruction ◽  
Pedagogical Strategies ◽  
Instructor Behaviors

Background: Pedagogical strategies related to clinical instruction are needed to improve students' education in the clinical setting. Description: In this article, we use the relevant literature to identify and define “effective” clinical instructor behaviors in athletic training. In addition, we propose a pairing of behaviors as a cueing strategy for athletic training clinical instructors. Objective: The purpose of the article is to provide a brief background on the following paired-behaviors: communication-action, demonstration-practice, and instruction-evaluation as key elements to effective clinical instruction in athletic training education. Educational Advantages: If clinical instructors recognize the importance of using these paired-behaviors in clinical education, it may dramatically impact student learning.

scholarly journals Perceptions of Approved Clinical Instructors: Barriers in the Implementation of Evidence-Based Practice

2013 ◽  
Vol 48 (3) ◽  
pp. 382-393 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Bonnie L. Van Lunen
Keyword(s):  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Training Education ◽  
Academic Program ◽  
Evidence Based ◽  
Clinical Instructors ◽  
Clinical Practices ◽  
Telephone Interviews ◽  
Data Collection And Analysis ◽  
Approved Clinical Instructors

Context: As evidence-based practice (EBP) becomes prevalent in athletic training education, the barriers that Approved Clinical Instructors (ACIs) experience in implementing it with students need to be understood. Objective: To investigate barriers ACIs face when implementing EBP concepts in clinical practice and in teaching EBP to professional athletic training students and to investigate the educational emphases to improve the barriers. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as an athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.81 ± 3.9 years) were interviewed. Data Collection and Analysis: We interviewed each participant by telephone. Interview data were analyzed and coded for common themes and subthemes regarding barriers and educational emphases. Themes were triangulated through multiple-analyst triangulation and interpretive verification. Results: Barriers to EBP incorporation and educational emphasis placed on EBP were the main themes reported. Resources, personnel, and student characteristics were subthemes identified as barriers. Resource barriers included time, equipment, access to current literature, and knowledge. Coworkers, clinicians, and coaches who were unwilling to accept evidence regarding advancements in treatment were identified as personnel barriers. Programmatic improvement and communication improvement were subthemes of the educational emphasis placed on EBP theme. The ACIs reported the need for better integration between the clinical setting and the classroom and expressed the need for EBP to be integrated throughout the athletic training education program. Conclusions: Integration of the classroom and clinical experience is important in advancing ACIs' use of EBP with their students. Collaborative efforts within the clinical and academic program could help address the barriers ACIs face when implementing EBP. This collaboration could positively affect the ability of ACIs to implement EBP within their clinical practices.

scholarly journals Evaluation of Athletic Training Students' Clinical Proficiencies

2008 ◽  
Vol 43 (4) ◽  
pp. 386-395 ◽  
Author(s):  
Stacy E. Walker ◽  
Thomas G. Weidner ◽  
Kirk J. Armstrong
Keyword(s):  
Real Time ◽  
Athletic Training ◽  
Clinical Experience ◽  
Education Program ◽  
Athletic Training Education ◽  
Athletic Training Students ◽  
Education Programs ◽  
Content Areas ◽  
Entry Level ◽  
Program Characteristics

Abstract Context: Appropriate methods for evaluating clinical proficiencies are essential in ensuring entry-level competence. Objective: To investigate the common methods athletic training education programs use to evaluate student performance of clinical proficiencies. Design: Cross-sectional design. Setting: Public and private institutions nationwide. Patients or Other Participants: All program directors of athletic training education programs accredited by the Commission on Accreditation of Allied Health Education Programs as of January 2006 (n  =  337); 201 (59.6%) program directors responded. Data Collection and Analysis: The institutional survey consisted of 11 items regarding institutional and program demographics. The 14-item Methods of Clinical Proficiency Evaluation in Athletic Training survey consisted of respondents' demographic characteristics and Likert-scale items regarding clinical proficiency evaluation methods and barriers, educational content areas, and clinical experience settings. We used analyses of variance and independent t tests to assess differences among athletic training education program characteristics and the barriers, methods, content areas, and settings regarding clinical proficiency evaluation. Results: Of the 3 methods investigated, simulations (n  =  191, 95.0%) were the most prevalent method of clinical proficiency evaluation. An independent-samples t test revealed that more opportunities existed for real-time evaluations in the college or high school athletic training room (t189  =  2.866, P  =  .037) than in other settings. Orthopaedic clinical examination and diagnosis (4.37 ± 0.826) and therapeutic modalities (4.36 ± 0.738) content areas were scored the highest in sufficient opportunities for real-time clinical proficiency evaluations. An inadequate volume of injuries or conditions (3.99 ± 1.033) and injury/condition occurrence not coinciding with the clinical proficiency assessment timetable (4.06 ± 0.995) were barriers to real-time evaluation. One-way analyses of variance revealed no difference between athletic training education program characteristics and the opportunities for and barriers to real-time evaluations among the various clinical experience settings. Conclusions: No one primary barrier hindered real-time clinical proficiency evaluation. To determine athletic training students' clinical proficiency for entry-level employment, athletic training education programs must incorporate standardized patients or take a disciplined approach to using simulation for instruction and evaluation.

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