Appropriate Medical Care Standards for Organizations Sponsoring Athletic Activity for the Secondary School–Aged Athlete: A Summary Statement

Objective To present the appropriate medical care standards for organizations that sponsor athletic activities for secondary school–aged athletes. Data Sources To develop the current standards and identify current best-practices evidence, the task force used a multistep process that included reviewing the existing 2004 Appropriate Medical Care for Secondary School–Aged Athletes consensus points and cross-referencing of National Athletic Trainers' Association (NATA) statements and official documents from the strategic alliance (the NATA, NATA Foundation, Board of Certification, and Commission on Accreditation of Athletic Training Education). Gaps in the recommendations from the 2004 Appropriate Medical Care for Secondary School–Aged Athletes document were identified by the task force, and the new appropriate medical care standards were developed and refined. Conclusions and Recommendations Twelve standards, with supporting substandards, were developed that encompassed readiness to participate in activity; facilities; equipment; protective materials; environmental policies; nutrition, hydration, and dietary supplementation; wellness and long-term health; comprehensive emergency action plans; on-site immediate care; on-site therapeutic interventions; psychological concerns; and athletic health care administration. Collectively, these standards describe a comprehensive approach to providing appropriate health care to secondary school–aged athletes and should serve as a framework with which organizations can evaluate and improve the medical care supplied to adolescent athletes.

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The Prioritized Research Agenda for the Athletic Training Profession: A Report From the Strategic Alliance Research Agenda Task Force

Journal of Athletic Training ◽

10.4085/1062-6050-374-18 ◽

2019 ◽

Vol 54 (3) ◽

pp. 237-244 ◽

Cited By ~ 6

Author(s):

Lindsey E. Eberman ◽

Stacy E. Walker ◽

Robert T. Floyd ◽

Tracey Covassin ◽

Esther Nolton ◽

...

Keyword(s):

Health Care ◽

Clinical Practice ◽

Focus Groups ◽

Athletic Training ◽

Research Agenda ◽

Strategic Alliance ◽

Task Force ◽

Continuous Process ◽

Research Priorities ◽

Web Based

Context Athletic trainers (ATs) must be equipped with evidence to inform their clinical practice. A systematic, inclusive, and continuous process for exploring research priorities is vital to the success of ATs and, more importantly, their patients' positive outcomes. Objective To identify research priorities and unify research with clinical practice to improve patient care and advance the profession. Design Mixed-methods study. Setting Focus groups and a Web-based survey. Patients or Other Participants A total of 87 ATs (43 men [49.4%], 44 women [50.6%]; age = 40 ± 11 years; experience = 18 ± 11 years) participated in focus groups. Of the 49 332 e-mails sent, 580 were undeliverable, 5131 ATs started the survey (access rate = 10.5%), and 4514 agreed to participate (response rate = 9.3%). Main Outcome Measure(s) Our study consisted of 6 focus-group sessions, a content-expert review, and a Web-based survey. Themes from the focus groups were used to develop the research priorities and survey instrument. We used the 25-item validated survey to determine whether the research priorities and findings of the focus groups were generalizable. Endorsement of research priorities and recommendations was achieved when respondents indicated they agreed or strongly agreed. Results Respondents endorsed 5 research priorities: health care competency (n = 4438/4493, 98.8%), vitality of the profession (n = 4319/4455, 96.9%), health professions education (n = 3966/4419, 89.8%), health care economics (n = 4246/4425, 96.0%), and health information technology (n = 3893/4438, 87.7%). We also made the following recommendations: (1) develop funding initiatives that align with the agenda, (2) develop postdoctoral fellowships focused on clinical research, (3) facilitate collaborative relationships between clinicians and researchers, and (4) make research evidence more readily available and more applicable. Conclusions Using a systematic and inclusive process, we developed a prioritized research agenda for the athletic training profession. The agenda was endorsed by the leaders of each Strategic Alliance organization and adopted as the Athletic Training Research Agenda.

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Summary Statement: Appropriate Medical Care for the Secondary School-Aged Athlete

Journal of Athletic Training ◽

10.4085/1062-6050-43.4.416 ◽

2008 ◽

Vol 43 (4) ◽

pp. 416-427 ◽

Cited By ~ 43

Author(s):

Jon Almquist ◽

Tamara C. Valovich McLeod ◽

Angela Cavanna ◽

Dave Jenkinson ◽

Andrew E. Lincoln ◽

...

Keyword(s):

Health Care ◽

Secondary School ◽

Medical Care ◽

Task Force ◽

Relevant Literature ◽

Action Planning ◽

Health Care Team ◽

Care Team ◽

Athletic Programs ◽

Staff Members

Abstract Objective: To present the recommendations made by the Appropriate Medical Care for Secondary School-Aged Athletes Task Force and to summarize the subsequent monograph developed around 11 consensus points. Data Sources: The MEDLINE, CINAHL, and SportDiscus databases were searched for relevant literature regarding secondary school-aged athletes; health care administration; preparticipation physical examination; facilities; athletic equipment; emergency action planning; environmental conditions; recognition, evaluation, and treatment of injuries; rehabilitation and reconditioning; psychosocial consultation; nutrition; and prevention strategies. Conclusions and Recommendations: Organizations that sponsor athletic programs for secondary school-aged athletes should establish an athletic health care team to ensure that appropriate medical care is provided to all participants. The 11 consensus points provide a framework—one that is supported by the medical literature and case law—for the development of an athletic health care team and for assigning responsibilities to the team, administrators, and staff members of institutions sponsoring secondary school and club-level athletic programs.

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Professional Involvement: Requirements as Students and Trends After Certification

Athletic Training Education Journal ◽

10.4085/090112 ◽

2014 ◽

Vol 9 (1) ◽

pp. 12-21

Author(s):

Jennifer N. Lancaster ◽

Bettye Myers ◽

David L. Nichols ◽

Kerry S. Webb

Keyword(s):

Health Care ◽

Athletic Training ◽

The United States ◽

Online Surveys ◽

Discussion Section ◽

Professional Involvement ◽

Entry Level ◽

Professional Activities ◽

The Difference ◽

Board Of Certification

Context The field of athletic training needs young engaged professionals for continued progress in allied health care. Academic and clinical requirements during the entry-level education could potentially impact the decisions and directions these students choose to pursue as young professionals. Objective To determine the difference in professional involvement of athletic trainers (ATs) based upon their participation in professional activities while completing their entry-level athletic training program (ATP). Design Online surveys to determine ATP requirements of students and to determine the involvement of ATs in 5 professional activities after their certification by the Board of Certification. Perception questions were also included. Patients or Other Participants Included 120 ATs from across the United States. All AT participants graduated within the 2004–2005 academic year and obtained certification in 2005. Data Collection and Analysis Online surveys were administered through PsychData. The McNemar test was used to determine changes in participation levels of participants as students and as professionals. Frequency of yes/no responses was used to present perceptions, and participants' comments were included in the discussion section. Results Student participation in community service, mentoring other students, and submitting presentation proposals did influence participation in these activities as a professional. However, professional involvement was not influenced by student membership in organizations, research, or mentoring by a health care professional. Conclusions Participation in some professional activities as students should be encouraged or required in order to promote continued participation in these activities when the students become athletic training professionals.

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Key Factors for Providing Appropriate Medical Care in Secondary School Athletics: Athletic Training Services and Budget

Journal of Athletic Training ◽

10.4085/1062-6050-45.1.75 ◽

2010 ◽

Vol 45 (1) ◽

pp. 75-86 ◽

Cited By ~ 16

Author(s):

George S. Wham ◽

Ruth Saunders ◽

James Mensch

Keyword(s):

South Carolina ◽

Secondary School ◽

Medical Care ◽

Athletic Training ◽

Sports Medicine ◽

Interscholastic Athletics ◽

Care Assessment ◽

Interscholastic Athletes ◽

Training Services ◽

Medicine Supply

Abstract Context: Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. Objective: To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. Design: Cross-sectional study. Setting: Mailed and e-mailed survey. Patients or Other Participants: One hundred sixty-six South Carolina high schools. Intervention(s): The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r = 0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. Main Outcome Measure(s): The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. Results: Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P < .001) when controlling for the setting, region, and rate of free or reduced lunch qualifiers. These 2 variables accounted for 30% of the variance in ACI score (R2 = 0.302). Post hoc analysis showed differences between ACI score based on the source of the athletic trainer and the size of the sports medicine supply budget. Conclusions: The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for interscholastic athletes.

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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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Transition to Practice for Graduate Assistant Athletic Trainers Providing Medical Care in the Secondary School Setting

Journal of Athletic Training ◽

10.4085/1062-6050-466-16 ◽

2018 ◽

Vol 53 (5) ◽

pp. 521-528 ◽

Cited By ~ 1

Author(s):

Jessica L. Kirby ◽

Stacy E. Walker ◽

Stephanie M. Mazerolle

Keyword(s):

Health Care ◽

Secondary School ◽

Medical Care ◽

Health Care Providers ◽

Athletic Trainers ◽

School Setting ◽

Transition To Practice ◽

Care Providers ◽

Team Physician ◽

Graduate Assistant

Context: Transition to clinical practice can be challenging for newly credentialed athletic trainers (ATs), who are expected to immediately step into their roles as autonomous clinicians. For those providing care in the secondary school setting, this transition may be complicated by the fact that many practice in isolation from other health care providers. Objective: To explore the transition to practice of newly credentialed graduate assistant ATs providing medical care in the secondary school. Design: Phenomenologic qualitative study. Setting: Secondary school. Patients or Other Participants: The 14 participants (2 men, 12 women; age = 23.3 ± 2.0 years) were employed in the secondary school setting through graduate assistantships, had been credentialed for less than 1 year, and had completed professional bachelor's degree programs. Data Collection and Analysis: We completed 14 semistructured phone interviews. Interviews were recorded and transcribed verbatim. A general inductive approach was used for data analysis. Trustworthiness was established through multiple-analyst triangulation, peer review, and member checks. Results: A period of uncertainty referred to a time during which participants were anxious as they began practicing independently. Legitimation through role engagement signified that as the period of uncertainty passed, participants developed more confidence in themselves and legitimation by engaging in their role. Acclimation through physician communication and professional relationships highlighted the importance of developing a relationship with the team physician, which provided a source of feedback and support for continued growth and confidence. Conclusions: To prepare for this period of uncertainty, educators and preceptors should encourage students to interact with members of the health care team and communicate with parents and coaches. Employers should implement initiatives to orient newly credentialed ATs to their roles, provide clear job expectations, and assign or assist with identifying mentors. Newly credentialed ATs should seek support from many different individuals, including the team physician, who can provide support, feedback, and encouragement.

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Secondary School Administrators' Perceptions and Knowledge of the Athletic Training Profession, Part I: Specific Considerations for Athletic Directors

Journal of Athletic Training ◽

10.4085/54-20 ◽

2020 ◽

Author(s):

Alicia M. Pike Lacy ◽

Christianne M. Eason ◽

Rebecca L. Stearns ◽

Douglas J. Casa

Keyword(s):

Secondary School ◽

Athletic Training ◽

Athletic Directors ◽

Wound Care ◽

Perceived Value ◽

Therapeutic Interventions ◽

Online Questionnaire ◽

Cross Sectional ◽

Peace Of Mind ◽

Count Response

Abstract Context: Athletic directors are charged with making impactful decisions for secondary school athletic programs that mitigate risk for stakeholders involved. This includes decision-making regarding the provision of medical care for student-athletes. To date, limited research has explored athletic directors' perceptions of athletic training. Objective: To evaluate public school athletic directors' knowledge and perceptions of the athletic trainer (AT) role. Design: Concurrent mixed methods. Setting: Cross-sectional online questionnaire. Patients or Other Participants: Athletic directors representing all 50 states and the District of Columbia (n=954; 818 males, 133 females, 3 preferred not to answer; age = 47.8 ± 9.1 years; years in current role = 9.8 ± 8.3). Intervention(s): Questionnaire composed of demographics, various quantitative measures assessing athletic directors' knowledge and perceived value of ATs, and open-ended questions allowing for expansion on their perspectives. Main Outcome Measure(s): Descriptive statistics were reported, with key quantitative findings presented as count response and overall percentages. Qualitative data were analyzed using the general inductive approach. Results: A majority of respondents recognized the ATs' role in injury prevention (99.8%), first aid/wound care (98.8%), therapeutic interventions (93.8%), and emergency care (91.6%). Approximately 61% (n=582) identified AT employment as a top sport safety measure, and 77% (n=736) considered an AT to be extremely valuable to student-athlete health and safety. Athletic directors appeared to recognize the value of ATs as they provide “peace of mind” and remove the responsibility of making medical decisions from coaches and administration. Conclusions: Athletic directors appeared to recognize the value ATs bring to the secondary school setting and demonstrated adequate knowledge regarding ATs' roles and responsibilities. Educational efforts for this population should focus on AT-related tasks that are not frequently seen in the public eye, yet add to perceived value, in order to potentially influence hiring decisions.

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Athletic Training Services During Daily Patient Encounters: A Report From the Athletic Training Practice-Based Research Network

Journal of Athletic Training ◽

10.4085/1062-6050-51.8.03 ◽

2016 ◽

Vol 51 (6) ◽

pp. 435-441 ◽

Cited By ~ 13

Author(s):

Kenneth C. Lam ◽

Alison R. Snyder Valier ◽

Barton E. Anderson ◽

Tamara C. Valovich McLeod

Keyword(s):

Health Care ◽

Secondary School ◽

Athletic Training ◽

Clinical Data ◽

Preventive Services ◽

Research Network ◽

Practice Based Research ◽

Training Services ◽

Hot Pack ◽

Training Practice

Context: Athletic training services such as taping, wrapping, and stretching are common during routine care but rarely captured in traditional patient documentation. These clinical data are vital when determining appropriate medical coverage and demonstrating the value and worth of athletic trainers (ATs). Objective: To analyze clinical data from daily encounter forms within the Athletic Training Practice-Based Research Network (AT-PBRN). Design: Descriptive study. Setting: Secondary school athletic training clinics. Patients or Other Participants: Adolescent patients (n = 4888; age = 16.3 ± 1.4 years) seeking care from ATs. Main Outcome Measure(s): We used Web-based electronic medical records from December 1, 2009, to July 1, 2015, to obtain patient characteristics via deidentified data. Descriptive data regarding practice characteristics from patient encounter forms were analyzed and reported as percentages and frequencies. Results: A total of 36 245 patient encounters (mean = 7.5 ± 11.6 encounters per patient) were recorded. Football, basketball, soccer, track, and volleyball accounted for 85.1% of all encounters. Most encounters were for preventive services (48.8%, n = 22 329), followed by care for a current injury (37.2%, n = 17 027) and care for a new injury (13.9%, n = 6368). Of the preventive encounters, taping (52.7%) was the most common service provided, followed by ice- or hot-pack application (25.4%) and treatment (9.6%). Taping (28.7%) was also the most common service for current injuries, followed by treatment (26.7%) and ice- or hot-pack application (26.2%). Conclusions: Our findings highlight the unique role of ATs as health care providers who provide substantial preventive services to their patients. Further, these results represent one of the first attempts to describe athletic training services related to nontime-loss injuries, emphasizing the significant role that ATs play in the health care of secondary school athletes. These findings should help clinicians and administrators make more informed decisions regarding appropriate medical coverage.

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Characterizations of a Quality Certified Athletic Trainer

Journal of Athletic Training ◽

10.4085/1062-6050-46.6.672 ◽

2011 ◽

Vol 46 (6) ◽

pp. 672-679 ◽

Cited By ~ 13

Author(s):

Scot Raab ◽

Brent D. Wolfe ◽

Trenton E. Gould ◽

Scott G. Piland

Keyword(s):

Health Care ◽

Athletic Training ◽

Health Care Professionals ◽

Delphi Study ◽

Care Delivery ◽

Athletic Trainer ◽

Affective Traits ◽

National Athletic Trainers Association ◽

Certified Athletic Trainer ◽

Member Checks

Context: Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits. Objective: To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT). Design: Delphi study. Setting: Interviews in conference rooms or business offices and by telephone. Patients or Other Participants: Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers' Association (2, 3, 4, 9). Data Collection and Analysis: Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives. Results: We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits). Conclusions: According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting.

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The National Sports Safety in Secondary Schools Benchmark (N4SB) Study: Defining Athletic Training Practice Characteristics

Journal of Athletic Training ◽

10.4085/1062-6050-48.4.04 ◽

2013 ◽

Vol 48 (4) ◽

pp. 483-492 ◽

Cited By ~ 17

Author(s):

Tamara C. Valovich McLeod ◽

Kellie C. Huxel Bliven ◽

Kenneth C. Lam ◽

R. Curtis Bay ◽

Alison R. Snyder Valier ◽

...

Keyword(s):

Secondary School ◽

Secondary Schools ◽

Medical Care ◽

Athletic Training ◽

Athletic Trainers ◽

School Setting ◽

Practice Setting ◽

Web Based ◽

Practice Characteristics ◽

Training Practice

Context: Increased rates of sport participation and sport-related injury have led to greater emphasis on and attention to medical care of student-athletes in the secondary school setting. Access to athletic training services is seen as a critical factor for delivering adequate injury prevention and medical care to student-athletes. However, few data are available regarding practice characteristics of athletic trainers (ATs) in this setting. Objective: To characterize the practices of secondary school athletic trainers (ATs). Design: Descriptive study. Setting: Web-based survey. Patients or Other Participants: A total of 17 558 ATs with current National Athletic Trainers' Association membership were identified for survey distribution. Of these, 4232 ATs indicated that they practiced in the secondary school setting, and 4045 completed some part of the survey. Main Outcome Measure(s): A Web-based survey was used to obtain demographic information about ATs and their secondary schools and characteristics of athletic training practice. Descriptive data regarding the athletic trainer's personal characteristics, secondary school characteristics, and practice patterns are reported as percentages and frequencies. Results: Most respondents were in the early stages of their careers and relatively new to the secondary school practice setting. Nearly two-thirds (62.4%; n = 2522) of respondents had 10 or fewer years of experience as secondary school ATs, 52% (n = 2132) had been certified for 10 or fewer years, and 53.4% (n = 2164) had 10 or fewer years of experience in any practice setting. The majority of respondents (85%) worked in public schools with enrollment of 1000 to 1999 (35.5%) and with football (95.5%). More than half of respondents were employed directly by their school. Most respondents (50.6%) reported an athletic training budget of less than $4000. The majority of ATs performed evaluations (87.5%) on-site all of the time, with a smaller percentage providing treatments (73.3%) or rehabilitation (47.4%) services all of the time. Conclusions: This is the first study to describe secondary school athletic training that reflects national practice trends. To improve the quality of athletic training care and to support and improve current working conditions, the profession must examine how its members practice on a day-to-day basis.

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