scholarly journals Change Management and Athletic Training: A Primer for Athletic Training Educators

2020 ◽  
Vol 15 (4) ◽  
pp. 269-277
Author(s):  
David C. Berry ◽  
Christine Noller

Context Change management is a discipline guiding how organizations prepare, equip, and support people to adopt a change to drive organizational success and outcomes successfully. Objective To introduce the concept of change management and create a primer document for athletic training educators to use in the classroom. Background While Lean and Six Sigma methodologies are essential for achieving a high-reliability organization, human resistance to change is inevitable. Change management provides a structured approach via different theoretical methods, specific principles, and tools to guide organizations through growth and development and serves an essential role during process improvement initiatives. Synthesis There are several theories or models of change management, 3 of which are specifically relevant in health care. Kotter and Rathgeber believe change has both an emotional and situational component and use an 8-step approach: increase urgency, guide teams, have the right vision, communicate for buy-in, enable action, create short-term wins, and make-it-stick [Kotter J., Rathgeber H. Our Iceberg is Melting: Changing and Succeeding Under Any Circumstances. New York, NY: St. Martin's Press, 2006]. Bridges' Transitional Model focuses on the premise that change does not influence project success; instead, a transition does [Bridges W. Managing Transitions: Making the Most of Change. Reading, MA: Addison-Wesley Publishing, 1991]. Lewin's model suggests that restraining forces influence organizations and that driving forces cause change to happen [Lewin K. Problems of research in social psychology. In: Cartwright D, ed. Field Theory in Social Science: Selected Theoretical Papers. New York, NY: Harpers; 1951]. Recommendation(s) Whether athletic trainers approach change management in a leadership role or as a stakeholder, newly transitioning professionals and those seeking leadership roles should value and appreciate change management theories and tools. Moreover, while no best practice statement exists relative to the incorporation of change management into a curriculum, addressing the subject early may allow immersive-experience students an opportunity to use change management during a process improvement initiative, facilitating a greater appreciation of the content. Conclusion(s) Athletic training curriculums should consider including change management course content, whether separately or in combination with other process-improvement content, thereby familiarizing athletic trainers with a common language for organizational and professional change.

2020 ◽  
Vol 15 (4) ◽  
pp. 259-268 ◽  
Author(s):  
Christine Noller ◽  
David C. Berry

Context Lean as a quality improvement philosophy is new to athletic training despite widespread use in health care for many years. Objective To introduce the concepts of Lean and Lean Six Sigma and create a primer document for athletic training educators in the classroom. Background Lean requires organizations to exercise effort along with several dimensions simultaneously to improve patient quality and efficiency while controlling costs and reducing waste. When appropriately executed, Lean transforms how an organization and its employees work, creating an avid quest for quality improvement and, ultimately, patient safety. Synthesis Lean is a cultural transformation that changes how an organization operates. It requires new habits, skills, and attitudes throughout the organization, from executives to front-line staff. Lean is a journey, not a destination. The culture of Lean involves the relentless pursuit of continuous quality improvement and is composed of 6 principles and numerous tools. Recommendation(s) Whether athletic trainers approach Lean or Lean Six Sigma in a leadership role, or as a stakeholder in a Kaizen event, all should have a working knowledge of the principles, methods, elements, philosophy, and tools of robust process improvement. Moreover, while no best-practice statement exists about how to incorporate Lean Six Sigma into a curriculum, addressing process improvement early may allow immersive-experience students an opportunity to engage in a process improvement initiative, facilitating a greater appreciation of the content, and offer opportunities to engage professionals from other disciplines. Conclusion(s) Lean is reproducible in sports medicine clinics, orthopedic practices, and outpatient and athletic health care facilities, but only when athletic trainers understand the application. Moreover, for this reason, athletic training programs should strongly consider adding a robust process improvement course/content to their graduate curriculums.


2020 ◽  
Vol 15 (4) ◽  
pp. 251-258 ◽  
Author(s):  
Christine Noller ◽  
David C. Berry

Context Health care organizations are integrating employee training and educational programs to designate themselves as high-reliability organizations (HROs). HROs continually strive to evaluate and create an environment in which potential problems are anticipated, detected early, and virtually always responded to early enough to prevent catastrophic consequences. Objective This primer document introduces the concept of high reliability in health care (from a historical and foundational perspective) and establishes a framework for athletic training educators to introduce the concepts at the professional, postprofessional, or residency educational program level. Background While the theory of high reliability is new to athletic training, its quality and origins in health care are established. HROs use systems thinking to evaluate and design for safety and continuous improvement to create an environment where potential problems are anticipated, detected early, and responded to early enough to prevent tragic consequences. Synthesis The HRO focuses attention on emergent problems and deploys strategies to address those problems. HROs behave in ways that seem counterintuitive—they do not hide failures; instead, HROs celebrate them. HROs seek out problems and avoid focusing on just 1 aspect of work to see how all the parts fit together. They expect unexpected events and develop capabilities to manage them, deferring decisions to empowered experts. However, high reliability is only achieved through robust process improvement, which is only achieved with a complementary approach to Lean Six Sigma and change management. Recommendation(s) Given the complexity of patient care in athletic training, the potential for medical error(s), and the need for quality improvement, HROs hold promise for athletic training. Conclusion(s) As future health care leaders, athletic trainers should be educated to foster innovation and improve health care delivery to diverse patient populations. Athletic trainers should want to embrace the principles of HROs. Achieving high reliability can be accomplished with adequate exposure to and training within the classroom and during clinical education opportunities.


2013 ◽  
Vol 48 (3) ◽  
pp. 405-415 ◽  
Author(s):  
Cailee W. McCarty ◽  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Eric J. Newton ◽  
Bonnie L. Van Lunen

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students. Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training educators (n = 24) and postprofessional students (n = 71). Main Outcome Measure(s): Likert-scale items (1 = strongly disagree, 4 = strongly agree) assessed attitudes and beliefs and perceived barriers, whereas multipart questions assessed accessibility to resources. Kruskal-Wallis H tests (P ≤ .05) and Mann-Whitney U tests with a Bonferroni adjustment (P ≤ .01) were used to determine differences among groups. Results: Athletic trainers agreed (3.27 ± 0.39 out of 4.0) that EBP has various benefits to clinical practice and disagreed (2.23 ± 0.42 out of 4.0) that negative perceptions are associated with EBP. Benefits to practice scores (P = .002) and negative perception scores (P < .001) differed among groups. With respect to perceived barriers, athletic trainers disagreed that personal skills and attributes (2.29 ± 0.52 out of 4.0) as well as support and accessibility to resources (2.40 ± 0.40 out of 4.0) were barriers to EBP implementation. Differences were found among groups for personal skills and attributes scores (P < .001) and support and accessibility to resources scores (P < .001). Time (76.6%) and availability of EBP mentors (69.6%) were the 2 most prevalent barriers reported. Of the resources assessed, participants were most unfamiliar with clinical prediction rules (37.6%) and Cochrane databases (52.5%); direct access to these 2 resources varied among participants. Conclusions: Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.


2009 ◽  
Vol 4 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Patrick Sexton ◽  
Linda S. Levy ◽  
K. Sean Willeford ◽  
Mary G. Barnum ◽  
Greg Gardner ◽  
...  

Objective: The primary objective of this paper is to present the evolution, purpose, and definition of direct supervision in the athletic training clinical education. The secondary objective is to briefly present the factors that may negatively affect the quality of direct supervision to allow remediation and provide higher quality clinical experiences for athletic training students. Background: Athletic training educators and clinical instructors often engage in discussions regarding the direct supervision of ATSs. These discussions tend to center around concerns about ATS preparation, and how the current level of preparedness differs from that of the past. Some believe that direct supervision, rather than unsupervised practice, retards the ATSs' development; however, there is no current literature to support this concept. Description: Supervision means to watch or direct, while mentoring means to tutor, instruct, or guide; therefore, mentoring may be more descriptive of the desired/intended interaction between an ATS and their clinical instructor (CI). The intent of supervision is for an ATS to refine and improve their clinical proficiencies under CI guidance. For this to occur, the CI must alter their interactions with the ATS as the student evolves. Clinical Advantages: Developing the CIs' understanding of the intent and continuum of expectations associated with direct supervision will allow them to maximize their students' education and position them to become highly skilled and confident Athletic Trainers.


2013 ◽  
Vol 48 (3) ◽  
pp. 394-404 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Cailee W. McCarty ◽  
Eric J. Newton ◽  
Stacy E. Walker ◽  
...  

Context: Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown. Objective: To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%. Main Outcome Measure(s): Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables. Results: Athletic trainers demonstrated low knowledge scores (64.2% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P < .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P < .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P < .001). Conclusions: Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.


2017 ◽  
Vol 52 (12) ◽  
pp. 1109-1120 ◽  
Author(s):  
Kelly Potteiger ◽  
William A. Pitney ◽  
Thomas A. Cappaert ◽  
Angela Wolfe

Context:  Environmental sustainability efforts are becoming a critical concern in health care. However, little is known regarding how athletic trainers feel about the environment or what can be done to reduce the environmental impact of the practice of athletic training. Objective:  To examine athletic trainers' attitudes toward and perceptions of factors related to environmental sustainability. Design:  Sequential, mixed methods using a survey, focus groups, and personal interviews. Setting:  Field study. Patients or Other Participants:  Four hundred forty-two individuals completed the survey. Sixteen participated in the qualitative portion. Main Outcome Measure(s):  Quantitative results from the Athletic Training Environmental Impact Survey included data from a 5-point Likert scale (1 = lowest rating and 5 = highest rating). Descriptive statistics and 1-way analyses of variance were used to describe perceptions and determine differences in mean opinion, National Athletic Trainers' Association district, and use of green techniques. Qualitative data were transcribed verbatim and analyzed inductively. Results:  The mean score for opinion of the environment was 3.30 ± 0.52. A difference was found between opinion and National Athletic Trainers' Association district (F9, 429 = 2.43, P = .01). A Bonferroni post hoc analysis identified this difference (P = .03) between members of District 2 (Delaware, New Jersey, New York, Pennsylvania) and District 9 (Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, Tennessee). An inductive analysis resulted in 3 emergent themes: (1) barriers to using green techniques, (2) motivators for using green techniques, and (3) solutions to overcoming the barriers. The information gleaned from participants in the qualitative portion of the study can be useful for clinicians wishing to implement basic conservation efforts in their practice settings and may guide future sustainability projects. Conclusions:  Overall, participants reported a positive opinion of environmental sustainability topics related to athletic training. However, many barriers to practicing green techniques were identified.


2021 ◽  
Vol 16 (4) ◽  
pp. 270-277
Author(s):  
Patricia A. Aronson ◽  
Lorin A. Cartwright ◽  
Rebecca M. Lopez

Context It has become increasingly important that athletic trainers (ATs) understand and promote diversity, inclusion, and cultural competency. One technique athletic training educators can use to promote cultural competency for those in the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community is by attending a safe space ally training (SST) program to integrate the concepts of SST programing into their curriculum. Objective To provide athletic training educators with techniques to integrate inclusion and cultural competence regarding the LGBTQIA+ community into the athletic training curriculum using SST content. Our goal is that athletic training educators will train future ATs as well as embrace individual professional development. Background The National Athletic Trainers' Association (NATA) LGBTQ+ Advisory Committee (AC) has created an SST workshop for athletic trainers. Educators can promote cultural competency throughout the curriculum using evidence-based training programs such as the NATA LGBTQ+ AC SST. Description The emphasis of SST is to improve cultural competence regarding sexual minorities to improve inclusivity in all athletic training settings. It is critical that athletic training education programs prepare graduates to be competent, compassionate, patient-centered and professional ATs who are ready to function as health care professionals for all patients. Clinical Advantage(s) A goal of cultural competency is to create an inclusive environment within all athletic training settings, whether it be in a classroom, a clinic, or a nontraditional work setting. Health disparities and health care inequities must be appreciated by every AT to deliver compassionate and competent care for all in marginalized populations. Educators can make a difference in the future of athletic training by increasing the cultural competency of their students. Conclusion(s) Patient-centered care, knowledge of the care of those in diverse and minority populations, and ethical behavior can be enhanced through SST programs.


2012 ◽  
Vol 7 (3) ◽  
pp. 86-94 ◽  
Author(s):  
Kasee J. Hildenbrand ◽  
Judy A. Schultz

Context: Health care professionals, including athletic trainers are confronted daily with multiple complex problems that require critical thinking. Objective: This research attempts to develop a reliable process to assess students' critical thinking in a variety of athletic training and kinesiology courses. Design: Our first step was to create a panel of professionals, faculty, students, and critical thinking specialists to create a list of desirable traits and skill sets. Next, the panel specifically examined the language used by a university's existing critical thinking rubric and considered possible modifications for the kinesiology and athletic training education programs. This process involved the creation of a team of raters who participated in a norming process. Setting: University undergraduate classroom. Participants: Students enrolled in a lower level anatomy class and a higher level motor learning class within the kinesiology program and a group of stakeholders. Outcome Measures: To develop consistency using a norming process to examine the validity and reliability of a critical thinking rubric. Results: The panel norming process for the human anatomy course resulted in an overall interrater reliability score of 94% for a low (poor) paper, 90.5% for a medium (average) paper, and 89% for a high (excellent) paper. This high reliability coefficient provided confidence that evaluations of critical thinking would be reliable. In terms of validity, the results indicated that the group assessment of critical thinking can distinguish between various papers. Conclusion: Using the rubric allowed an established set of skills to be intentionally linked to critical thinking.


2016 ◽  
Vol 11 (3) ◽  
pp. 127-137 ◽  
Author(s):  
Sara Nottingham ◽  
Jessica L. Barrett ◽  
Stephanie M. Mazerolle ◽  
Christianne M. Eason

Context: Mentorship has been identified as a contributor to the socialization of athletic training preceptors. Understanding how mentorship occurs and contributes to preceptor development may help athletic training educators facilitate effective mentorship within their athletic training programs. Objective: Examine preceptors' perceptions of mentoring as part of their socialization into this role. Design: Qualitative study. Setting: Commission on Accreditation of Athletic Training Education programs. Patients or Other Participants: Twelve athletic trainers representing 4 National Athletic Trainers' Association districts, including 5 men and 7 women, average age = 32 ± 10.5 years, and average of 5 ± 5.0 years' experience as a preceptor. Main Outcome Measure(s): Participants responded to 14 interview questions regarding their perceptions of mentoring. Two researchers analyzed data using an inductive approach to identify themes and supporting categories. Trustworthiness was established by piloting the interview, using multiple analyst triangulation, and peer review. Results: Four themes emerged from the data: (1) characteristics, (2) processes, (3) mentoring by emulating, and (4) roles of mentoring. Participants identified that communication and commitment are characteristics of effective mentorship. Preceptors learn to mentor by emulating other preceptors, and mentoring relationships develop through both formal and informal processes. Mentoring serves multiple roles for preceptors, including providing a support system and facilitating reciprocal learning for both mentors and protégés. Conclusions: Participants perceive mentoring as beneficial to their initial and ongoing development as preceptors. Preceptors learn to mentor by emulating current and past mentors, emphasizing the importance of modeling for both preceptors and students. Clinical education coordinators can facilitate the mentoring of preceptors by educating them on the benefits of engaging in it as well as connecting experienced preceptors with newer preceptors.


2017 ◽  
Vol 12 (2) ◽  
pp. 134-145 ◽  
Author(s):  
Ellen K. Payne ◽  
Stacy E. Walker ◽  
Stephanie M. Mazerolle

Context: Little research is available on how athletic training educators develop their instructional styles over the course of their careers and what influences their teaching practices. Understanding the development of athletic training educators' teaching practices may help promote effective teaching in athletic training programs and help guide professional development. Objective: To gain a better understanding of how athletic trainers develop as educators and how their experiences as an educator influence their teaching. Design: Qualitative study. Setting: Higher education institutions. Patients or Other Participants: We interviewed 11 doctorally trained athletic trainers teaching in undergraduate professional athletic training programs. Main Outcome Measure(s): Data were collected through in-depth interviews, and additional artifacts (curricula vitae, syllabi, videotaped teaching lessons) were used to triangulate data collected during the interviews. We used a phenomenological approach to analyze the data and maintained trustworthiness through member checking, data-source triangulation, multiple-analyst triangulation, and peer review. Results: Two main themes emerged from the data: (1) role induction through role continuance and (2) teaching for student learning. Participants discussed how their teaching evolved over the course of their careers, how they valued their clinical practice, how they promoted student learning, and how they aimed to challenge students to transfer knowledge learned into clinical practice. Conclusions: From the data, we are able to understand that athletic training educators develop their teaching practices through engaging in their role as a teacher. This was an informal, continual process of learning how to be an educator.


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