scholarly journals Critical Assessment and Reflection on Experience Form: A Novel Approach to Clinical Assessment

2021 ◽  
Vol 16 (4) ◽  
pp. 307-315
Author(s):  
Meredith J. Madden ◽  
Donna Ritenour ◽  
Kimberly L. Mace

Context There is a clear need for quality improvement in health care. The 2020 Commission on Accreditation of Athletic Training Education Standards for Professional Athletic Training Programs require students to apply concepts of quality improvement to provide athletic training care and deliver excellent patient outcomes. As such, programs may be looking for strategies to view students' clinical experiences through a lens of quality improvement. Objective To introduce the Critical Assessment and Reflection on Experience (CARE) form, which is a novel clinical education tool that assesses student clinical skills using critical reflection and quality improvement concepts. Background Historically, students have demonstrated achievement by comparing their skill performance with a competency checklist. Typically, the skills assessed, and the level of achievement expected progress to allow learning over time. However, current athletic training clinical education literature has shifted to promote experiential learning, critical thinking, and active reflection to develop competence. Description Students complete the CARE form after patient encounters or other clinical experiences. The form requires students to practice documentation and communication skills, but also to critically reflect on performance by applying quality improvement, patient safety, and evidence-based practice concepts. Clinical Advantage(s) The form holds advantages for multiple stakeholders, including students, preceptors, and program administrators. The CARE form encourages students to engage in authentic patient interactions rather than relying on contrived learning experiences. By encouraging live patient encounters, this tool results in less burden on preceptors to create additional opportunities for students. Program administrators can use the tool to incorporate quality improvement standards meaningfully into the curriculum. Additionally, the CARE form creates opportunity to document program assessment. Conclusion(s) Professional programs should consider implementing the CARE form as a clinical experience assessment tool to develop students' quality improvement and critical thinking skills when providing athletic training services.

2015 ◽  
Vol 10 (3) ◽  
pp. 219-226 ◽  
Author(s):  
Patricia A. Aronson ◽  
Thomas G. Bowman ◽  
Stephanie M. Mazerolle

Context The perceptions of athletic training students (ATSs) regarding their clinical education experiences are not fully understood. It is important to investigate ATS perceptions of clinical education to allow athletic training educators to provide educational experiences that will maximize learning. Objective To determine what ATSs value during their clinical education experiences. Design Qualitative study. Setting Participants completed an electronic preceptor evaluation. Patients or Other Participants Nineteen (14 female, 5 male; average age = 22 ± 1 years) senior ATSs over 2 years enrolled in a Commission on Accreditation of Athletic Training Education–accredited athletic training program participated in our study. Participants came from 1 Commission on Accreditation of Athletic Training Education–accredited athletic training program in the Mid-Atlantic region. Data Collection and Analysis We asked seniors to evaluate their final clinical education experience by completing an open-ended questionnaire. We analyzed the data following the principles of grounded theory. We negotiated over the coding scheme until we reached full agreement, performed a peer review, and conducted member checks to ensure trustworthiness of the results. Results Three major themes emerged from the data. Athletic training students enjoy interacting with preceptors who act as appropriate professional role models. Our participants also found value in being able to develop their clinical skills with appropriate situational supervision. Finally, ATSs appreciate when preceptors teach them new information by stimulating their critical thinking skills. Conclusions To help provide positive learning environments for senior ATSs, athletic training education administrators should select preceptors who can successfully model professional responsibilities, present ATSs with authentic learning experiences, and promote higher-level thinking. We believe providing ATSs with exposure to preceptors who can meet these criteria may better prepare students for professional practice, alter persistence decisions, and should be a goal of clinical experiences for the benefit of ATSs.


2019 ◽  
Vol 14 (3) ◽  
pp. 156-166
Author(s):  
Jessica L. Rager ◽  
Julie Cavallario ◽  
Dorice A. Hankemeier ◽  
Cailee E. Welch Bacon ◽  
Stacy E. Walker

Context As professional athletic training programs transition to the graduate level, administrators will need to prepare preceptors to teach advanced learners. Currently, preceptor development is variable among programs and ideal content has yet to be identified. Exploring the development of preceptors teaching graduate learners can lead to an understanding of effective preceptorships. Objective To explore graduate professional athletic training program administrators' (ie, program directors', clinical education coordinators') experiences preparing and implementing preceptor development. Design Consensual qualitative research. Setting Individual phone interviews. Patients or Other Participants Eighteen program administrators (11 women, 7 men; 5.92 ± 4.19 years of experience; 17 clinical education coordinators, 1 program director). Participants were recruited and interviewed until data saturation was achieved. Main Outcome Measure(s) Interviews were conducted using a semistructured interview guide, and were recorded and transcribed verbatim. Data were analyzed by a 4-person research team and coded into themes and categories based on a consensus process. Credibility was established by using multiple researchers, an external auditor, and member checks. Results Participants reported the delivery of preceptor development occurs formally (eg, in person, online) and informally (eg, phone calls, e-mail). The content typically included programmatic policies, expectations of preceptors, clinical teaching methods, and new clinical skills that had been added to the curriculum. Adaptations to content were made depending on several factors, including experience level of preceptors, years precepting with a specific program, and geographical location of the program. The process of determining content involved obtaining feedback from program stakeholders when planning future preceptor development. Conclusions Complex decision making occurs during planning of preceptor development. Preceptor development is modified based on programmatic needs, stakeholder feedback, and the evolution of professional education. Future research should explore the challenges associated with developing preceptors, and which aspects of preceptor development are effective at facilitating student learning and readiness for clinical practice.


2020 ◽  
Vol 15 (1) ◽  
pp. 18-25
Author(s):  
Stephanie Mazerolle Singe ◽  
Sarah L. Myers ◽  
Matthew Campbell ◽  
Chad Clements ◽  
Lindsey E. Eberman

Context A clinical immersive experience is a new requirement within the clinical education standards as outlined by the Commission on Accreditation of Athletic Training Education. Objective Determine athletic training program administrators' perceptions of challenges facing athletic training programs as they implement immersive clinical experiences during clinical education. Design Sequential mixed methods. Setting Commission on Accreditation of Athletic Training Education athletic training programs. Patients or Other Participants Twenty-four administrators (7 male, 17 female) from 24 institutions with undergraduate and professional master's programs (1 undergraduate, 12 professional master's, and 4 offering both undergraduate and master's programs) responded to the survey, which was Phase 1 of the study. Seventeen of those who previously completed the Phase 1 survey volunteered to participate in Phase 2 of one-on-one, semistructured phone interviews (4 clinical education coordinators, 12 program directors, 1 department chair). Data Collection Phase 1: 24 participants completed an online survey. Phase 2: 17 of the 24 respondents participated in a one-on-one, semistructured phone interview. Quantitative data collected in Phase 1 were analyzed by calculating means and frequencies, and in Phase 2, a general inductive approach was used to evaluate qualitative raw data from the interviews. Researcher triangulation and peer review were completed for credibility. Results The 3 subthemes that emerged specific to administrators' perceived challenges regarding immersive clinical experiences for students were (1) isolation, (2) financial burden, and (3) time engaged in learning. The 3 main subthemes that emerged specific to the administrators' perceived challenges regarding immersive clinical experience for programs were (1) lack of a definition of the experience, (2) scheduling, and (3) preceptor involvement. Conclusions Program administrators continue to seek clarity on when and how immersive clinical experiences should be implemented. These challenges, if not addressed, could influence buy-in from the faculty and preceptors, and affect the success of the student.


2016 ◽  
Vol 11 (2) ◽  
pp. 72-81 ◽  
Author(s):  
Stephanie M. Mazerolle ◽  
Christianne M. Eason ◽  
Sara Nottingham ◽  
Jessica L. Barrett

Context: Mentorship is a developmental process whereby a novice individual, as he/she becomes inducted into his/her area of expertise, is guided by a more experienced person. Speculation exists that years of experience can impact this relationship. Objective: To determine the impact mentoring can have on athletic training student development and evaluate if experience as a preceptor is viewed as influential on the mentor experience. Design: Mixed-methods study. Setting: Commission on Accreditation of Athletic Training Education accredited programs. Patients or Other Participants: We recruited 17 (14 females, 3 males) athletic training students to participate in our study. On average, our participants were 21 ± 1 years old and represented varying levels of academic standing (1 sophomore, 9 juniors, 7 seniors). All participants indicated they currently had a mentor when asked directly. Main Outcome Measure(s): Participants responded to the Athletic Training Perceptions of Effective Mentoring survey and 14 open-ended interview questions regarding their perceptions of mentoring. An inductive approach was used to identify themes and supporting categories. Trustworthiness was established by using multiple-analyst triangulation, peer review and piloting of the instruments, and triangulation of data using a mixed-methods approach. Results: Athletic training students perceive their mentoring experiences as those that provide support and understanding, advance their clinical practice, and allow for the development of career goals. Age and experience did not appear to impact the overall experience of the student but rather facilitates the type of mentoring relationship developed. Conclusions: Mentoring was perceived to be an advantageous aspect of the socialization process for the athletic training student. It provided support and understanding during times of increased stress, allowed for the development of clinical skills, and provided the chance to cultivate a professional identity.


2017 ◽  
Vol 12 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Jessica R. Edler ◽  
Lindsey E. Eberman ◽  
Stacy Walker

Context: Clinical education is a foundational component of healthcare education by which students acquire, practice, and demonstrate competency in clinical proficiencies through classroom, laboratory, and clinical experiences. Currently, the most common practice of clinical education in athletic training is clinical integration. Objective: The purposes of this article are to describe how athletic training and similar health professions implement clinical education and to present clinical immersion as an alternative to clinical integration. Background: Clinical education is delivered differently across healthcare disciplines. Some disciplines use clinical immersion, while others use clinical integration. Some professions have specific requirements, while others are left to the discretion of the program administrators. However, few professions are measuring the effectiveness of each, leading to questions about best-practice models in clinical education. Description: Clinical integration occurs when students complete clinical and didactic course work concurrently, while in the clinical immersion model, students are immersed in patient care full time with little or no didactic course work. A hybrid model of clinical education includes both integration and immersion. Clinical Advantage(s): Preliminary research within nursing suggests that students engaged in clinical immersion perform better on certification examinations than do those from an integration model. The clinical immersion model is enhanced by the implementation of standardized patients and simulations to prepare students for immersive experiences. These encounters provide an opportunity for students to demonstrate competency before engaging in patient care, which promotes patient safety. Conclusion(s): Program administrators have the opportunity and professional responsibility to explore different curricular models and to ultimately develop better methods of preparing future athletic trainers. Moreover, educators have a responsibility to measure and report outcomes to help provide a body of knowledge regarding best practices in clinical education.


2007 ◽  
Vol 2 (1) ◽  
pp. 10-15
Author(s):  
Steve Cernohous ◽  
Sharon West

Objective: The objective of this paper is to present the practical use of a Mandala that: 1) provides opportunities for athletic training students to explore, reflect on and appreciate their clinical experiences; 2) provides educators with a model to understand and value athletic training student experiences; 3) organizes and captures factors and associated relationships that influence the athletic training student's clinical experience; and 4) provides impetus for further research and discussion between and among athletic training educators. Background: Athletic training educators often find it difficult to demonstrate and assess the behavioral component of learning. Creative teaching strategies and exercises that help athletic training students develop interpersonal competence, self-awareness, and self-reflection are needed in athletic training education. One approach to address this need is to employ the practical exercise of creating athletic training student Mandalas; portraits of self-expression and interpretation of their athletic training clinical experience. Description: The Mandala of Clinical Education depicts the individualistic and complex elements of the athletic training student clinical experience. It is a manifestation of a milieu of intrinsic and extrinsic elements, personal experience, and established research. The athletic training student is positioned in the center of the Mandala, embraced by contributing elements and the wholeness of the clinical experience. The artistic design reveals a series of gates, doors, and portals in which the elements of the student's experiences interact and serve as a point for self-reflection. Conclusion: Mandalas allow the athletic training student and educator opportunities to explore, understand, and value all clinical experiences in athletic training. Mandalas may also facilitate athletic training students developing interpersonal competence, self-awareness and self-reflection, all of which are key components to the foundational behaviors of professional practice.


2020 ◽  
Author(s):  
Reisha Rafeek ◽  
Bidyadhar Sa ◽  
Patrick Harnarayan ◽  
Niall Farnon ◽  
Shala Singh ◽  
...  

Abstract Background: The sudden advent of the COVID pandemic resulted in the closure of schools and universities in Trinidad, limiting face to face interactions and removing dental students from the clinical environment in The University of the West Indies. The dental school was challenged to complete the final year teaching with a rapid transition to online teaching. This study examined students’ and teachers’ perceptions of the effectiveness of emergency remote online teaching.Method: An online cross-sectional survey was administered on the perception of the online learning environment and challenges experienced and effectiveness of strategies used. Overall thirty-three dental students and eleven clinical academic teachers participated. The questionnaire was emailed to the participants for data collection and they responded by using a Likert scale. Reliability of the questionnaire was determined. Chi-squared (χ2) tests were applied for determining the perceptions of students and teachers towards online teaching. Frequencies and percentages were also computed.Result: Cronbach’s alpha of the students’ and teachers’ questionnaire was calculated at 0.838 and 0.801 respectively. The majority of students (60.6% - 89.5%) perceived that online teaching strategies, have enhanced their clinical reasoning and critical thinking skills in clinical practice, felt motivated to learn, liked learning in their own space, at their own pace and found it easy to adapt. Nearly two-third students (63.6%) were happy to recommend continued use of online strategies. However, the majority (87.9%) perceived it to be somewhat or not effective at all in acquiring clinical skills. The challenges experienced were problems with connectivity to the internet (87.9%) while (48.5%) had experienced distraction during remote teaching. All χ2 values were found to be statistically significant (either P<0.01 or P<0.05). The majority of teachers (72.7% - 92.9%) perceived that they created an enthusiastic online environment, effectively communicated with the students, engaged students in clinical reasoning and critical thinking and gave formative feedback. Teachers were equally divided on whether or not they prepared students to practice clinical skills.Conclusion: Students’ perceptions are similar to teachers’ perceptions in both are positive to the online teaching strategies but both groups reflected concerns over the acquisition of clinical skills.


2014 ◽  
Vol 9 (4) ◽  
pp. 166-173 ◽  
Author(s):  
Gary E. Morin ◽  
Sharon Misasi ◽  
Charles Davis ◽  
Corey Hannah ◽  
Matthew Rothbard

Context Clinical education is an important component of athletic training education. Concern exists regarding whether clinical experience adequately prepares students to perform professional skills after graduation, particularly with patients in emerging settings. Objective To determine the confidence levels of athletic training graduates in performing professional skills, providing care to patients in emergent settings, and to suggest improvements in clinical education. Design and Setting A descriptive design involving an online survey. The survey was administered via email 2 weeks after the closing of the April 2011 Board of Certification (BOC) examination window. Patients or Other Participants All 832 first-time candidates from undergraduate and graduate Commission on Accreditation of Athletic Training Education–accredited programs sitting for the BOC examination during the April 2011 testing window were surveyed. Eighteen percent (n = 166) elected to participate. Main Outcome Measure(s) Responses were acquired regarding levels of confidence in performing athletic training skills and caring for multiple patient populations. Participants were permitted to suggest improvements in clinical education. A multivariate analysis of variance was used to determine if educational setting played a role in confidence levels. Cluster analysis was used to develop high, moderate, and low confidence groups. Participants' comments were thematically separated into specific categories. Results Participant confidence levels were strong in performing athletic training skills on traditional patient populations, although body region was a factor. Lower confidence levels were reported for caring for elderly and special needs individuals, with insufficient clinical experiences stated as the primary cause. Confidence levels for recognizing nonorthopaedic concerns were lower than for recognizing musculoskeletal injury issues. Conclusions Participants felt confident in performing athletic training skills, particularly for athletic populations. Confidence scores were lower for other populations, and it is apparent that clinical experience with different patient populations is essential. Participants felt that greater clinical experiences are necessary, with further opportunities in clinical decision making and program administration decisions.


2009 ◽  
Vol 4 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Linda S. Levy ◽  
Greg Gardner ◽  
Mary G. Barnum ◽  
K. Sean Willeford ◽  
Patrick Sexton ◽  
...  

Introduction: The medical education model provides the basis for athletic training students to learn theoretical and practical skills. Clinical rotations are completed where they apply what they have learned under the direct supervision of a clinical instructor (CI) or approved clinical instructor (ACI). Approved clinical instructors are taught how to evaluate athletic training students' clinical skills and proficiencies, yet are left to decide for themselves how students should be supervised. No formal supervision training is required for potential CIs/ACIs. Situational Supervision is one potential model that can be used by athletic training educators to provide guidance to CIs/ACIs regarding student supervision. This model provides a method for students to be supervised according to their knowledge base, experience and self-confidence. Objective: To present the Situational Supervision Model that can be used to develop athletic training students' clinical skills. Background: Based on Blanchard and Hersey's Situational Leadership, Situational Supervision provides CIs/ACIs with one supervision model that can be used in athletic training clinical education. Description: As students become more comfortable with clinical skills and mature in motivation and competence, CIs/ACIs need to adapt supervision styles to match the students' progressing development. Clinical Advantages: Using situational supervision, clinical instruction becomes a cooperative interaction between CIs/ACIs and athletic training students that is dependent on the students' needs and abilities, which may result in higher satisfaction and production for both the students and the CIs/ACIs.


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.


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