Lifesaving Medications Use By Athletic Trainers

The athletic trainer's (AT) emergency management skill set requires competency in the delivery of basic lifesaving medications. Some lifesaving medications have been a part of athletic training practice for decades, but that list has grown as ATs' practice setting has expanded - increasing the types of em ergent conditions that the AT may have to treat. The 2020 CAATE curricular standards require athletic training students be trained to administer the following: supplemental oxygen, nitroglycerine, low dose aspirin, bronchodilators, epinephrine using automated injection device, glucagon, and naloxone. Clinically, the conditions treated by these medications can be categorized as follows: cardiac, respiratory, hypoglycemia, or anaphylaxis. All ATs should know the indications, contraindications, administration methods, and the details of patient monitoring for each medication. Generally, these medications are safe, have clear indications for use, and few contraindications. While ATs are trained to administer these medications, they must consider state laws and local policies.

Promoting Interprofessional Communication through Situation, Background, Assessment, and Recommendation (SBAR): An Educational Technique

Context The Board of Certification Standards of Professional Practice and the 2020 Curricular Content Standards indicate athletic trainers should establish working relationships with collaborating medical professionals and be able to communicate effectively. In addition, increased emphasis on interprofessional collaboration (IPC) in practice is apparent throughout health care professions and their educational programs. However, integrating both interprofessional communication and IPC within 1 learning opportunity can be difficult. Objective To share an educational approach aimed to enhance athletic training students' abilities and confidence in delivering patient information to physician assistant students via the situation, background, assessment, and recommendation (SBAR) technique. Background As part of the health care team, athletic trainers need to communicate with various providers while making clinically based decisions. Anecdotally, learners in their final year of health care education are not confident in their ability to make recommendations to other health care professionals. The SBAR communication strategy from the evidence-based framework TeamSTEPPS has become widely adopted in health care disciplines and may help to enhance confidence in communication. Description This learning activity enables athletic training students to use a patient case scenario to develop an SBAR for delivery via phone to a physician assistant studies student. This article describes the content, delivery methods, outcomes to date, and connection to the 2020 Curricular Content Standards. Clinical Advantage(s) This clinically relevant activity provides a low-stakes, real-life opportunity for students to practice communication skills, including the following: condensing the evaluation process, clinical decision-making skills, and the ability to make recommendations for a plan of care. Active participation in the communication process enhances reasoning skills needed for collaborative clinical decision making and the transfer of care, when applicable. Conclusion(s) Developing and implementing an interprofessional SBAR communication experience with 2 health care disciplines is an innovative strategy that bridges the gap between clinical education and actual patient care experiences while addressing curricular content needs.

Interactive Activities to Aid in a Comprehensive Understanding of Mental Health Within the Professional Athletic Training Curriculum

Context Mental health is a significant issue in the United States, with approximately 18.5% of adults and 22% of adolescents having a diagnosable mental illness. Athletic trainers are in a prime position to recognize signs of mental health illness in their patients and to facilitate referral to a mental health professional. Objective To introduce interactive approaches for developing mental health first aid and referral skills in professional athletic training students. Background Although the 2020 Commission on Accreditation of Athletic Training Education curricular content standards require programs to educate students about identification and referral for mental health conditions, the standards do not provide specific suggestions for instructing this content. Description Three educational activities have been implemented into the curriculum: an exploratory counseling session, Mental Health First Aid certification, and a standardized patient encounter. Clinical Advantage(s) The exploratory counseling session improves athletic training students' empathy for individuals living with mental illness. The Mental Health First Aid curriculum has been shown to raise awareness of mental health conditions and positively influence the number of people who receive professional help. Standardized patient scenarios have been shown to increase critical thinking and confidence with mental health cases and to increase knowledge in mental health assessment. Conclusion(s) Students' reflections support that these components have increased their competence and confidence in recognizing, intervening, and making referrals for individuals with suspected mental health concerns.

The Impact Grit and Achievement Goal Orientation have on Athletic Training Students' Persistence

Purpose: Athletic training education continues to evolve thereby increasing the importance of student retention. Understanding student motivation through achievement goal orientation and grit scores may help support student’s persistence in an athletic training program. The purpose was to determine if a relationship exists between achievement goal orientation and grit to help provide educators a better understanding of their students’ reasons for persisting to help improve retention. Methods: An achievement goal orientation survey and grit scale were administered, and quantitative data was analyzed statistically from Commission on Accreditation of Athletic Training Education- accredited programs in good standing for the 2018-2019 academic year. Results: A total of 520 professional athletic training students participated. There was a significant main effect (F(1,3)=690.0, pConclusions: Athletic training students have similar grit scores across all cohorts and classify higher with mastery goal orientation compared to performance-approach, performance-avoidant, and work-avoidant orientations. Educators should understand students’ motivation to provide support and challenging tasks for their passion and perseverance for athletic training. Key Words: grit, mastery, performance-approach, performance-avoidant, work-avoidant.

The Scavenger Hunt: An Educational Technique for Preceptors and Athletic Training Students

Context Entry-level athletic trainers (ATs) often lack tools necessary to help build confidence and professional networks, especially if they are the only clinicians in their facility. One-way athletic training education can help is to encourage preceptors to assist in mentoring athletic training students (ATSs) as they navigate the shift from student to AT. Objective To describe 1 educational technique developed by a preceptor that showcases effective mentoring, networking, volunteer opportunities, and communication. Background Mentorship is important for all entry-level ATs. By providing opportunities before graduation and assisting ATSs in learning how to network and communicate with potential mentors, future ATs can then continue the mentoring pipeline as they accept preceptor positions. Description This activity was developed by a preceptor while the ATS was in her immersive setting. It provided the ATS an opportunity to develop networking skills while still having support from the preceptor as mentor and while also growing the number of colleagues in her network. By providing a self-discovery activity, the ATS learned how to effectively maneuver through a large conference while gaining confidence, contacts, and a better understanding of the profession. Clinical Advantage(s) The preceptor developed a mentoring relationship with the ATS while also giving her the opportunity to build connections and identify characteristics that she would like to have in future mentors. Conclusion(s) Networking is often a difficult skill for new professionals. By creating this scavenger hunt, the preceptor demonstrated effective mentoring in addition to pushing the ATS outside of her comfort zone to develop her own professional network and observe how professionals can give back to their association.

Program Directors' and Athletic Training Students' Educational Experiences Regarding Patient-Centered Care and Transgender Patient Care

Context The United States transgender patient population often suffers from insufficient health care and faces barriers to obtaining health care. Understanding the current classroom education provided in professional athletic training programs related to patient-centered and transgender patient care is necessary to foster improvements to the education of future health care providers. Objective To explore the education, comfort, and experience of professional athletic training students and program directors (PDs) on patient-centered care (PCC) and transgender patient care. Design Cross-sectional survey. Setting Online survey. Patients or Other Participants A total of 74 PDs of Commission on Accreditation of Athletic Training Education-accredited professional athletic training programs (age = 46 ± 9 years) and 452 athletic training students (age = 23 ± 3 years) responded to the survey. Data Collection and Analysis Two surveys were created from literature and were reviewed by a committee of content experts. Participants were sent links to their respective survey in March 2020. Surveys contained questions on demographic information, PCC, and transgender patient care. Data were analyzed descriptively with follow-up χ2 analyses comparing athletic training students' comfort and competence between those who learned and did not learn about transgender patient care. Results Most PDs reportedly felt comfortable (98.6%, n = 73) and competent (94.6%, n = 70) teaching PCC. Half (50% n = 37/74) of PDs include transgender health care in their program's curriculum but lacked competence (37.8%, n = 28) in teaching. All students felt comfortable (100%, n = 452) and competent (98.7%, n = 446) practicing PCC, but only 12.4% (n = 54) reported practicing it during clinical education. Less than half (43.1%, n = 195/452) of students learned about transgender patient care, yet most (78.3%, n = 354) felt comfortable but lacked competence (41.8% n = 189). Conclusions Few students reportedly practice PCC during clinical education. Both groups perceived deficiencies in competence related to transgender patient care. We suggest PDs teach transgender health care in their curriculum and seek professional development to create meaningful educational experiences.

Prevalence and Predictors of Burnout in Athletic Training Students: A Comparison of Undergraduate and Graduate Students

Context Burnout is a psychological syndrome consisting of increased emotional exhaustion (EE), depersonalization (DP), and decreased personal accomplishment (PA). To date, examinations of burnout among athletic training students (ATS) is limited. Objective To determine prevalence and antecedents of burnout among ATS. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants Students enrolled in athletic training programs (ATP). Intervention(s) A survey assessed demographics, stressors, and burnout measured by the Maslach Burnout Inventory–Human Services Survey. Main Outcome Measure(s) Multiple regression analyses were used to determine relationships between variables. Results A total of 725 students participated. Most respondents were undergraduates (n = 582, 80%), female (n = 518, 71%), Caucasian (n = 564, 78%), and single (n = 422, 58%). Mean burnout scores for EE, DP, and PA were 33 ± 10, 17 ± 4.5, and 39 ± 5.8, respectively. Survey responses showed that 70.8% of undergraduate and 62.9% of graduate students reported high EE. All the students (100%) in both samples reported high DP. Undergraduates pursuing internships or residencies (b = −7.69, P < .001) and who were currently enrolled in non–Division I institutions (b = −2.90, P < .01) had decreased EE. Increased stress revealed increased EE (overall stress: b = 3.11, P < .001; social stress: b = 1.32, P < .05; class stress: b = 1.45, P < .05). Increases in clinical hours also related to increased EE (b = 1.49, P < .001). Those pursuing internships or residencies (b = −2.10, P < .05) and who were female (b = −2.10, P < .05) reported decreased DP. Being married (b = 2.87, P < .01), increased clinical hours (b = 0.77, P < .001), and social stress (b = 0.59, P < .05) resulted in increased DP. Increased PA was seen in students intending to pursue graduate education (b = 1.76, P < .05) and female students (b = 1.17, P < .05). Graduate students' stress levels revealed increased EE (b = 6.57, P < .01) and DP (b = 0.98, P < .05). Conclusions Differences exist between undergraduate and graduate burnout scores and associated predictors. Further research is needed to identify student responses to burnout.

Implementing Suicide Prevention Training into an Athletic Training Curriculum: An Introductory Model

Context Best practice guidelines indicate the need for suicide prevention training for athletic trainers. However, no resources exist that address suicide prevention programs that are specifically designed for athletic trainers and their roles working with student-athletes and mental health crisis teams. Objective To describe an introductory model for implementing suicide prevention training into an athletic training curriculum. Background Current Commission on Accreditation of Athletic Training Education standards identify suicidal ideation as one of the behavioral health conditions that need to be addressed within athletic training curricula. Introducing educational models for implementing suicide prevention training and mental health emergency action plans (EAPs) into curricula will assist educators in preparing athletic training students to recognize and assist student-athletes who are in a suicidal crisis. Description An introductory educational model for implementing suicide prevention training into an athletic training curriculum that highlights gatekeeper training, appropriate suicide terminology, recognition of suicidal ideation in student-athletes, proper responses to student-athletes in crisis, use of experiential exercises, and development of a mental health—suicide-specific EAP. Clinical Advantage(s) Within this educational model, a threefold benefit exists for athletic training students: (1) engagement in meaningful experiential exercises to enhance their readiness to enter clinical practice with the skills and knowledge needed to recognize, assist, and refer student-athletes dealing with suicidal ideation; (2) skill development in the design, development, and implementation of a mental health—suicide-specific EAP; (3) interdisciplinary collaboration with mental health professionals that enhances appreciation for their expertise and promotes the value of each professional's role on the mental health crisis team. Conclusion(s) This introductory model for implementing suicide prevention training within an athletic training curriculum offers an instructional strategy that supports the Commission on Accreditation of Athletic Training Education standards, professional readiness for athletic training students, and interdisciplinary collaboration among mental health and athletic training professionals.

Biotensegrity Is Needed in Athletic Training Professional Education

Context Tensegrity is a structural-organization model initially described in the architecture and design fields. By applying tensegrity design principles to biological structures, scientists have developed biotensegrity to explain a complex systems-on-systems structural-organization philosophy for integrated human movements. Objective To provide a brief historical overview of tensegrity and biotensegrity principles, including recommendations and benefits for integrating these structural models into athletic training education. Background Tensegrity and biotensegrity structures require constant interaction between continuous tension and discontinuous compression elements that connect through focal adhesion points. During the 1970s and 1980s, scientists applied tensegrity concepts to biological organisms to create an integrated model of human structure and interaction. Since then, biotensegrity has grown as an accepted biological structural model capable of explaining complex and integrated human movements. Synthesis By teaching tensegrity and biotensegrity principles, athletic training educators can provide athletic training students with a basic and consistent human body structural model. With this knowledge, students can better comprehend the integrated kinetic chain, including current and future prevention, examination, and rehabilitation paradigms. Results Although absent from the Practice Analysis, seventh edition, and the 2020 Commission on Accreditation of Athletic Training Education curricular content standards, tensegrity and biotensegrity relate to many injury prevention, examination, treatment, and rehabilitation concepts regularly taught in professional athletic training programs. Recommendation(s) Athletic training educators should consider ways to incorporate biotensegrity models into professional athletic training programs to improve critical thinking and whole-person health care principles of athletic training students. Conclusion(s) Integrating tensegrity and biotensegrity principles into professional athletic training programs provides a structural hierarchy of human body organization that athletic training students can apply to a multitude of current and future methodical approaches.

Self-Confidence and Perceptions of Athletic Training Students Following Simulated Experiences: A Mixed-Methods Pilot Study

Purpose: Athletic training clinical education provides students with a variety of real-life patient encounters under the supervision of a credentialed athletic trainer. However, clinical education experiences may not allow for all students to practice more invasive or less common skills such as rectal thermometry. The purpose of this study was two-fold: 1) determine the effect of a series of low to high-fidelity simulated rectal thermometry experiences on athletic training students’ self-confidence scores; and 2) through a phenomenological qualitative approach, explore athletic training students’ perceptions following the simulated rectal thermometry experiences. Method: This study used a quasi-experimental, mixed methods, one-group repeated measures design. Participants were nine first year professional Master of Athletic Training students who completed four simulated experiences on the skill of rectal thermometry. The outcome measures were The Athletic Trainer’s Self-Confidence Scale (ATSCS) and qualitative semi-structured open-ended interviews. Results: Friedman’s ANOVA revealed a statistically significant improvement from the participant’s baseline ATSCS scores to the last post-test scores. We identified three major themes following qualitative interviews: 1) Perception changes before and after participation; 2) Benefits of a series of four simulations; 3) Explanations for the improvements in confidence and competence. Conclusions: A series of simulated learning activities using high-fidelity and standardized patient interactions can help improve athletic training students’ self-confidence. Though future research is needed, athletic training education programs should consider implementing simulated experiences to equip athletic training students to transition to practice.