Integrating Safe Space Ally Training Into the Athletic Training Curriculum

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.

A Tiered Approach for Integrating Patient Outcome Measures into the Curriculum

Context Knowledge and understanding of effective practices for integration of patient-reported outcome measures (PROMs) within athletic training curricula are necessary to bridge the gaps between didactic application, content assessment, and clinical implementation. Objective To provide athletic training educators with a tiered approach to implement content and assessments related to PROMs in the athletic training curriculum. Background An emphasis in the athletic training community is the need to incorporate patient-oriented evidence that matters into clinical practice. One way of achieving this transfer of knowledge is incorporating PROMs into athletic training curriculum. The 2020 Commission on Accreditation of Athletic Training Education (CAATE) Standards include PROMs and strategies to evaluate them for use in clinical practice to improve patient care. Thus, stakeholders responsible for students' education must have the knowledge and ability to properly address these standards in order for students to utilize these skills as future athletic trainers. Description This article offers an approach for educators to teach and assess PROMs within their athletic training curriculum. Clinical Advantages By utilizing an effective teaching approach for the implementation of PROMs, educators, preceptors, and students may collectively integrate these validated tools accurately into patient care to provide a more holistic practice. In addition, using a tiered approach will increase understanding and confidence for athletic trainers who have identified barriers and may not have prior clinical experience in the implementation of PROMs with patient care. Conclusions The knowledge and use of PROMs are expected of students in CAATE-accredited athletic training programs. In order to ensure and enhance the transfer of knowledge from the didactic setting to clinical practice, the use of a tiered approach may benefit athletic training educators as they integrate this content into coursework. In turn, perhaps future clinicians may be more apt to value the benefits of PROMs.

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.

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

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.

Lean Six Sigma and Athletic Training: A Primer for Athletic Training Educators

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.

High Reliability: A Primer for Athletic Training Educators

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.

An Exploration of Mosston’s Spectrum of Teaching Styles in Athletic Training Education

Athletic training educators teach in didactic, laboratory and clinical settings, all requiring an array of pedagogical strategies to effectively instruct students. Mosston’s Spectrum of Teaching Styles is a theoretical framework to support pedagogical decision making in physical education. The purpose of the commentary is to examine teaching styles from Mosston’s Spectrum in the context of athletic training education. A general introduction, review of comparative literature and practical application to athletic training education is provided for each of the eleven teaching styles. The examination and application of educational theory from other disciplines may provide athletic training educators additional resources to enhance student learning.

Athletic Training Students' Perspectives and Performance When Learning Online

Context Technology continues to change throughout the world, and higher education is not absent from the adjustment. Athletic training educators should adapt to online learning opportunities that enhance the curriculum for their students. Objective To explore athletic training students' thoughts and knowledge when learning through a distance education platform. Design Cross-sectional, mixed-methods survey. Setting Six professional postbaccalaureate athletic training programs. Patients or Other Participants A total of 55 second-year athletic training students. Intervention(s) One-week asynchronous eLearning module focused on the background and use of telemedicine in health care. Main Outcome Measure(s) Participants completed the technology acceptance model tool before and after the module to gather their perspectives about online learning. During the eLearning module, knowledge acquisition was assessed with quizzes. Finally, a transactional distance theory tool including 2 open-ended response items was delivered at the end of the eLearning module. Results We identified that participants had a low acceptance for technology at the onset of the study that improved after the eLearning intervention for the constructs of self-efficacy (P = .010) and perceived ease of use (P ≤ .001) of eLearning technologies. The transactional distance tool highlighted that the facilitator and readings were helpful, which was also indicative of the scores on the module quizzes. We also identified benefits to eLearning from the student perspective, which included previous experiences, learning on their own time, and feelings that the module was productive to their growth as students. Some participants stated that the eLearning module presented too much work and was missing interaction, whereas others were neutral relative to the comparison between traditional and online learning. Conclusions Overall, the results of this study identified that technology acceptance and transactional distance are important components of online learning. Athletic training educators should educate learners regarding the differences in online education requirements.

Stakeholder Perceptions of Clinical Immersion in Athletic Training Programs

Context Multiple concepts contribute to effective clinical education practice, such as professional socialization, mentoring, and intergenerational learning differences. As the professional degree transition occurs, programs are being afforded the opportunity to restructure clinical education experiences. In March of 2018, the Commission on Accreditation of Athletic Training Education released the newest version of the professional program accreditation standards, and 1 of the new standards that has been adopted requires programs to include a 4-week immersive experience. This concept of immersion as a means to deliver clinical education is not a new concept, but few use it in athletic training. Objective Identify perceptions of immersion as seen by athletic training educators and offer potential integration methods. Design Qualitative interviews conducted over the fall and winter of 2017. Setting Individual phone interviews. Patients or Other Participants Eleven athletic training educators with a variety of demographic characteristics. Main Outcome Measure(s) We analyzed data using the constant comparative method (2 researchers). A third then analyzed data for triangulation. Results Three themes were identified: (1) benefits of immersion, (2) implementation concerns, and (3) strategies for implementation. Conclusions Although many debate the length of immersive experiences and the value that such an experience brings, educators within this study agreed that immersion would provide benefits to their current clinical offerings. Additionally, individuals currently offering immersion experiences provided real-life examples and strategies that have the potential to provide insight and guidance for those who are still looking at options for implementation.