Evolution of Athletic Training. Past, Present, Future

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1 Evolution of Athletic Training Past, Present, Future

2 Past 1800 s athletic trainers were present in the latter part of the century, however not formally recognized. ü Traditionally concerned with the athlete s health and safety, but has evolved to care for all who are physically active. Hired in 1897 to do odd jobs on campus and later as athletic trainer. For nearly two decades, the svelte trainer (sic) crouched on the sidelines of Clark Field with his pail of water on the ground and leather doctor s bag gripped tightly in his right hand as he awaited those faithful words; Texas timeout, Water, Henry. Although not formally trained as a doctor, Henry Reeves was aptly dubbed by those who observed him as the doctor of rubbing. (NATA News,02/06)

3 Past The first official, more recognized appearance of athletic trainers was right after World War I in intercollegiate athletics. ü 1930 s athletic trainers tried to form a national organization (National Athletic Trainers Association), however it didn t last long. ü 1940 s After struggling for existence the association disappeared during World War II.

4 Past 1950 s athletic trainers once again began forming a national organization In KC, Missouri athletic trainers met to establish professional standards and officially formed the National Athletic Trainers Association.

5 Past 1970 First national certification examination administered by NATA Certification Committee 1989 Board of Certification, Inc. (BOC) was incorporated in to provide a certification program for entry-level Athletic Trainers (ATs) athletic training recognized as an allied care profession by the American Medical Association

6 Past How to Become an Athletic Trainer Up until 2003 Two Routes 1) Internship route 2) NATA accredited curriculum route

7 Past Internship Route Take prerequisite courses in: ü Personal Health ü Human Anatomy and Physiology ü Kinesiology ü Exercise Physiology ü Basic Athletic Training ü Advanced Athletic Training ü First Aid/CPR 1500 practicum hours Pass Board of Certification Exam

8 Past NATA Approved Curriculum Route Take prerequisites courses in: ü Prevention of AT Injuries/Illnesses ü Evaluation of Athletic Injuries/Illnesses ü First Aid/CPR ü Therapeutic Modalities ü Therapeutic Exercise ü Administration of Athletic Training Programs ü Anatomy and Physiology ü Exercise Physiology ü Kinesiology ü Nutrition ü Biomechanics ü Psychology ü Personal Community Health 800 practicum hours Pass Board of Certification Exam

9 After 2003 only one route to certification ü Graduate from an approved Commission on Accreditation of Athletic Training Education (CAATE) program (earlier known as CAAHEP) Educated in 8 content areas: ü Evidence-Based Practice ü Prevention and Health Promotion ü Clinical Examination and Diagnosis ü Acute Care of Injury and Illness ü Therapeutic Interventions ü Psychosocial Strategies and Referral ü Healthcare Administration ü Professional Development and Responsibility A minimum of four clinical assignments Present Pass Board of Certification Exam Tested on 5 domains: ü Injury/Illness Prevention and Wellness Protection ü Clinical Evaluation and Diagnosis ü Immediate and Emergency Care ü Treatment and Rehabilitation ü Organizational and Professional Health and Well-Being

10 Present As of 2006 CAAHEP changed to CAATE ü (CAAHEP) Commission on Accreditation of Allied Health Education Programs ü (CAATE) Commission on Accreditation of Athletic Training Education CAATE is a self-accrediting body ü Makes the profession more credible ü Allows for autonomy

11 Present Complete 50 Board of Certification approved continuing education credits every two years. Range from: ü Seminars/Conferences ü Graduate Coursework ü Videos ü On-line Tests ü Etc.

12 NATA is organized with a board of directors with committees and separate regional districts ü 10 districts all together Now there are some 35,000 members and nearly 375 accredited academic programs Present

13 Future In 1996, the Education Task Force, identified 17 recommendations for reforming athletic training education. ü Some have been accomplished, others still are in the works! Healthcare demands are greater; more professional athletic training programs exist; the job market for athletic trainers has changed; state regulation of athletic trainers is more prevalent; and a shift in practice towards a medical model is apparent. Given these changes, the Executive Committee for Education developed out of 1 of the original 17 recommendations has developed a new plan for the direction of athletic training education. ü The Education Council, now the Executive Committee for Education, was established in Chad Starkey - first chair; Ken Knight - second chair; and Sara Brown - third chair.

14 Future Recommendation #1 Reform the Executive Committee for Education and its committees to a broader structure to: ü Identify and promote model practice in education ü Serve as a forum for special interest groups that relate to academic faculty, clinical education, post-professional education, and continuing education ü Facilitate scholarship in education ü Continue to partner with the CAATE, the Foundation and the BOC on joint initiatives

15 Future Recommendation #2 The NATA should conduct an analysis focused on professional education in athletic training to be completed by June A key outcome of this analysis is to determine the most appropriate professional degree to position athletic trainers to provide positive patient outcomes and ensure the longevity of the profession of athletic training.

16 Future Recommendation #3 Interprofessional education (IPE) should be a required component in professional and post-professional education programs in athletic training. ü Interprofessional education (IPE) occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care. ü IPE s are critical features to the professional education of healthcare providers and are especially relevant in today s healthcare environment in which no practitioners practice in isolation.

17 Future Recommendation #4 The NATA should encourage alignment of professional and post-professional education programs in schools of health professions. ü Creates easier opportunities for IPE s when programs are administratively located in schools of health professions. ü Housing athletic training programs in schools of health professions emphasizes the correct perception that athletic trainers are primarily healthcare providers.

18 Future Recommendation #5 The NATA should transition the responsibilities for accreditation of post-professional graduate degree programs and residency programs to the Commission on Accreditation of Athletic Training Education (CAATE). ü As an established independent accrediting agency, the CAATE is positioned to provide the administrative support necessary for all accreditation needs relating to post-professional and residency programs.

19 Future Recommendation #6 The NATA should encourage the development of residencies, specializations, and specialty certifications to provide career advancement and skill development specifically related to athletic training clinical practice.

20 Future Recommendation #7 The management and delivery services associated with the Athletic Training Education Journal should be integrated into those used for the Journal of Athletic Training. ü The current structure of separate publishing processes for two journals supported by the NATA creates some inefficiency that would be resolved by integrating the management and delivery services of the Athletic Training Education Journal (ATEJ) with the Journal of Athletic Training. ü In 2009, the ATEJ began using the same online submission and review platform (EJournalPress) as the JAT.

21 Future Recommendation #8 Significant effort should be expended to educate practitioners regarding the fundamentals of evidence-based practice and the use of outcome measures in their practice. ü This recommendation seeks to encourage the NATA to expand its support of the concept that EBP is the foundation of quality patient care.

22 Future Recommendation #9 The NATA should establish a mechanism for an interim review process for published position statements and rerelease of amended position statements as necessary. Additionally, a strategy to release new information that impacts the delivery of athletic training services and patient outcomes using multiple media strategies (eg, beyond print media) should be established to facilitate timely distribution.

23 Future Recommendation #10 The NATA and its strategic partners should adopt a model to frame the practice of athletic training using contemporary disablement model language. ü A model to frame athletic training practice, such as a disablement model, should be integrated into all of our educational endeavors and related communications. ü Disablement models facilitate the delivery of patient-centered, whole-person health care;. ü The profession of athletic training has failed to transition from a focus on disease-oriented evidence to an equal focus on patient-oriented evidence. Disease-oriented evidence is based on studies that examine the disease itself, such as cause, pathology, mechanisms of disease development and progression, prevalence, and prognosis. ü Alternately, patient-oriented evidence is focused on identifying the effect of a disease on a patient's health status, assessing the clinical examination procedures in determining diagnoses, and evaluating the effectiveness of treatment and prevention strategies. Such measures as morbidity, mortality, symptom improvement, cost reduction, and health-related quality of life (HRQOL) are patient oriented because patients inherently care about them.

24 Future Recommendation #11 The NATA, in collaboration with the Foundation, should continue its efforts to better inform our practice as athletic trainers and educators by identifying and supporting key areas of research as they relate to improving patient outcomes.

25 Future Recommendation #12 The NATA should examine issues surrounding transition to clinical practice both prior to and after certification. This assessment will give rise to identification of models that effectively support transition-to-practice for athletic trainers who have recently completed their professional education, certification, and licensure requirements. ü The new employment of other healthcare providers routinely includes a period of orientation and close supervision by an experienced provider. Identification of effective transition-to-practice models will serve as the foundation for a purposeful strategy that facilitates the change from student to practitioner.

26 Future Recommendation #13 The NATA should support the BOC s current efforts to establish facility accreditation standards.

27 Future Recommendation #14 The NATA should continue to foster advancement of new researchers in the development and execution of their research agenda. ü In order to capture the progress made in development of new researchers, the NATA, in collaboration with the Foundation, should continue to grow this support.

28 Recommendations and Their Impact Recommendations #2, #3, #4 - What is entry-level education? ü Currently, approximately 27 out of 375 (7.2%) professional programs are at the master s degree level ü Creative models for entry-level education include 2-3, 3-2, 4-1. ü Compelling questions to these recommendations see next slide!!

29 Continued Recommendations #2, #3, #4 Examples of Compelling Questions Include: 1) To what extent does transition to a professional degree at the post-baccalaureate level result in a better practitioner and, subsequently, better care for our clients/patients? ü a. Does isolated professional education (without competing institutional baccalaureate requirements) improve outcomes in terms of patient care, success on the Board of Certification examination, and job satisfaction? 2) How would a wide-spread transition to professional education at the postbaccalaureate level impact the number of graduates entering the profession and the number of institutions sponsoring CAATE-accredited athletic training education programs? 3) What is the impact on earning potential and student debt when comparing graduates of professional programs at the baccalaureate level and post-baccalaureate level? 4) How does the entry-level degree affect the perception of the profession by the public and other professions? 5) How does the entry-level degree affect how the profession is positioned with regard to evolving health care reform legislation?

30 Recommendations and Their Impact Recommendations #5, #6, #12 Post Professional Practice! ü Extensive debate surrounds our current educational processes and their impact on professional preparation, specifically as it relates to the ability of novice clinicians to practice independently. v The NATA Board of Directors approved the accreditation process for residency programs in 2010 and the first programs are currently engaged in the process. ü Historically, career paths of many athletic trainers are defined by changing practice settings or by assuming more of an administrative role. The development of accredited residencies, specializations, and specialty certifications is an important feature of re-defining career paths of athletic trainers in terms of increasing expertise in improving a patient s quality of care and life. v The next step is to develop resources to establish fields of specialization (Advanced Professional Practice) and to stimulate creation of more residencies with a plan to measure their value to both the clinician and the patient.

31 Continued Recommendations #5, #6, #12 An individual enters the profession of athletic training by passing the Board of Certification (BOC) exam. ATC s may then choose to pursue further advanced education and training at the post-professional level. A variety of post-professional athletic training education and training programs currently exist to support the professional development of athletic trainers. The CAATE accredits post-professional graduate athletic training programs (degree programs) and post-professional residency programs (certificate of completion).

32 Continued Recommendations #5, #6, #12 Post-Professional Graduate Athletic Training Programs The mission of a post-certification graduate athletic training program is to expand the depth and breadth of the applied, experiential, and propositional knowledge and skills of entry-level certified athletic trainers, expand the athletic training body of knowledge, and to disseminate new knowledge in the discipline. A.T. Still University University of Hawaii at Manoa Illinois State University Indiana State University Indiana University University of Kentucky Michigan State University Western Michigan University University of North Carolina Ohio University University of Oregon California University of Pennsylvania Temple University Old Dominion University University of Virginia University of Toledo

33 Continued Recommendations #5, #6, #12 Post-Professional Residency Programs The purpose of post-professional residency programs in athletic training is to provide advanced preparation of athletic training practitioners through a planned program of clinical and didactic education in specialized content areas using an evidence-based approach to enhance the quality of patient care, optimize patient outcomes, and improve patients health-related quality of life. Integrated Clinical Sports Medicine Residency for Athletic Trainers NHMI's Athletic Training Residency is the first residency ever to be accredited by CAATE.

34 Recommendations and Their Impact Recommendation #13 Athletic Training Rooms/Healthcare Facilities ü Development of a facility accreditation process would provide guidance for employers and athletic trainers in developing their healthcare facilities and policies. ü No longer should the Athletic Training Room be considered a place between to locker rooms. ü Instead it is a place where healthcare practitioners are tending to patients, as such the room needs to comply with healthcare facility standard. ü Think about it! Colleges have student health centers and high schools have a room for the school nurse all of which that operate as a healthcare facility. For example: Documentation, confidentiality, blood borne pathogen barriers, blood borne pathogen containers, equipment safety inspections, proper sanitation precautions, emergency action plans, patient confidentiality, safe working environments.

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