Athletic training education program directors (PDs) face the

Athletic Training Education Journal; 2008;3(Jul-Sep):115-122 115 by the National Athletic Trainers Association, Inc. www.nataej.org Using a Web-Based Database to Record and Monitor Athletic Training Students Clinical Experiences Kirk W. Brown, PhD, ATC; Lisa Williams, MLS; Thomas Janicki, PhD University of North Carolina Wilmington, Wilmington, NC Objective: The purpose of this article is to introduce a documentation recording system employing the Microsoft Structured Query Language (MS-SQL) database used by the Athletic Training Education Program (ATEP) for recording and monitoring of athletic training student (ATS) clinical experiences and hours. Background: Monitoring ATSs clinical experiences and hours can be a monumental task for an athletic training education program director (PD). This article seeks to explain and demonstrate how a web-based database is incorporated into an athletic training education program to manage the ATSs clinical experiences. To date, a thorough review of the literature did not reveal any published documentation of a web-based database being used for monitoring ATSs clinical Athletic training education program directors (PDs) face the daunting task of monitoring and maintaining national accreditation standards set forth by the Commission on Accreditation of Athletic Training Education (CAATE). Management of the ATEP carries with it a multitude of responsibilities which may involve tenure and promotion, academic advising, athletic team travel, teaching, and monitoring clinical experience hours for athletic training students (ATSs), which can 1-3 create time management challenges. Documentation of clinical experiences allows a PD to monitor and ensure ATS clinical experience diversity. Maintaining accurate documentation also 4 helps meet CAATE accreditation Standard J3.5 and ten states Practice Acts that still require documentation of clinical hours as 5, 6 part of their application process. The purpose of this article is to introduce a documentation recording system that uses a web-based Microsoft Structured Query Language (MS-SQL) database. This Dr. Brown is an Assoc. Professor and ATEP Director at the Univ. Of North Carolina Wilmington. brownk@uncw.edu Lisa Williams williamsl@uncw.edu Tom Janicki janickit@uncw.edu experiences. In our ATEP, prior documentation of the ATSs clinical experiences consisted of a paper-based system which involved the ATS writing down their clinical hours and having their assigned approved clinical instructor (ACI) or clinical instructors (CI) verify them. After reviewing other software application programs (i.e., Microsoft Excel and Microsoft Access), it was determined that these programs did not provide the flexibility needed for a program-wide database. Therefore, time management and evaluation accessibility constraints played a pivotal role in the decision to move to a web-based database. Key Words: W eb-based Clinical Documentation, Computer- Based Clinical Education Management, Clinical Hours, CAATE Standards, Database, Clinical Experience password protected website system allowed ATSs and their supervisors to remotely record and monitor their clinical experiences. During the past six years, a paper-based system was used in our ATEP to document ATS clinical experience hours. Athletic training students were required to write down the clinical hours they earned each week and have them verified by their ACI or CI. The weekly paperwork was kept on file for each of the six semesters that the ATS was enrolled in the ATEP. However, as the number of ATSs in the ATEP increased, the paper-based documentation system became time consuming and cumbersome. Time management and document handling concerns were the most significant determining factors when changing the documentation process. While software applications such as Microsoft Access and Microsoft Excel were reviewed by the PD to assist with the transition from paper documentation to electronic 7 documentation, departmental and academic responsibilities did not allow the PD the time necessary to learn and create an electronic system for recording clinical hours. Fortunately, a potential solution presented itself in house at UNCW, when the ATEP program was approached by the Information Systems and Operations Management (ISOM) department to collaborate on a student project that would create a web-based solution employing 8 an advanced database. This one to two semester-long project pairs an ISOM student with either an internal University or an external community-based client to develop a real world solution to a problem. In this

116 Brown - Web-Based Database situation, an ISOM student worked with the PD to establish what criteria to include in the database based on CAATE accreditation requirements. The requirements selected from standard J3.3 include: equipment intensive, general medical, and upper and lower extremities intensive experiences. The type of clinical experience, the activity, gender of the participants, practice or a game, and the location of the experience (i.e., on-campus, high school, or professional teams) are also required to be documented. Once desired criteria were determined, the PD and the ISOM student established an easy means for the end user (i.e. PD) to enter data and verify reported clinical hours. The current semester s clinical assignment schedule was also posted to the database. The web-based database is composed of three main components that reflect each of three different user type s data entry and reporting needs. The first type of user is the Administrator, who has rights to modify and update all data; the second type is the ACI or CI who has rights to verify their ATS s clinical hours; and the third user type is the ATS who can only enter their clinical experience hours. The Administrator s page, which includes the Administrator Options, ACI or CI Options and Student Options, can be only managed by the PD or the Clinical Coordinator (CC). To access the reports and verify options, the Administrators, ATS, ACI or CI select the login page (http://csbapp.csb.uncw.edu/athtraining) from the UNCW Athletic Training web site under Clinical Hours. Key Administrator options include: adding users, validating activities, validating locations, and assigning ATSs to an ACI or CI. Each of these is described below. Once the user has logged into the system, the menu choices offered were based on their role in the system (and database). For example, the PD or CC sees the Administrator s Options which includes the report options, data entry fields, and semester clinical rotation schedules (Figure 1). The data entry fields include Assign AT Student to an ACI/CI, Activities, Locations, and Users, and are used to compile or edit the clinical hours documentation database. The first step in compiling this database involved adding user types. In the Users field, the categories include ATS majors (1 st nd rd year, 2 year, 3 year), Pre-Athletic Training Student (PRATS- which are the observation students that have not been formally admitted into the ATEP), alumni, ACI or CI, and Inactive (Figure 2). The data entry form for users included the user s university identification number, email address, first and last name, and user category. ACIs and CIs were listed in a drop-down menu at the bottom of the form (Figure 3). The database was designed so that when a new user is added to the system, an automatic email notification is generated that gives instructions on how to access and use the web-based database. The second step in developing the database was entering the various clinical experience locations. In the Location field, the Administrator is able to add new locations, edit previously entered locations and change the status of the location to active or inactive (Figure 4). The third step in compiling the database was linking valid clinical experiences to the supervising ACI or CI. The Activities field allowed the Administrator to add the activity description based 4 on CAATE Standard J3.3 and select the activity gender, type, and location(s) from a drop-down menu (Figure 5). Once the information in the activities field was added by the Administrator, the ATS was able to record their clinical experience (See Student Options) and the Administrator was able to edit previously entered activities (Figure 6). Figure 1. Entry fields for Administrator, ACI/CI and ATS

Athletic Training Education Journal 2008;3(Jul-Sep) 117 Figure 2. Different types of users Figure 3. Select CI/ACI user type

118 Brown - Web-Based Database Figure 4. Location name and status Figure 5. Add a new activity description

Athletic Training Education Journal 2008;3(Jul-Sep) 119 Figure 6. Add a new activity The Assign AT Students to an ACI/CI field allows the Administrator the option to view and edit the ATSs level in the ATEP and their ACI or CI assignment (Figure7). This option is designed to allow for better time management for the Administrator by displaying the complete list of ATSs on one screen. This option is beneficial as the number of ATSs grows in the ATEP. The last field in the Administrator Options is the Clinical Rotation Schedule (Figure 1). The ATS are assigned to their ACI or CI at the beginning of the school year and are entered into a Microsoft Word document that is uploaded for all of the ATSs and ACI or CI to view. Everything in the database is controlled by data entry, but the Clinical Rotation Schedule is a separate document that is stored on the Administrator s computer and uploaded to the server for access by all participants. The web system is programmed to retrieve the Clinical Rotation Schedule for display when requested. The Semester Dates field allows the Administrator to set the academic calendar for when the clinical rotations begin and end each semester. The Change length of time to verify allows the Administrator to set a date limit of how many days the ACI or CI has to verify the ATS clinical hours. This option is put into place to persuade the ACI or CI to be timely with their verifications (we currently have it set at 15 days). The ATS is affected by the timeliness of clinical hour s verification because they are not able to view their total hours completed until the ACI or CI has verified their hours. Figure 7. ATS assignments to their ACI/CI

120 Brown - Web-Based Database ACI/CI Options When the ACI or CI logged into the database, they saw ACI/CI Options which included clinical hour reports by ATSs, ACI/CI hour verification for the ATS, and the clinical rotation schedule (Figure 1). However, the ACI or CI was only able to view and verify their current ATS s assignments and clinical hours. Student Options When the ATS logged into the database, they saw Student Options (Figure 1) which included a data entry field for recording clinical experiences, a semester summary which allowed them to view their total clinical hours per semester, and the clinical rotation schedule. A demonstration of the six steps necessary to enter clinical experiences into the database is outlined in Figure 8. The ATS was also able to record or edit clinical hours by selecting the Record / Edit Hours link to access the activity, experience, gender, game/practice, location, and date/time. Once the required information was recorded, the ATS could generate a detailed report of their clinical experience. The other two links in the Student Options were the Semester Summary and Clinical Rotation. While the Semester Summary link generated a report of the ATS clinical experience for each semester that has been verified by their ACI or CI, the Clinical Rotation link allows the ATS to download their next clinical rotation assignment which has been uploaded by the Administrator. Figure 8. Six steps for clinical experience documentation

Athletic Training Education Journal 2008;3(Jul-Sep) 121 Generating Reports The ATS and Administrator were able to view two different types of reports (Figure 9): a detailed report and summary report through the link Reports by AT Student. The detailed report (Figure 10) listed all of the ATSs approved clinical experiences for the current semester and the summary report (Figure 11) listed the ATSs approved clinical experiences for the current semester as well as past semesters cumulative hours. The summary report was further divided into four categories: 1) number of approved clinical hours for the current semester; 2) number of approved clinical hours cumulative; 3) percentage of approved clinical hours for the current semester; and 4) percentage of approved clinical hours cumulative. At the beginning of each semester, the total number of approved clinical hours and the percentage of approved clinical hours were reset at zero. The cumulative clinical hours and percentages reflect all previous past semesters. The ability for the Administrator to see semester and summary reports for single and all students were a key time saving feature of the (Figure 12). Figure 9. Reports by AT Student Figure 10. Detailed ATS Report Figure 11. Summary Report

122 Brown - Web-Based Database Figure 12. All current ATS semester report Conclusion From conception, the design, development and beta-testing of the web-based database took about one year. During that period, modifications were made to eliminate programming errors. While construction and modification of this web-based database required the technical expertise of a MS-SQL language programmer, end users (i.e. PDs) did not need to understand the technical requirements to successfully use the system. Since its inception, additional useful features such as downloading reports into Excel spreadsheets, retrieval of archived data, and separate report for PRATS (which mirrors the ATSs report) have been added. Adopting the web-based database over the paper-based system has come with a price. For example, a MS-SQL server was required to compress and store data, and technical support for maintaining the server, backing up data and increasing the server s capacity as the database grows with a growing ATEP were also necessary. Furthermore, to prevent data loss from system failure, the database was backed up nightly. Informal face to face conversations with ATSs, ACIs, and CIs determined there was a very small learning curve when adopting the web-based database. These stakeholders found the database very user friendly and more convenient to monitor their clinical hours when compared to the paper-based system. They especially valued the flexibility offered by its remote access. The computer-based system also gave the PD access to easily sorted and retrieved ATS data for required CAATE reporting. Overall, the database provided a central location for storing ATS clinical experiences, reduced the chance for human error with miscalculations and misplaced paper documentation, and offered an easier way for all ATEP participants to work collaboratively to monitor the ATSs clinical experiences. References 1. Judd MR, Perkins SA. Athletic Training Education Program Directors' Perceptions on Job Selection, Satisfaction, and Attrition. J Athl Train. Jun 2004;39(2):185-192. 2. Perkins SA, Judd MR. Dilemmas of Program Directors: Then and Now. J Athl Train. Dec 2001;36(4):396-400. 3. Capel SA. Attrition of athletic trainers. Athletic Training. 1990;25(1):34-39. 4. Commission on Accreditation of Athletic Training Education. Standards for the Accreditation of Entry-level Athletic Training Education Programs. CAATE 2007. 5. Blackburn TA, Guido JA. Rehabilitation after ligamentous and labral surgery of the shoulder: Guiding concepts. Journal of Athletic Training. 2000;35(3):373-381. 6. State by state, athletic training advances. NATA News; December 2006:14. 7. Nelson E. Using Access or Excel to manage your data. http://office.microsoft.com/en-us/help/ha010429181033.aspx. Accessed November 11, 2007, 2007. 8. Janicki TN, Fischetti D, Burns A. Incorporating real world projects and emerging technologies into one MIS capstone course Information Systems Educators Conference. Dallas, TX; 2006. 9. Musthaler L. Making databases, apps more efficient Making databases, apps more efficient. Network World. 09/17/ 2007;24(36):48-48.