Master s Level Professional Athletic Training Programs: Program Characteristics, Graduation Requirements, and Outcome Measures

ATHLETIC TRAINING EDUCATION JOURNAL Q National Athletic Trainers Association www.natajournals.org ISSN: 1947-380X DOI: 10.4085/100125 ORIGINAL RESEARCH Master s Level Professional Athletic Training Programs: Program Characteristics, Graduation Requirements, and Outcome Measures Jennifer Lynn Ostrowski, PhD, LAT, ATC; Brent Marshall, MS, ATC Health Promotion & Human Performance, Weber State University, Ogden, UT Context: While currently there are 2 curriculum route options leading to athletic training certification, the future of athletic training education is being heavily debated. While master s-level professional (MLP) athletic training programs account for less than 8% of all accredited programs, these programs have seen tremendous growth in the past decade. Little is known about the characteristics of these MLP programs or the graduates they produce. Objective: To perform exploratory analysis of MLP program history, cohort characteristics, program and graduation requirements, and outcome measures. Design: Cross-sectional design involving online survey research. Patients or Other Participants: Eleven MLP program directors. Main Outcome Measure(s): Survey data were collected via Formstack.com. Open-ended questions were categorized based on common themes and were coded. Descriptive statistics and correlations were calculated. Results: Accreditation of MLP programs was pursued for a variety of reasons. Programs admit an average of 13.5 students per year, and, on average, MLPs have 22 students. Ninety-one percent of students are retained into the second year, and 91% of students graduate. Ninety-one percent of MLP programs require either a thesis or structured research project; 45% require a comprehensive examination. The average 3-year aggregate first-time Board of Certification (BOC) examination pass rate was 91.7%. Pass rate was significantly correlated with thesis/structured research requirements. Ninety-three percent of graduates pursue employment using their Athletic Trainer Certified (ATC) credential. Ninety-one percent of program directors believe that MLP programs better prepare students to pass the BOC exam and better prepare them to practice as athletic trainers and believe the undergraduate route to certification should be eliminated. Conclusions: High retention, graduation, first-time BOC pass rates, and employment using the ATC credential of MLP students make a strong case for MLP programs as the future of athletic training education. Key Words: CAATE, route to certification, professional education Dr Ostrowski is currently Director of the Undergraduate Athletic Training Program and Assistant Professor of Athletic Training at Weber State University. Please address all correspondence to Jennifer Lynn Ostrowski, PhD, LAT, ATC, Health Promotion & Human Performance, Weber State University, 1435 Village Drive, Dept 2801, Ogden, UT 84408. jennostrowski@weber.edu. Full Citation: Ostrowski JL, Marshall B. Master s level professional athletic training programs: program characteristics, graduation requirements, and outcome measures. Athl Train Educ J. 2015;10(1):25 31. Athletic Training Education Journal j Volume 10 j Issue 1 j January March 2015 25

Master s Level Professional Athletic Training Programs: Program Characteristics, Graduation Requirements, and Outcome Measures Jennifer Lynn Ostrowski, PhD, LAT, ATC; Brent Marshall, MS, ATC INTRODUCTION Over the past decade there has been a focus among educators and leaders within the Commission on Accreditation of Athletic Training Education (CAATE) and the Executive Council on Education regarding the future of athletic training education. 1 3 Much of this discussion has centered on other allied health professions shifts to post-bachelor s professional education programs. Today, most health care related professions (eg, physical therapist, occupational therapist, Physician Assistant) require the attainment of either a master s-level or doctoral-level degree in order to enter the profession. 1,2 The debate that is currently taking place with regard to athletic training education revolves around the 2 current route options to certification: bachelor-level professional (BLP) and master s-level professional (MLP). With the elimination of the internship route to certification in 2004, these 2 routes to athletic training certification remain. 4 6 While the first BLP programs appeared in 1969, the first MLP program was not accredited until 1996. 7 As of June 2013, 333 BLP programs and 27 MLP programs are accredited (CAATE, written communication, June 17, 2013). While accreditation standards, educational competencies, and clinical proficiencies for the 2 curriculum routes are identical, there are many fundamental differences between the BLP and MLP routes to certification. Differences at the MLP level include increased focus on athletic training course work (general education requirements already completed), additional research experience, and tuition and financial aid considerations. 1 Of primary interest are differences between BLP and MLP programs in terms of professional preparation, Board of Certification (BOC) exam success, and entrance of graduates into the athletic training profession. Athletic training educators and stakeholders are currently examining these 2 routes to certification in an attempt to determine the best educational preparation for athletic trainers. Over the past 10 years, there has been an over 400% increase in the number of MLP programs (2003, n ¼ 6; 2013, n ¼ 27), versus 44% growth in the number of BLP programs (2003, n ¼ 231; 2013, n ¼ 333) (CAATE, oral communication, June 17, 2013). Such programmatic growth has not occurred since the National Athletic Trainers Association (NATA) Board of Directors mandated the elimination of the internship route to certification, resulting in a 300% increase in the number of BLP programs within a 7-year period (1997 2004). 3 Additionally, according to the CAATE, since 2003, three institutions have closed their BLP programs in order to develop MLP programs (oral communication, March 4, 2013). Despite the ongoing educational debate of BLP versus MLP, little is known about MLP programs with regard to program and graduation requirements, retention and BOC pass rates, and graduate employment/placement rates. Therefore, the purpose of this exploratory study was to survey MLP program directors regarding these areas to develop a more comprehensive understanding regarding the common characteristics of MLP programs. METHODS A research opportunity notification was sent via FormStack. com to the program directors of all 25 MLP programs that were listed on the CAATE Web site as of February 2012. Program directors were sent 2 reminder emails; the first reminder was sent 2 weeks after the initial survey invitation, and the second reminder was sent after an additional 2 weeks. As part of the survey invitation email, program directors were informed that completion of the survey indicated their consent to participate in the research study. This study was approved by our university s institutional review board. Survey Design The survey instrument was developed based on the research questions and a review of the literature and was based on similar themes to those included in our survey of MLP athletic training students. 8 Before data collection, we tested the usability and technical operation of the survey with 3 BLP athletic training program directors who would not be invited to take the final survey. We made adjustments to the readability of the survey questions based on this feedback (feedback included clarification of wording, reducing redundancy of questions). The survey included 31 questions divided into the following categories: program director demographics (3 questions), program history (9 questions), cohort characteristics (5 questions), program requirements (7 questions), outcome measures (3 questions), and program director opinion (4 questions). Nineteen questions were multiple choice (primarily yes/no), 10 questions required respondents to enter an integer or percentage, and 2 questions were open-ended (see the Table for a list of questions and question type). Statistical Analysis Open-ended questions were categorized based on the common themes that emerged; categories were created to allow for the use of statistical analysis. We used deductive and inductive content analyses to interpret the emerging themes from the raw data. Data were organized by coding each individual raw data response with a 1-word or 2-word description, forming a meaning unit. Meaning units were then categorized according to their similarities and organized within the research areas under investigation. All responses were independently coded, and there was 100% agreement between the authors on the categories. All quantitative data analyses were conducted using SPSS (Version 20, SPSS Inc, Chicago, IL). Statistical analyses included standard correlations (for numerical data) and point biserial correlations (measures of association for dichotomous and continuous variables). Mean, range, and standard deviation statistics were calculated for quantitative data, and Athletic Training Education Journal j Volume 10 j Issue 1 j January March 2015 26

cross tabs were used to determine percentages of each category within the nominal data (multiple choice questions, coded open-ended questions). See the Table for a description of how each question was analyzed. RESULTS Program Director Demographics Of the 25 MLP program directors who received our survey, 11 responded (44% response rate). Respondents reported having been a program director for just over 8 years (8.3 6 3.6 years; range, 3 12 years). The majority (63.6%) pursued the internship route to certification (no respondents graduated from an MLP program). Just over half (54.5%) had previously been a program director or faculty member in a BLP program (BLP faculty members, 6.3 6 3.5 years; range, 0 11 years). Program History Responding MLP programs had all been accredited as of 2003 or more recently (2003 2011; mean ¼ 6.2). No MLP programs transitioned from a BLP program. One responding MLP program currently has both MLP and BLP programs at its institution. Just over half of the responding MLP programs previously offered an internship route to certification (54.5%; n ¼ 6), and 50% of those that had internship routes moved to an MLP program after the elimination of the internship route to certification (3/6). Three MLP programs also offer postprofessional programs in which they employ graduate assistant athletic trainers: 2 offer post-professional athletic training (PPAT) master s programs, 1 offers a terminal degree in a related field (field not specified). Fifty-five percent (n ¼ 6) of respondent MLP programs pursued accreditation as the result of their college/university looking to develop additional graduate programs, while 36% (n ¼ 4) did so because of a lack of MLP programs in the geographical area. The remaining program director indicated that the MLP program was preferred over the BLP route as a result of the related ability to recruit more focused, mature students. Cohort Characteristics Respondent programs had a 3-year average program size of 21.9 (SD ¼ 7.6; range, 14 36), accepting an average of 13.5 students per cohort (SD ¼ 5.7; range, 9 25). Average first-tosecond year retention rate was 91.4% (SD ¼ 6.7%; range, 80% 100%). Primary reasons reported for students not being retained into the second year were academic difficulties (n ¼ 7) and personal/life change (n ¼ 4) (1 program reported 100% retention rate; 1 program selected both). The reported 3-year average graduation rate was 91.2% (SD ¼ 6.5%; range, 81% 100%). Program Requirements The minimum GPA required to remain in good standing was 3.0 on a 4.0 scale in 10 of the 11 programs (2.8 was required in the remaining program). Two MLP programs require students to complete a thesis in order to graduate (18%); 8 of the 9 remaining MLP programs require a nonthesis structured research project (89% of nonthesis programs). One MLP program requires students to present at a conference; no MLP programs require students to publish a scholarly research article. Forty-five percent require a comprehensive examination (n ¼ 5). Two MLP programs also have professionalism requirements, such as attendance at state/national Conferences and/or state/national Capital Hill Day. Outcome Measures The average 3-year aggregate first-time BOC pass rate was 91.7% (SD ¼ 9.5%; range, 70% 100%). Program directors reported that 93% of graduates practice as athletic trainers after graduation (SD ¼ 9.96%; range, 68% 100%), while an additional 1% go on to pursue a terminal degree (SD ¼ 2.96%; range, 1% 10%). Program Director Opinion Ninety-one percent of responding program directors believed that the MLP route to certification better prepares athletic training students to pass the BOC examination and better prepares athletic training students to practice as athletic trainers (n ¼ 10 for each). Ten program directors also believed that the BLP route to certification should be eliminated (not the same 10 as reported previously). Program directors were asked about their perception of the purpose of the MLP route to certification. Five themes emerged during coding of responses provided by 9 program directors: serves a more focused student (5 responses); serves a more mature student (4 responses); alternate to the bachelor s route to certification (3 responses); improved professional preparation of students (3 responses); and serves students who are more committed to a career in athletic training (2 responses). Some respondent comments were coded as multiple themes. Correlations Standard correlations and point biserial correlations were calculated to evaluate potential associations between variable sets. Specifically, we were interested in potential associations between retention and graduation rates, between cohort sizes and various program characteristics, and between BOC pass rates and various program requirements. We found a significant relationship between retention and graduation rates (r(9) ¼ 0.696, P ¼.025, 95% confidence interval [CI] ¼ 0.112 1.298). No significant correlations were found between cohort size and existence of other athletic training programs at the institution (BLP, PPAT, terminal degree) (r(9) ¼ 0.006, P ¼.985, 95% CI ¼ 0.748 0.760) or between cohort size and years of accreditation (r(9) ¼ 0.519, P ¼.101, 95% CI ¼ 0.125 1.164). A significant relationship was found between structured research requirement and first-time BOC pass rates (r(9) ¼ 0.762, P ¼.006, 95% CI ¼ 0.273 1.250); specifically, the program without a structured research requirement had the lowest BOC pass rate. No significant correlation was found between programs that required a comprehensive examination and first-time BOC pass rates (r(9) ¼ 0.031, P ¼.929, 95% CI ¼ 0.723 0.784). DISCUSSION The elimination of the internship route to certification marked a fundamental shift to curriculum-based education for all prospective athletic trainers. Some of the goals in eliminating the internship route included betterment of the profession, betterment of the professional image, competition in the health care arena, adaption to the expectations of the health Athletic Training Education Journal j Volume 10 j Issue 1 j January March 2015 27

Table. Survey Questions Question Category Question Text Data Analyses Program director demographics Program history Cohort characteristics Program requirements 1. How many years have you been the AT program director? (#) 2. What route to certification did you pursue? (MC) 3. Have you ever been a program director/ faculty member in undergraduate AT program? If yes, for how many years? 4. What was the year of your MLP program s initial accreditation? (#) 5. Does your institution currently offer an accredited undergraduate AT program? 6. Did your institution ever (previously) offer an accredited undergraduate AT program? 7. Did your MLP program transition from an undergraduate program? 8. Did your institution ever (previously) offer an internship route to athletic training certification? 9. Did your MLP program transition from an internship route? 10. Does your institution offer an accredited postcertification Master s in athletic training? 11. Does your institution offer an accredited terminal degree in athletic training? 12. Why did your institution pursue accreditation as an MLP program? (MC) 13. What is the average MLP program size during the past 3 years? (#) 14. What is the average number of students accepted per cohort (average of past 3 cohorts)? (#) 15. What is the program retention rate (average during the past 3 years)? (#) 16. What is the primary reason students do not return for the second year? (MC) 17. What is the program graduation rate (average during the past 3 years)? (#) 18. What is the minimum GPA required for good standing in your program? (#) 19. Do you require athletic training students to complete a thesis in order to graduate? 20. Do you require athletic training students to complete a research project (NOT a thesis) in order to graduate? 21. Do you require athletic training students to publish an article in order to graduate? (yes/ no) 22. Do you require athletic training students to present at a conference in order to graduate? 23. Do you require athletic training students to pass a comprehensive examination in order to graduate? 24. Do you require any additional graduation requirements? If yes, please list. (openended) 1. Mean, range, standard deviation 2. Cross tabs for nominal data 3. Cross tabs for nominal data; mean, range, standard deviation for average years 4. Average length of program accreditation calculated 5. Cross tabs for nominal data 6. Cross tabs for nominal data 7. Cross tabs for nominal data 8. Cross tabs for nominal data 9. Cross tabs for nominal data 10. Cross tabs for nominal data 11. Cross tabs for nominal data 12. Cross tabs for nominal data 13. Mean, range, standard deviation 14. Mean, range, standard deviation 15. Mean, range, standard deviation 16. Cross tabs for nominal data 17. Mean, range, standard deviation 18. Cross tabs for nominal data 19. Cross tabs for nominal data 20. Cross tabs for nominal data 21. Cross tabs for nominal data 22. Cross tabs for nominal data 23. Cross tabs for nominal data 24. Coded, then cross tabs for nominal data Athletic Training Education Journal j Volume 10 j Issue 1 j January March 2015 28

Table. Continued Question Category Question Text Data Analyses Outcome measures 25. What is your first-time BOC pass rate (average during past 3 exam cycles)? (#) 26. What percent of graduates practice as an athletic trainer following graduation? (#) 27. What percent of graduates pursue a terminal degree? (#) Program director opinion 28. What is your perception of the purpose of the MLP route to certification? (open-ended) 29. Do you believe that the MLP route to certification better prepares athletic training students to pass the BOC exam? 30. Do you believe that the MLP route to certification better prepares athletic training students to practice as athletic trainers? 31. Do you believe that all AT programs should transition to MLP programs (eliminating the undergraduate route to certification)? (yes/ no) 25. Mean, range, standard deviation 26. Mean, range, standard deviation 27. Mean, range, standard deviation 28. Coded, then cross tabs for nominal data 29. Cross tabs for nominal data 30. Cross tabs for nominal data 31. Cross tabs for nominal data Abbreviations: AT, athletic training; #, enter a value; MC, multiple choice question; yes/no, dichotomous value; MLP, Master s-level professional; GPA, grade point average; BOC, Board of Certification. care community, and strengthening the quality, reputation, and educational requirements of the Athletic Trainer Certified (ATC) credential. 5 The overarching goal of this educational reform was to enhance the credibility of the field among health care professions and to better prepare athletic trainers to perform their function of caring for the physically active. 9 The shift to MLP education could arguably have many of the same goals. During the research period leading up to the National Athletic Trainers Association Board of Director s decision in 1997 and the ultimate termination of internship programs in 2004, many published studies 10 12 compared and contrasted internship and curriculum (BLP and MLP) routes to certification. To our knowledge, this is the first study to survey athletic training MLP program directors. Information and data collected from the survey were able to yield preliminary information regarding program demographics, program history, cohort characteristics, program and graduation requirements, program outcome measures (graduation rates, BOC pass rates, employment placement rates), and program director opinions regarding the MLP route to certification. Program History Of the 11 responding programs, 3 developed their MLP program when they closed their internship program, while no MLP programs developed from BLP programs. According to the CAATE, only 3 institutions have ever closed their BLP programs to develop MLP programs ( oral communication, March 4, 2013). With the CAATE having released its substantive change document for programs transitioning from bachelor s to post-bachelor s programs in March 2013, it is expected that many undergraduate programs will transition to the master s level. As part of this process, it may be helpful to consult with programs that have moved to MLP from either internship or BLP programs to develop strategies to aid in this transition. Additionally, two MLP programs also have a PPAT master s program, and 1 MLP program offers a terminal degree in a related field. Institutions with both MLP and PPAT programs could be consulted to gain insight into how the 2 programs complement each other but maintain separation within the same institution. Should athletic training move to a post-bachelor s entry to the profession, it would effectively eliminate PPAT master s programs. 1 This is an important consideration in the debate surrounding the future of athletic training education. Concerns have been raised about the potential elimination of the graduate assistant model 1 ; however, the increase in residency programs (now accredited by the CAATE) and the emergence of the first DAT program (clinical doctorate in athletic training) may aid in filling the gap between entry-level education and a terminal degree. Fifty-five percent of MLP programs surveyed reported that they pursued the development of an MLP program as the result of their college/ university looking to develop additional graduate programming; this may well be the motivation for PPAT master s programs to consider developing clinical DAT programs. Cohort Characteristics There was a wide range of cohort sizes reported in our study (13.5 6 5.7; range, 9 25). There were no significant correlations between cohort size and existence of other athletic training programs at the institution (BLP, PPAT, terminal degree) or between cohort size and years of accreditation. We therefore conclude that cohort sizes are largely institutiondependent. Despite many program differences across the MLPs surveyed, our data indicate that students who are retained past the first year will likely graduate, despite the demanding nature of the second year, with its increased clinical responsibility and structured research requirements in the majority of MLP programs. Athletic Training Education Journal j Volume 10 j Issue 1 j January March 2015 29

Program Requirements Ten MLP programs reported that the minimum GPA to remain in good standing was 3.0 on a 4.0 scale (2.8 was required in the 11th program). This is consistent with previous anecdotal reports, in that GPAs in the range of 2.5 to 3.0 were the common minimums, and is based on the common minimum graduate school GPA requirements of 3.0. 1 Ninety-one percent of MLP programs reported requiring a thesis or structured research project. This has been cited as an advantage of MLP programs. 1 Data from this study suggest that the requirements of a thesis or structured research requirement were correlated with higher first-time BOC pass rates. However, the limited number of responses (10 programs required structured research, 1 program did not require structured research) may limit the generalizability of this correlation. Additional research should continue to explore this relationship. Outcome Measures The 3-year aggregate first-time BOC pass rate reported by program directors (mean ¼ 91.7%; pooled estimate) is significantly higher than the national averages in each of the past 3 exam cycles (2009 2010: 43.3%; 2010 2011: 60.7%; and 2011 2012: 82.3%). 13 No previous studies have compared first-time pass rates between BLP and MLP candidates; however, if the data obtained in this study are accurate and generalizable to all MLP programs, the first-time pass rate of MLP candidates is significantly higher than that of BLP candidates. A comparison of BLP and MLP pass rates would contribute significantly to the conversation about the future of athletic training education. The 93% graduate placement rate reported here is consistent with self-reported pursuit of employment using the ATC credential in research with current MLP students. 8 Additionally, the percent of MLP graduates reportedly pursuing employment using their ATC credential is higher than the 82.4% that been reported in previous research 14 that pooled both BLP and MLP graduates. Unfortunately, the limited number of programs that participated in this study may make it difficult to generalize this percentage to all MLP graduates. Program Director Opinions The themes of focused and mature student recruitment emerged in several ways as a purpose of MLP programs, both as write-in responses for the other option for Question 12 and as open-ended responses for Question 28. Seven of 9 responses to Question 28 mentioned more focused student or more mature student. This is somewhat intuitive, as graduate-level education innately has a more focused nature, while undergraduate education encompasses general education requirements in addition to major-specific coursework. 2 Anecdotally, students who enter MLP programs may be more committed to becoming an athletic trainer, as the master s degree is the advanced degree for the majority of athletic trainers. Conversely, recent expert commentary 1 suggests that students entering BLP programs may be using the curriculum as a stepping stone toward other health care professions. Previous research 8 has indicated that MLP students typically wait only 1.2 years after completion of their undergraduate degree to enroll in an MLP program and that nearly 95% of students who enter MLP programs do so because they want to become an athletic trainer (while less than 5% enter MLP programs only after not being accepted into their graduate program of choice). The results of this current study and our previous research 8 seem to imply that MLP programs are, in fact, recruiting students who are more likely to pursue employment using their ATC credential (93.5% reported by MLP students, 93.6% reported by program directors). The percent of MLP students who pursue employment using their ATC credential is at least equivalent to graduates of PPAT programs (based on qualitative interviews with PPAT students and anecdotal expert commentary). 15 17 Several program directors in this study highlighted this as an important purpose of the MLP route to certification: educating students who truly want to be athletic trainers. The most common rationales proposed for moving athletic training education to the post-bachelor s level (MLP) include improving the professional preparation of students and aligning our professional programs with our peer health care professions. 1,2 These are very similar to rationales cited for the elimination of the internship program: enhancing the credibility of the field and better preparation of athletic trainers. 9 Other recent arguments for moving to the MLP level include the perception that there is a greater emphasis placed on research at the graduate level. 2 In our study, 10 of 11 programs represented required a thesis or structured research project. If we are able to generalize these findings, 91% of MLP programs have a structured research requirement. Our correlation found that programs with this requirement had higher first-time BOC pass rates. However, as stated previously, the limited number of program directors who participated in this study indicates that caution should be taken when attempting to generalize our results to all MLP programs. While additional research in this area is needed, as the CAATE and the NATA Board of Directors consider a possible transition to mandatory post- bachelor s education, they should consider a structured research requirement as part of MLP program accreditation standards. This opinion has been expressed previously. 1 CONCLUSIONS The MLP program is one of the 2 curriculum options for individuals wishing to become athletic trainers. Within the past decade, the number of accredited MLP programs has risen dramatically, and our data suggest that MLP programs are educating students who are likely to enter the athletic training profession. MLP programs have retention and graduation rates above 90% and an average self-reported first-time BOC pass rate of 91.7%. Ninety-three percent of graduates practice as athletic trainers, with an additional 1% going on to pursue a terminal degree in a related field. The CAATE and the NATA Board of Directors should consider retention and graduation rates, first-time BOC pass rates, and employment rates using the ATC credential in their debate with regard to the future of athletic training education. Limitations and Future Research Limitations of our study include the fact that the data reported by MLP program directors were self-reported, which may impact the validity of the data. Additionally, while our response rate was slightly higher than is typically gained through survey data (44%), 14 of the 25 MLP programs were Athletic Training Education Journal j Volume 10 j Issue 1 j January March 2015 30

not represented in this study. This may diminish the generalizability of our results, about which we attempted to caution throughout the discussion. We also recognize that our survey was limited in its scope, potentially omitting some additional lines of questioning that could contribute to the ongoing educational debate. This study is an important first step, as it provides some preliminary evidence that MLP programs are graduating students who succeed on the BOC examination and pursue employment using their ATC credential at higher rates than students in BLP athletic training programs. However, direct comparisons between BLP and MLP programs are lacking. These comparisons were major discussion points between 1994 and 1997 as the Education Task Force researched a potential shift and presented their recommendation to eliminate the internship route to the NATA Board of Directors. Additional studies making direct comparisons of BLP and MLP program outcomes will contribute greatly to the discussion of the future of athletic training education. Future research efforts should focus on the feasibility of transitioning BLP programs to MLP programs. Without this research, mandates from the CAATE and/or the NATA Board of Directors on transitioning to the MLP degree may result in many BLP programs looking to transition without a template or best-practice standards. These research efforts could be enhanced by retrospective analysis of other allied health professions successful transitions to master s entrylevel degrees. Further research is being conducted by the authors to correlate additional MLP program and graduation requirements with BOC pass rate and employment rates to attempt to determine the characteristics of the most successful MLP programs. Finally, additional research efforts should examine the effects on patient satisfaction and outcomes of moving exclusively to MLP programs, as this is the quintessential real-world outcome that both athletic training educators and practitioners can agree on. REFERENCES 1. Pitney WA. Requiring professional athletic training programs at the post-baccalaureate level: considerations and concerns. Athl Train Educ J. 2012;7(1):4 10. 2. Wilkerson G, Colston M, Bogdanowicz B. Distinctions between athletic training education programs at the undergraduate and graduate levels. Athl Train Educ J. 2006;1(1):38 40. 3. Potteiger K, Brown CD, Kahanov L. Altering the athletic training curriculum: a unique perspective on learning over time. Athl Train Educ J. 2012;7(2):60 69. 4. Peer KS, Rakich JS. Accreditation and continuous quality improvement in athletic training education. J Athl Train. 2000; 35(2):188 193. 5. Craig DI. Educational reform in athletic training: a policy analysis. J Athl Train. 2003;38(4):351 357. 6. Delforge GD, Behnke RS. The history and evolution of athletic training education in the United States. J Athl Train. 1999;34(1): 53. 7. Commission on Accreditation of Athletic Training Education. Accredited professional athletic training education programs. Commission on Accreditation of Athletic Training Education Web site. Available at: http://www.caate.net/. Accessed March 2, 2013. 8. Ostrowski J, Iadevaia C. Characteristics and program decisions of entry-level master s athletic training students. Athl Train Educ J. 2014;9(1):36 42. 9. Weidner TG, Henning JM. Historical perspective of athletic training clinical education. J Athl Train. 2002;37(4):S222 S228. 10. Middlemas D, Manning J, Gazzillo L, Young J. Predicting performance on the National Athletic Trainers Association Board of Certification examination from grade point average and number of clinical hours. J Athl Train. 2001;36(2):136 140. 11. Starkey C, Henderson J. Performance on the athletic training certification examination based on candidates routes to eligibility. J Athl Train. 1995;30(1):59 62. 12. Turocy P, Comfort R, Perrin D, Gieck J. Clinical experiences are not predictive of outcomes on the NATA BOC examination. J Athl Train. 2000;35(1):70 75. 13. Johnson SB. Examination report for the 2011 2012 testing year; Board of Certification (BOC) certification examination for athletic trainers. BOCATC Web site. http://bocatc.org/dev/ images/stories/public/2011examreport.pdf. Accessed February 7, 2014. 14. Neibert P, Huot C, Sexton P. Career decisions of senior athletic training students and recent graduates of accredited athletic training education programs. Athl Train Educ J. 2010;5(3):101 108. 15. Mazerolle SM, Gavin KE, Pitney WA, Casa DJ, Burton L. Undergraduate athletic training students influences on career decisions after graduation. J Athl Train. 2012;47(6):679 693. 16. Sauers EL. The future of post-baccalaureate professional program education in athletic training. In: Proceedings of the National Athletic Trainers Association 2007 Educators Conference; January 12 14, 2007, Montgomery, TX. 17. Bowman T, Dodge T. Factors of persistence among graduates of athletic training education programs. J Athl Train. 2011;46(6): 665 671. Athletic Training Education Journal j Volume 10 j Issue 1 j January March 2015 31