Athletic Training

This article defines and describes the academic discipline of athletic training. Athletic training is discussed in the context of its professional organization, the National Athletic Trainers Association (NATA) and through the discussion of athletic training education programs and the program accreditation process. Important topics in the development of athletic training students are also addressed including professional development, learning styles and teaching methods. The development of professionalism and suggestions for developing students' professionalism are offered as well as research on the learning styles of athletic training students. Effective teaching methods are also discussed within the context of the clinical education setting.

Keywords Accreditation; Allied Health; Athletic Trainer; Athletic Training Programs (ATEPs); Cognitive Sequential; Commission on Accreditation of Athletic Training Education (CAATE); Gregorc Mind Styles; Learning Styles; National Athletic Trainers Association (NATA); Peer-Assisted Learning; Reflective Journaling/Learning Log; Teaching Methods

Physical Education > Athletic Training

Overview

The athletic training profession is a part of the allied health field. Athletic trainers provide health care in the areas of physical medicine and rehabilitation services by helping prevent, assessing, treating, and rehabilitating injuries (National Athletic Trainers Association, 2007). Athletic trainers also coordinate health care with physicians and other similar health professionals like physical therapists, occupational therapists, and physicians assistants. They typically work in high schools, colleges, professional sports, hospitals, corporations, clinics, and the military (NATA, 2007a). Approximately, 50% of certified athletic trainers are employed outside the traditional 'school' setting (NATA, 2007). Still, common sites of employment are the athletic programs in colleges, universities, and secondary schools.

In the secondary school or collegiate setting, athletic trainers are often the first health professional that treats an injured athlete (AAHPERD, 2007). Within the secondary school setting, certified athletic trainers provide important support to the athletic programs as important members of the allied health care team since team physicians are not typically on staff for all or any athletic events (AAHPERD, 2007). Athletic trainers working in a secondary school setting may be responsible for nutritional counseling, aspects of athletes' rehabilitation programs, strength and conditioning, and injury prevention and treatment (taping, bracing, etc.) pre-game and pre-practice.

During games and practices, athletic trainers evaluate injuries that occur and determine whether the athlete should see a physician or if the injury can be treated and managed by the athletic training staff. The secondary school athletic trainer may be employed full-time by the school as the certified athletic trainer, he or she may also be a teacher in the school (e.g., physical education or health teacher), or he or she may be contracted to work for the high school's athletic program through a private sports medicine clinic or corporation.

The National Athletic Trainers Association (NATA), founded in 1950, is a membership association for athletic trainers who are certified as well as individuals who are interested in the athletic training career (NATA, 2007). The association serves to set standards and guidelines for the athletic training profession. A very active professional organization, the NATA also provides up-to-date guidelines for the treatment of frequently occurring illnesses and injuries (e.g., heat-related illness, head injuries), professional conferences, continuing education opportunities, position papers on controversial topics, information on the profession, promotion of research, legislation/political activism that will impact health care and the field of athletic training, and information targeting individuals who engage in physical activity.

Certified athletic trainers are required to have earned a bachelor's degree in athletic training, have successfully passed a rigorous three-part certification examination, engage in continuing education, and adhere to the guidelines and polices that are set forth by the National Association (NATA, 2007b). The undergraduate curriculum for athletic training education includes classroom and clinical-based education. The coursework includes the following foundation courses/subject areas: “human anatomy, human physiology, kinesiology/biomechanics, nutrition, statistics and research design, strength training and reconditioning, and acute injury and illness” (NATA, 2007, p. 1).

Students are also required to complete coursework in the professional areas of: “risk management of injury/illness prevention, pathology of injury/illness, assessment of injury/illness, general medical conditions and disabilities, therapeutic modalities, therapeutic exercise and rehabilitation, health care administration, weight management and body composition, psychosocial intervention and referral, medical ethics and legal issues, pharmacology, and professional development and responsibilities” (NATA, 2007b, p. 1).

Athletic training education programs (ATPs) require two years of clinical setting education that includes attending to patients with general medical ailments (NATA, 2007). After students have completed their initial entry-level athletic training education through an accredited program, the student may sit for the Board of Certification, Inc. Examination in order to become an Athletic Trainer, Certified (ATC). The examination process ensures that students are educated and trained in “prevention, recognition, evaluation, and assessment, immediate care, treatment, rehabilitation, and reconditioning, organization and administration, and professional development” (Athletic Training Education Program Educational Goals and Objectives, 2006).

While the NATA and Board of Certification, Inc. both provide professional preparation and ethical guidelines for the profession of athletic training, the Commission on Accreditation of Athletic Training Education (CAATE) is an independent organization that is responsible for accrediting and monitoring athletic training education/preparation programs and their curricula. The CAATE aims to "develop, maintain, and promote appropriate minimum standards of quality of entry level Athletic Training education programs" (CAATE, 2006, p. 2).

In order for an institution's athletic training program to become accredited, the institution must successfully meet a rigorous set of standards including, but not limited to, institutional sponsorship, appropriate and sufficient staffing (including program director and clinical instruction staff), a physician who acts as a consultant to the program, sufficient support and administrative staff, financial resources, physical resources (i.e., facilities, equipment, clinic), operational plan and policies, and curriculum design and course development (CAATE, 2006). These standards are to be met and documented in the comprehensive review process, which includes an extensive self-study report and on-site visit to verify the self-study report and decide how well the program is meeting the standards set by CAATE (CAATE, 2006).

After the on-site visit, a report of the findings from the visit is submitted to the program and they are required to submit a rejoinder outlining and responding to each point of deficiency that was noted by the initial visit report. Once accreditation application materials are submitted, the application review process takes approximately one year. Athletic training education programs may or may not be fully accredited. Accreditation is valid for five years and continuing accreditation for seven years. Programs may be placed on “probation, withholding, withdrawing accreditation, and voluntary withdrawal of accreditation” (CAATE, 2006, p. 1).

Undergraduate and graduate athletic training education programs may be housed in one of many departments including, exercise science, kinesiology, sport science, sport medicine, physical education, or health science departments. Athletic training education programs demand students' time and commitment due to the extended hour days that students are required to complete once in the clinical setting.

Undergraduate students typically complete foundation coursework and are required to meet set standards (e.g., a specific grade point average minimum, letters of recommendation) in order to advance to the clinical site portion of their academic preparation. Students may, for example, complete clinical work with the college or university's athletic teams, with local high school athletic programs, and/or physical therapy/sports medicine clinics under the supervision of physicians and certified athletic trainers. While the athletic training education program focuses on the foundation and professional coursework and the clinical education components, the profession and its professional preparation programs are still faced with challenges in the promotion of professional and ethical development, different student learning styles, and effective methods of teaching.

Further Insights

Professional Development

Once an athletic training student has completed the academic preparation, sits for the Board of Certification examination, and starts his or her first professional position, it is of the utmost importance that the athletic trainer be competent and feel confident to make ethical and professional decisions (Gardiner & Mensch, 2004). The professional leap between working in a clinical setting with faculty and mentor supervision to certified athletic trainer in the “real world,” can be a challenge for new athletic trainers.

To assist the transition, athletic training education program directors and faculty have the opportunity to set forth guidelines and policies that can assist student professional development (Gardiner & Mensch, 2004). Faculty and advisors should act as role models for their students by displaying appropriate ethical and professional behavior. Some formal experiences that can also be implemented into an athletic training program include:

• Athletic training student organization

Through the creation of an athletic training student organization, the program faculty can promote students' management and organization skills as well as responsibility by maintaining the student organization. These student organizations may be designed to meet the needs and goals of the student group, which may be attained through community volunteering opportunities, sponsoring workshops, fund-raising events, maintaining a budget, and assisting and encouraging students to attend professional conferences (Gardiner & Mensch, 2004).

• A "professional-points" program

This type of program sets a requirement for the minimum number of points athletic training students must earn through volunteering and working at a variety of athletic training related events and also requires students to maintain current membership in the NATA each year (Gardiner & Mensch, 2004). Students who do not meet the minimum requirements are then penalized by having all course grades lowered one level. Awards are given to students who exceed the minimum requirements.

• Student-mentor program

Student-Mentor Programs provide mentorship to beginning athletic training students from junior and senior students who serve as mentors (Gardiner & Mensch, 2004). The mentors serve to assist newer students in their clinical observations, signing off on their clinical hours, guiding students through the academic process, and assisting in evaluating their professional behavior. The new athletic training students are provided with the opportunity to observe appropriate professional behavior and have another student serve as an athletic training program "guide" (Gardiner & Mensch, 2004).

• Journal club (Gardiner & Mensch, 2004)

Faculty encourages students to continue this practice after graduation by providing them with the tools, confidence, and interest in continuing their education through staying current in the field. Each of these suggestions for student professional development illustrates how faculty can successfully and effectively incorporate professional development into the curriculum.

Student Learning Styles & Teaching Methods

An important topic in athletic training education is how students learn concepts, theories, and practices that are essential to the academic preparation of athletic trainers. Scientific research in these areas is increasing, as research is being conducted to identify the learning styles of athletic training students and what types of learning methods are effective and/or provide new insights on traditional teaching methods. Athletic training programs have incorporated the clinical portion of the education program in order to provide students with hands-on practice and learning in their chosen field of study. Scientific research has lent support to the inclusion of the clinical learning environment; however more recently scholars have suggested the need for athletic training educators to consider student learning styles and how this impacts teaching methods in all areas of the professional preparation process (Gould & Caswell, 2006). A selection of learning and teaching research and methods will be discussed here.

Peer-assisted learning is a practice that has been used by athletic training educators in a clinical setting that houses students who learn how to work together to learn, practice, or teach. Research in allied health fields has shown that students experience a lower level of anxiety and stress when working with their fellow students rather than clinical instructors, improved organizational skills, increased confidence in ability to make decisions, improved proficiency test scores, and improved leadership skills. However, this type of research has been limited in the athletic training field (Henning, Weidner, & Jones, 2006).

Henning, Weidner, and Jones (2006) conducted research to examine the effects of peer-assisted learning in the athletic training clinical setting. This research indicated that students reported that they enhanced and refined their understanding of their clinical skills based on interactions with their peers. These interactions included working with peers on clinical skills and receiving feedback on skill demonstration.

This feedback appeared to be beneficial because it was provided immediately in the learning environment, yet the results indicated that this feedback was not viewed by the athletic training students as more effective or more helpful than feedback from the clinical instructors. Students also reported a decrease in anxiety and stress when working with their peers on practicing skills than when they were required to practice skills in the company of their clinical instructors. This research lends support to the implementation or continuation of peer-assisted learning in the athletic training education program.

In the clinical setting, athletic training students are required to practice and learn clinical skills that they will eventually have to recall and perform independently. By practicing with peers, students are able to gain confidence in their abilities to execute the clinical skills prior to testing for proficiency under the direction of their instructor. Henning and her colleagues also suggest that peer-assisted learning provides a unique opportunity for the more experienced or advanced students to teach clinical skills to newer students. This exercise requires the advanced students to demonstrate their ability to synthesize the information needed for the skill and articulate that information to the learner. Peer-assisted learning in the clinical setting can be complemented with instruction being provided in a manner that is effective for the learning styles of each student.

Gould & Caswell (2006) conducted research to determine what learning style athletic training students prefer based on Gregorc Mind Styles. The findings of this research indicated that these students prefer a cognitive sequential learning style (Gould & Caswell, 2006). The cognitive sequential style of learning, as defined by the Gregorc Mind Style model utilized by the researchers, indicates that the athletic training students prefer a structured environment that involves hands-on activities.

Given the nature of the athletic training profession, this finding is not astonishing, yet due to the limited amount of research that is being conducted on learning styles, this finding lends support to the continuation and extension of this type of research. Based on their findings, Gould and Caswell (2006) suggest that athletic training educators should focus on providing opportunities for hand-on activities through simulations and breakout sessions. This finding also suggests that peer-assisted learning in the clinical setting should be structured and be accompanied by well prepared and structured instruction.

The use of reflective journaling/learning logs in clinical athletic training provides students with the opportunity to reflect on an experience outside of the moment in which the situation occurred (Kaiser, 2004). By reflective journaling after the moment has passed, students are able to analyze and comment on a situation and the decisions that were made or not made without the emotion of the moment clouding the critical evaluation and thought process. This reflective opportunity extends the learning situation beyond the moment of the situation to maximize learning (Kaiser, 2004). Reflective journaling in athletic training education helps students to develop their critical thinking and problem-solving skills while deepening their level of understanding (Kaiser, 2004).

Kaiser noted that reflective journals/learning logs serve as documentation of student progression. Students can learn from mistakes, how to empathize, observe, and identify those incidents that are critical to their learning and to the field of athletic training (Kaiser, 2004). Through the process of self-expression, athletic training students develop personally and reduce stress by allowing themselves an opportunity to relieve tension or frustration. Clinical instructors can evaluate reflective journals through a pass/fail system, by skimming and responding to select passages, and by peer review with instructor criteria (Kaiser, 2004).

Athletic training has become an allied health care profession through the professionalization of the field. The creation of the National Athletic Trainers Association in 1950 provided professional support and guidance to athletic trainers and to those groups or individuals interested in the field. Through the accreditation process, undergraduate and graduate level athletic training programs are required to develop curricula that are in alignment with the standards set forth by the Commission on Accreditation of Athletic Training Education. Research on the teaching methods and learning techniques of athletic training students can provide faculty and staff insight into how to more effectively deliver the course material to meet the needs of the students in the classroom and clinical setting.

Terms & Concepts

Accreditation: The process of review and certification for athletic training programs.

Athletic Trainer: Allied health professional who provides health care in the areas of physical medicine and rehabilitation services by preventing, assessing and treating injuries (National Athletic Trainers Association, 2007).

Athletic Training Programs (ATEPs): Collegiate education programs professionally and academically preparing athletic trainers.

Cognitive Sequential: A learning style that prefers structured, physical hands-on tasks (Gould & Caswell, 2006).

Commission on Accreditation of Athletic Training Education (CAATE): organization that is responsible for accrediting athletic training preparation programs and curricula.

Gregorc Mind Styles: Theory of learning styles that focuses on the cognitive skills of perception and organization.

Learning Style: Differences in how individuals successfully acquire knowledge, i.e., visual, tactile, auditory.

National Athletic Trainers Association (NATA): Professional association for members who are certified athletic trainers and other individuals who are interested in the athletic training career.

Peer-Assisted Learning: Learning which takes place by way of experiences and instruction led by or done in conjunction with students who are at the same or nearly the same academic or experiential level.

Reflective Journaling/Learning Log: "Provides students an opportunity to ponder and reflect back on an experience and to give meaning to that incident" (Kaiser, 2004, p. 39).

Bibliography

American Alliance of Health, Physical Education, Recreation, & Dance. (2007). Fields of study: Athletic training. AAHPERD Website. Retrieved May 14, 2007, from http://www.aahperd.com/

Athletic Training Education Program Educational Goals and Objectives. (2006). Troy University. Department Website. Retrieved May 9, 2007 from http://spectrum.troy.edu/~anderson/index.htm.

Commission on Accreditation of Athletic Training Education (CAATE). (2006). Standards for the accreditation of entry-level athletic training education programs. Commission on Accreditation of Athletic Training Education Website. Retrieved May 9, 2007, from http://www.caate.net/ss_docs/acc_process_overview9-08%5B1%5D.pdf.

Commission on Accreditation of Athletic Training Education (CAATE). (2006). Overview of the accreditation process. Commission on Accreditation of Athletic Training Education Website. Retrieved May 9, 2007, from http://74.125.47.132/search?q=cache:MCnF8IFUV60J:caate.net/ss_docs/acc_process_overview.doc+http://caate.net/ss_docs/acc_process_overview.doc.&cd=1&hl=en&ct=clnk&gl=us&client=firefox-a

Gardiner, A. & Mensch, J.M. (2004, July). Promoting professional development in athletic training. Athletic Therapy Today, 9, p. 30-31). Retrieved May 9, 2007 from EBSCO online database SPORTDiscus with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=13772230&site=ehost-live

Gould, T.E. & Caswell, S.V. (2006). Stylistic learning differences between undergraduate athletic training students and educators: Gregorc mind styles. Journal of Athletic Training, 41 , p. 109-116. Retrieved May 9, 2007 from EBSCO online database SPORTDiscus with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=20713914&site=ehost-live

Henning, J. M., Weidner, T.G. & Jones, J. (2006). Peer-assisted learning in the athletic training clinical setting. Journal of Athletic Training, 41 , p.102-108. Retrieved May 9, 2007 from EBSCO online database SPORTDiscus with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=20713913&site=ehost-live

Kaiser, D.A. (2004, Nov.). Using reflective journals in athletic training clinical education. Athleftic Therapy Today, 9 , p.41. Retrieved May 9, 2007 from EBSCO online database SPORTDiscus with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=15071936&site=ehost-live

Mestre, L. S. (2010). Matching up learning styles with learning objects: what's effective?Journal Of Library Administration50(7/8), 808-829. Retrieved December 18 2013, from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=54302828&site=ehost-live

National Athletic Trainers Association (NATA). (2007b). Athletic trainers- Not "trainers." National Athletic Trainers Association Website. Retrieved May 9, 2007, from http://caate.net/ss_docs/standards.6.8.2006.pdf

National Athletic Trainers Association (NATA). (2007b, March). Athletic training education overview. National Athletic Trainers Association Website. Retrieved May 9, 2007, from http://www.nata.org/consumer/docs/educationfactsheet05.pdf

Robles, J., Cox, C. D., & Seifert, C. F. (2012). The impact of preceptor and student learning styles on experiential performance measures. American Journal of Pharmaceutical Education 76, 1-7. Retrieved December 29, 2013, from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=87613935&site=ehost-live

Wilson, M. L. (2012). Learning styles, instructional strategies, and the question of matching: A literature review. International Journal Of Education, 4, 67-87. Retrieved December 18 2013, from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=87394121&site=ehost-live

Suggested Reading

Journal of Athletic Training. EBSCO online database SPORTDiscus with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=s3h&jid=JTT&site=ehost-live

Mensch, J.M. & Ennis, C.D. (2002). Pedagogic strategies perceived to enhance student learning in athletic training education. Journal of Athletic Training, 37 , p.S199-S207.

Newsham, K.R. (2006). Athletic training students with disabilities: A survey of entry-level education programs. Journal of Athletic Training, 41 , p. 409-414. Retrieved May 9, 2007 from EBSCO online database SPORTDiscus with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=23643159&site=ehost-live

Essay by Shelby L. Hinkle Smith, Ph.D.

Dr. Shelby L. Hinkle Smith holds a Doctorate in exercise science from the University of Northern Colorado, specializing in the area of social psychology of sport and exercise. She currently teaches as Adjunct Faculty at Clinton Community College in Plattsburgh, New York in the Department of Health, Physical Education, and Recreation. Hinkle Smith also serves as the Field house Manager at The Sports & Fitness Edge in Williston, Vermont where she is responsible for sport programming and overseeing the children's after school, summer, and vacation camp programs. Dr. Hinkle Smith's research and areas of interest focus on cognitive dissonance and hazing in sport as well as character and moral development and education through sport and physical education programs. Additionally, she is a certified high school field hockey official and a United States Field Hockey Futures Program Coach.