Influences of Athletic Trainers' Return-to-Activity Assessments for Patients With an Ankle Sprain.

CONTEXT: Athletic trainers (ATs) inconsistently apply rehabilitation-oriented assessments (ROASTs) when deciding return-to-activity readiness for patients with an ankle sprain. Facilitators and barriers that are most influential to ATs' assessment selection remain unknown. OBJECTIVE: To examine facilitators of and barriers to ATs' selection of outcome assessments when determining return-to-activity readiness for patients with an ankle sprain. DESIGN: Cross-sectional study. SETTING: Online survey. PATIENTS OR OTHER PARTICIPANTS: We sent an online survey to 10 000 clinically practicing ATs. The survey was accessed by 676 individuals, of whom 574 submitted responses (85% completion rate), and 541 respondents met the inclusion criteria. MAIN OUTCOME MEASURE(S): The survey was designed to explore facilitators and barriers influencing ATs' selection of pain; ankle-joint swelling, range of motion, arthrokinematics, and strength; balance; gait; functional capacity; physical activity level; and patient-reported outcome assessments when making return-to-activity decisions for patients after an ankle sprain. The survey asked for reasons that participants chose to use or not use each measure (eg, previous education, personal comfort, most appropriate, available or feasible, perceived value, and other). The survey contained 12 demographic items that characterized the sample of respondents and were examined as potential influences on the facilitators and barriers. Chi-square analysis was used to identify relationships among participant demographics and facilitators of or barriers to assessment selection. RESULTS: Selection of each ROAST and non-ROAST was most commonly facilitated by previous education, availability or feasibility, or perceived value. Avoidance of each ROAST was most often caused by the lack of previous education, availability or feasibility, or perceived value. The presence of facilitators and barriers was affected by various demographic variables. CONCLUSIONS: A variety of facilitators and barriers affected ATs' implementation of expert-recommended assessments when determining return-to-activity readiness in patients with an ankle sprain. Some subpopulations of ATs experienced more favorable or prohibitive conditions for assessment use.

Athletic Trainers' Perceptions of Salary Negotiation Decision-Making During the Hiring Process.

CONTEXT: Appropriate salaries for athletic trainers (ATs) have been a contentious topic for decades. While professional advocacy efforts to increase ATs' salaries have gained traction, little is known about ATs' experiences with negotiation during the hiring process. OBJECTIVE: To explore the reasons, influences, and factors influencing ATs' negotiation decisions. DESIGN: Qualitative study. SETTING: Individual video interviews. PATIENTS OR OTHER PARTICIPANTS: 28 ATs who participated in a previous study and indicated a willingness to participate in the qualitative follow-up were interviewed (17 women, 10 men, 1 non-binary individual; age = 37.8±8.9 years; athletic training experience = 15.1±8.3 years). Of the 28 participants, 18 did negotiate, while 10 did not. DATA COLLECTION AND ANALYSIS: An individual videoconference interview was conducted with each participant. After transcription, data were analyzed into themes and categories following the consensual qualitative research tradition. To ensure trustworthiness of the findings, we confirmed accuracy through member checks, triangulated the data using multi-analyst research teams, and confirmed representativeness by including an external auditor. RESULTS: Four parallel themes emerged during data analysis; factors for determining salary negotiation, reasons for negotiating/not negotiating, negotiation influencers/deterrents, and experiences with negotiation/impact of not negotiating. CONCLUSIONS: Negotiators used a variety of data sources to support their requests, and their decisions were motivated by their known value, the area's cost of living, and their current financial or employment situations. Negotiators relied on previous experiences to guide negotiations and provided successes and regrets from their negotiation experience. Nonnegotiators also used a variety of data types but were deterred by fear: of not knowing how to negotiate, losing the offer, or off 26 ending those involved. Non-negotiators highlighted lack of confidence they had in their ability to negotiate and provided the financial consequences and personal regrets from not negotiating. More training, education, and publicly available data are needed to assist ATs in future negotiation attempts.

Athletic Trainers' Perceptions of and Experiences with Professional Development Approaches for Enhancing Clinical Documentation.

CONTEXT: Little is known about how athletic trainers (ATs) learn clinical documentation, but previous studies have identified that ATs desire a need for more educational resources specific to documentation. OBJECTIVE: To obtain ATs' perspectives on learning clinical documentation. DESIGN: Qualitative study. SETTING: Web-based audio interviews. PATIENTS OR OTHER PARTICIPANTS: 29 ATs who completed two different continuing education (CE) clinical documentation modules. Participants averaged 36.2±9.0 years of age and included 16 women and 13 men representing 21 U.S. states and 8 clinical practice settings. DATA COLLECTION AND ANALYSIS: Participants were recruited from a group of ATs who completed one of two web-based CE clinical documentation modules. Within 3 weeks of completing the educational modules, participants were interviewed regarding their perceptions of how they learn clinical documentation, including their experiences completing the modules. Using the Consensual Qualitative Research approach, 3 researchers and 1 internal auditor inductively analyzed the data during 5 rounds of consensus coding. Trustworthiness measures included multi-analyst triangulation, data source triangulation, and peer review. RESULTS: Two themes emerged from the data, including 1) mechanisms of learning documentation and 2) benefits of the educational modules. ATs primarily learn documentation through professional education and workforce training, but training appears to be inconsistent. Participants perceived both educational modules were effective at increasing their knowledge and confidence related to learning documentation. The CE modules incited a growth mindset and intention to change behavior. CONCLUSIONS: ATs are satisfied with web-based CE learning experiences specific to clinical documentation and may benefit from more CE offered in these formats. Educators are encouraged to integrate clinical documentation principles throughout the curriculum, during both didactic and clinical education. Workforce training is also valuable for improving knowledge and skills related to clinical documentation, and employers should onboard and support ATs as they start new positions.

Muslim Collegiate Student-Athletes' Experience with Fasting During Ramadan While Participating in Sport.

CONTEXT: As colleges and universities continue to focus on creating diverse, equitable, and inclusive environments, it is important to gain more knowledge on the experiences that Muslim student-athletes have while fasting during the month of Ramadan. While previous researchers have investigated the physical effects of fasting on the body, little is known about the challenges or support Muslim student athletes experience while fasting and participating in sport during Ramadan. OBJECTIVE: To explore the experiences of Muslim collegiate student-athletes regarding fasting during Ramadan while participating in sports. DESIGN: Consensual qualitative research. SETTING: Individual video interviews. PARTICIPANTS: 12 Muslim collegiate student-athletes (4 women, 8 men; age = 19.9±1.4 years) from 7 universities across 7 states were interview. DATA COLLECTION AND ANALYSIS: semi-structured interview guide consisting of questions pertaining to the Muslim student-athletes' beliefs, challenges, experiences, and feelings were used to gather perceptions of fasting during Ramadan while participating in sport. Data were analyzed by a multi-analyst research team and coded into common themes and categories via a multi-phase consensus process. RESULTS: Four major themes emerged from the interview process, including the significance of fasting and Ramadan (familial influence, religious belief, introspection and spiritual growth), intrinsic challenges (physical mental and emotional, time constraints), extrinsic challenges (lack of available resources, knowledge and curiosity of others, lack of understanding by others) and various support (sport-specific support, community support, desired support) that impacted participants' experiences with fasting during Ramadan while participating in sport. CONCLUSIONS: The athletic community should seek to better support Muslim student-athletes and respect the importance of fasting during Ramadan. Parties interested in the success of these athletes in sport should improve their understanding regarding Ramadan and the desired support of Muslim student-athletes during fasting.

Negotiation Practices of Athletic Trainers Employed in the Clinical Setting.

CONTEXT: Athletic trainers (ATs) are comparatively underpaid relative to peer health care professionals. Whereas many factors contribute to the salary and benefits of a given employment position, negotiation is a factor of the final salary and benefits package that is achieved. It is unclear to what extent ATs negotiate salary or other terms of employment during the hiring process. OBJECTIVE: To explore the negotiation practices of ATs during the hiring process. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 587 ATs employed in the clinical setting who previously held at least 1 full-time employment position. MAIN OUTCOME MEASURE(S): Independent variables were several demographic factors as well as the current salary range. Dependent variables were participants' responses to various survey items focused on experiences with salary and terms-of-employment negotiation. Summary statistics were used to characterize all variables and multiple χ2 analyses (P < .05) were performed to determine the significant influences of independent variables on negotiation practices. RESULTS: More than half of ATs (57.6%) did not attempt to negotiate their salary, and almost three-quarters of ATs (70.5%) did not negotiate their terms of employment during the hiring process. The most successfully negotiated terms were moving expenses (72.3%) and continuing education funding and reimbursement (62.7%). The influence of demographic factors on negotiation and negotiation success varied, with significant findings for the number of previous full-time employment positions, gender, marital status, salary range, and number of dependents. CONCLUSIONS: It is alarming that more than half of ATs did not negotiate salary or terms of employment during the hiring process. Whereas widespread training on negotiation practices is warranted, our findings suggest it would be most beneficial for early-career and female ATs. All ATs must become comfortable with negotiating salary and terms of employment to effect change in the average salary and employment status of those in the profession.

Influence of Gender in Preceptor-Student Dyads on Student Performance in Clinical Education: A Report from the AATE Research Network.

CONTEXT: Health professions education programs incorporate clinical education to prepare students for autonomous clinical practice. Although preceptor-student gender dyads impact student evaluations, specific influences of gender dyad pairings on student autonomy and behavior implementation have not been identified. OBJECTIVE: To examine the influence of preceptor-student gender dyads on athletic training student opportunities to engage in clinical practice during clinical experiences and to determine whether constitution of preceptor-student gender dyads influenced student ability to enact professional behaviors during patient encounters (PEs). METHODS: Multisite panel design involving 12 professional athletic training programs (ATPs, 5 undergraduate, 7 graduate). Participants included 338 athletic training students enrolled in ATPs that used E*Value to document PEs during clinical experiences. Student gender, student role in the PE (observe, assist, or perform), preceptor gender, and student implementation of behaviors associated with core competencies during the PE were measured outcomes. RESULTS: The 30,446 PEs were categorized into 4 preceptor-student dyad categories. Female students with male preceptors were less likely to perform PEs than they were to observe them (OR 0.76; 95%CI 0.69, 0.83; p<0.001). Female students with female preceptors reported fewer opportunities for behaviors associated with interprofessional education and collaborative practice (IPECP) (X2(3)=16.6, p=0.001). CONCLUSIONS: Female athletic training students under male preceptorship had fewer opportunities to perform during PEs, and female students under female preceptorship had limited opportunities to participate in IPECP. Health professions education program administrators should encourage students to advocate for opportunities in autonomous practice and implementation of professional behaviors.

Implementation of Patient-Centered Care by Athletic Training Students during Clinical Experiences: A Report from the Association of Athletic Training Education Research Network.

Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. A multisite panel design was used to recruit 363 students from twelve professional athletic training programs (five undergraduate, seven graduate). Over 1.5 years, clinical experience patient encounter data were logged in E*Value Case Logs, including student role during the encounter, length of encounter, and clinical site. Generalized estimating equations models characterized the likelihood students included PCC behaviors in 30,522 encounters. Discussing patient goals was associated with student role (χ2(2) = 40.6, p < 0.001) and length of encounter (χ2(4) = 67.6, p < 0.001). Using patient-reported outcome measures was associated with student role (χ2(2) = 21.6, p < 0.001), length of encounter (χ2(4) = 34.5, p < 0.001), and clinical site (χ2(3) = 17.3, p = 0.001). Implementing clinician-rated outcome measures was affected by length of encounter (χ2(4) = 27.9, p < 0.001) and clinical site (χ2(3) = 8.6, p = 0.04). PCC behaviors were largely associated with student role and length of encounters; clinical site had less impact. Athletic training educators should emphasize progressive autonomous supervision with preceptors and encourage students to facilitate slightly longer patient visits, when possible, to incorporate more PCC behaviors.

Salivary microRNA as a prospective tool for concussion diagnosis and management: A scoping review.

BACKGROUND: Despite increased efforts directed toward research, concussions are a growing concern and can be a complex injury for healthcare professionals to manage. Current practices are largely dependent on patients self-reporting symptoms and a clinical assessment, which uses objective tools that lack effectiveness. With the demonstrated effects of concussions, it is imperative that a more valid or reliable objective tool, like a clinical biomarker, be identified to improve outcomes. One potential biomarker that has shown promise is salivary microRNA. However, there is no objective consensus as to which microRNA offers the most clinical value regarding concussions, hence this review. Therefore, the purpose of this scoping review was to identify salivary miRNAs associated with concussions. METHODS: Two independent reviewers performed a literature search to identify research articles. Studies using human subjects, collected salivary miRNA, and were published in English were included. Data of interest were salivary miRNA, collection timing, and relation to concussion diagnosis or management. RESULTS: This paper reviews nine studies that analyzed salivary miRNA for concussion diagnosis and management. CONCLUSIONS: In total, the studies have identified 49 salivary miRNA that show promise in assisting with concussion practices. With continued research, the use of salivary miRNA may enhance clinicians' abilities to diagnose and manage concussions.

Content Validation of the Athletic Training Milestones: A Report from the Association for Athletic Training Education Research Network.

The Athletic Training Milestones were developed as a comprehensive framework to assess athletic trainers' knowledge, skill, and behavior acquisition across the continuum of athletic training practice. However, without established content validity, it is unclear whether the Athletic Training Milestones can be used effectively as a clinical evaluation and research tool to evaluate competence and performance across multiple users and sites. We conducted a highly conservative content validity index (CVI) with data from 12 content experts. Our findings revealed an extremely high overall scale CVI of 0.99, and CVI scores of the 28 individual subcompetency items assessed ranged from 0.83 to 1.00. For the athletic training profession to truly embrace competency-based evaluation and performance assessments, we need a highly valid and comprehensive instrument, such as the Athletic Training Milestones.

Negotiation Practices of Athletic Trainers Employed in the Clinical Setting.

CONTEXT: Athletic trainers (ATs) are comparatively underpaid relative to peer healthcare professionals. While many factors contribute to salary and benefits of a given employment position, negotiation is a factor of the final salary and benefits package that is achieved. It is unclear to what extent ATs negotiate salary or other terms of employment during the hiring process. OBJECTIVE: To explore the negotiation practices of ATs during the hiring process. DESIGN: Cross-sectional. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: 587 ATs employed in the clinical setting that previously held at least one full-time employment position. MAIN OUTCOME MEASURES: Independent variables included several demographic factors as well as current salary range. Dependent variables were participants' responses to various survey items focused on experiences with salary and terms of employment negotiation. Summary statistics were used to characterize all variables and multiple chi-square analyses (p<.05) were performed to determine significant influences of independent variables on negotiation practices. RESULTS: More than half of ATs did not attempt to negotiate their salary (57.6%), and almost three-quarters of ATs did not negotiate terms of employment (70.5%) during the hiring process. The most successfully negotiated terms were moving expenses (72.3%) and continuing education funding/reimbursement (62.7%). The influence of demographic factors on negotiation and negotiation success varied with significant findings for: number of previous full-time employment positions, gender, marital status, salary range, and number of dependents. CONCLUSIONS: It is alarming that more than half of ATs do not negotiate salary or terms of employment during the hiring process. While widespread training on negotiation practices is warranted, our findings suggest it would be most beneficial for early-career and women ATs. ATs must become comfortable with negotiating salary and terms of employment in order to effect change on the average salary and employment status of those in the profession.

Assessments Used by Athletic Trainers to Decide Return-to-Activity Readiness in Patients.

CONTEXT: Patients with ankle sprains are often cared for by athletic trainers (ATs). Expert consensus was previously established for Rehabilitation-Oriented Assessments (ROASTs) that should be included in ankle sprain evaluations. However, it is unknown what methods ATs use to determine return-to-activity readiness following an ankle sprain. OBJECTIVE: Our purpose was to identify ATs' methods for determining patients' return-to-activity readiness following an ankle sprain and demographic determinants of ATs' methods. SETTING: Online survey Study Design: Cross-sectional study Level of Evidence: CEBM Level 1 Participants: We recruited 10,000 clinically practicing ATs. A total of 676 accessed the survey, 574 submitted responses (85% completion rate), and 541 respondents met inclusion criteria. MAIN OUTCOME MEASURES: We distributed an online survey to participants to ask them about their assessment of pain, swelling, range of motion, arthrokinematics, strength, balance, gait, functional capacity, physical activity level, and patient-reported outcomes in deciding return-to-activity. Descriptive statistics characterized participant demographics and frequencies of assessment measures used by ATs. Chi-square analyses identified relationships between demographics and assessment selection. RESULTS: Pain, swelling, range of motion, strength, balance, gait, and functional capacity were assessed by 76-97% of ATs. Arthrokinematics, physical activity level, and patient-reported outcomes were assessed by 25-36% of participants. When selecting specific assessment methods, ATs often did not use recommended ROASTs. ATs with higher degrees, more advance educational programs, employment in non-traditional settings, more clinical experience, and familiarity with expert consensus recommendations were more likely to use ROASTs. CONCLUSIONS: Before approving return-to-activity for patients with ankle sprains, some recommended outcomes and assessment methods are not evaluated by ATs. Practice in non-traditional settings, more advanced degrees, more clinical experience, and familiarity with expert-consensus guidelines appear to facilitate use of ROASTs.

Perceived Instability, Pain, and Psychological Factors for Prediction of Function and Disability in Individuals With Chronic Ankle Instability.

CONTEXT: Chronic ankle instability (CAI) is associated with residual instability, pain, decreased function, and increased disablement. Injury-related fear has been associated with CAI, although its relationship to other impairments is unclear. The fear-avoidance model is a theoretical framework hypothesizing a relationship among pain catastrophizing, injury-related fear, chronic pain, and disability. It has been useful in understanding fear's influence in other musculoskeletal conditions but has yet to be studied in those with CAI. OBJECTIVE: To explore relationships among instability, pain catastrophizing, injury-related fear, pain, ankle function, and global disability in individuals with CAI. DESIGN: Cross-sectional study. SETTING: Anonymous online survey. PATIENTS OR OTHER PARTICIPANTS: A total of 259 people, recruited via email and social media, with a history of ankle sprain completed the survey; of those, 126 participants (age = 32.69 ± 4.38 years, females = 84.92%, highly active = 73.81%) were identified as having CAI and were included in the analysis. MAIN OUTCOME MEASURE(S): Demographics of gender identity, age, and physical activity level were recorded. Assessments used were the Identification of Functional Ankle Instability questionnaire (instability), the Pain Catastrophizing Scale (pain catastrophizing), the Tampa Scale of Kinesiophobia-11 (injury-related fear), a numeric pain rating scale and activity-based question (pain presence), the Quick Foot and Ankle Ability Measure (ankle function), and the modified Disablement in the Physically Active Scale (disability). Relationships among variables were explored through correlation and regression analyses. RESULTS: After we controlled for instability and pain, pain catastrophizing and injury-related fear were significantly related to function and disability ratings in individuals with CAI. Together, the variables predicted 48.7% (P < .001) of the variance in function and 44.2% (P < .001) of the variance in disability. CONCLUSIONS: Greater instability, pain catastrophizing, injury-related fear, and pain predicted decreased function and greater disability in those with CAI. These findings are consistent with the hypothesized relationships in the fear-avoidance model, although further investigation is needed to determine causality of these factors in the development of CAI.

Characteristics of Patient Encounters for Athletic Training Students During Clinical Education: A Report From the Association for Athletic Training Education Research Network.

CONTEXT: To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients who have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences. OBJECTIVE: To describe the characteristics of patient encounters (PEs) ATSs engaged in during clinical experiences. DESIGN: Multisite panel design. SETTING: Twelve professional athletic training programs (5 bachelor's, 7 master's). PATIENTS OR OTHER PARTICIPANTS: A total of 363 ATSs from the athletic training programs that used E*Value software to document PEs during clinical experiences. MAIN OUTCOME MEASURE(S): During each PE, ATSs were asked to log the clinical site at which the PE occurred (college or university, secondary school, clinic, or other), the procedures performed during the PE (eg, knee evaluation, lower leg flexibility or range of motion, cryotherapy), and the patient's diagnosis, with the International Classification of Diseases, Tenth Revision code (eg, S83.512A knee sprain, anterior cruciate ligament). RESULTS: A total of 30 630 PEs were entered by 338 ATSs across 278 unique clinical settings. More than 80% of PEs occurred in college or university and secondary school settings. More than half of the diagnoses were categorized as affecting the lower body region. Examination and evaluation procedures and application of therapeutic modality procedures each contributed approximately 27% of procedures. CONCLUSIONS: It was surprising that ATSs were not gaining experience in all clinical practice settings in which athletic trainers commonly practice. Our data suggest that students may be consigned to working with patients who have more frequently occurring injuries, which may not prepare them for the realities of autonomous clinical practice. These findings indicate that directed efforts are needed to ensure that ATSs are provided opportunities to engage with diverse patient populations who have a variety of conditions in an array of clinical site types during their clinical experiences.

Core Competency-Related Professional Behaviors During Patient Encounters: A Report From the Association for Athletic Training Education Research Network.

CONTEXT: To enhance the quality of patient care, it is important that athletic trainers integrate the components of the core competencies (CCs; evidence-based practice [EBP], patient-centered care [PCC], health information technology [HIT], interprofessional education and collaborative practice [IPECP], quality improvement [QI], professionalism) as a part of routine clinical practice. In what ways, if any, athletic training students (ATSs) are currently integrating CCs into patient encounters (PEs) during clinical experiences is unclear. OBJECTIVE: To describe which professional behaviors associated with the CCs were implemented by ATSs during PEs that occurred during clinical experiences. DESIGN: Multisite panel design. SETTING: A total of 12 professional athletic training programs (5 bachelor's, 7 master's level). PATIENTS OR OTHER PARTICIPANTS: A total of 363 ATSs from the athletic training programs that used E*Value software to document PEs during clinical experiences participated. MAIN OUTCOME MEASURE(S): During each PE, ATSs were asked to report whether professional behaviors reflecting 5 of the CCs occurred (the professionalism CC was excluded). Summary statistics, including means ± SDs, counts, and percentages were tabulated for the professional behaviors of each CC. RESULTS: Data from 30 630 PEs were collected during the study period. Professional behaviors related to EBP were the most frequently incorporated during PEs (74.3%, n = 22 773), followed by QI (72.3%, n = 22 147), PCC (56.6%, n = 17 326), HIT (35.4%, n = 10 857), and IPECP (18.4%, n = 5627). CONCLUSIONS: It is unsurprising that EBP and PCC behaviors were 2 of the most frequently incorporated CCs during PEs due to the emphasis on these competencies during the past several years. However, it is surprising that ATSs did not incorporate behaviors related to either HIT (in 65% of PEs) or IPECP (in 82% of PEs). These findings suggest that directed efforts are needed to ensure that ATSs are provided opportunities to incorporate professional behaviors related to the CCs during clinical experiences.

The Role Mentoring Plays in the Transition to Practice of Newly Credentialed Athletic Trainers.

CONTEXT: Mentoring has been identified as an important method of supporting newly credentialed athletic trainers (ATs) during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs in developing a plan to better facilitate the transition. OBJECTIVE: To examine which aspects of the mentoring relationship provided the most benefit during the transition to practice of newly certified ATs. DESIGN: Qualitative study. SETTING: Individual phone interviews. PATIENTS OR OTHER PARTICIPANTS: A total of 13 ATs who graduated from a professional master's program, were certified from February through July 2016, and obtained employment from July through August 2016 participated in this study (6 women, 7 men; age = 26 ± 3 years; work settings included professional sports, college, secondary and middle school, and clinic). Data saturation guided the number of participants. DATA COLLECTION AND ANALYSIS: Phone interviews using a semistructured interview guide were conducted at 3, 8, and 12 months of work experience. Data were analyzed using a constant comparative approach. Credibility was established via investigator triangulation, peer debriefing, and member checks. RESULTS: Participants recognized the mentoring relationship as a foundational aspect of the transition to practice. Mentors should be available by phone, email, or text to answer questions, provide feedback, or discuss ideas. Respondents wanted honest feedback, even when that feedback was constructively critical. Feedback was sought regarding topics such as patient care, communication, and networking. Participants needed reassurance and support from their mentors to help validate and improve their self-confidence. CONCLUSIONS: Newly credentialed ATs should seek mentors who will be available to communicate in various ways and will provide regular and constructive feedback. Future researchers should investigate how mentoring relationships influence other aspects of the transition to practice, such as patient care, overall job performance, turnover, and satisfaction.

The Role Mentoring Plays in the Transition to Practice of Newly Credentialed Athletic Trainers.

CONTEXT: Mentoring has been identified as an important method to support newly credentialed athletic trainers during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs to develop a plan, which could better facilitate the transition. OBJECTIVE: To examine what aspects of the mentoring relationship provided the most benefit during transition to practice. DESIGN: Grounded theory. SETTING: Individual phone interviews. PATIENTS OR OTHER PARTICIPANTS: 13 athletic trainers who graduated from a professional master's program, were certified between February and July of 2016, and obtained employment between July to August 11 of 2016 participated in this study (6 female, 7 male, 26±3 years; work settings included professional sports, college, secondary and middle school, and clinic). Data saturation guided the number of participants. DATA COLLECTION AND ANALYSIS: Phone interviews using a semi-structured interview guide were conducted at 3, 8 and twelve months of work experience. Data were analyzed using a constant comparative approach. Credibility was established through investigator triangulation, peer debriefing, and member checks. RESULTS: Participants recognized the mentoring relationship as a foundational aspect of the transition to practice. Mentors should be available by phone, email, and/or text and to answer questions, provide feedback and/or discuss ideas. Participants want honest feedback, even when that feedback is constructively critical. Feedback was sought regarding topics such as patient care, communication, and networking. Participants needed reassurance and support from their mentor which helped to validate and improve confidence. CONCLUSIONS: Newly credentialed athletic trainers should seek a mentor who will be available to communicate in various ways and provide regular and constructive feedback. Future research should investigate how mentoring relationships influence other aspects of the transition such as patient care, overall job performance, turnover, and satisfaction.

The Effect of Fibular Reposition Taping on Postural Control in Individuals With Chronic Ankle Instability: A Critically Appraised Topic.

Clinical Scenario: History of acute ankle sprains can result in chronic ankle instability (CAI). Arthrokinematic changes resulting from CAI may restrict range of motion and contribute to postural control deficits. Mulligan or fibular reposition taping (FRT) has been suggested as a means to realign fibular positional faults and may be an effective way to improve postural control and balance in patients with CAI. Clinical Question: Is there evidence to suggest that FRT will improve postural control for patients with CAI in the affected limb compared with no taping? Summary of Key Findings: Three of the 4 included studies found no significant difference in postural control in patients receiving FRT compared with sham or no tape. Clinical Bottom Line: There is moderate evidence refuting the use of FRT to improve postural control in patients with CAI. Strength of Recommendation: There is grade B evidence to support that FRT does not improve postural control in people with CAI.

Athletic Training Student Core Competency Implementation During Patient Encounters.

CONTEXT: Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience. OBJECTIVE: To determine the relationship between the frequency and length of PEs, as well as the student's role and clinical site during PEs, and the students' perceived CC implementation during these encounters. DESIGN: Cross-sectional study. SETTING: Professional athletic training program, National Collegiate Athletic Association Division I institution. PATIENTS OR OTHER PARTICIPANTS: We purposefully recruited 1 athletic training program that used E*Value software; 40 participants (31 females, 9 males) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. INTERVENTION(S): Participants viewed a 20-minute recorded CC educational module followed by educational handouts, which were also posted online for reference throughout the semester. The E*Value software was used to track PEs, including the type of encounter (ie, actual patient, practice encounter, didactic practice scenario), the type of site where the encounter occurred (university, high school), and the participant's role (observed, assisted, performed), as well as responses to an added block of questions indicating which, if any, of the CCs were implemented during the PE. MAIN OUTCOME MEASURE(S): Variables per patient were PE length (minutes), participant role, site at which the encounter occurred, and whether any of the 6 CCs were implemented ( yes/ no). Variables per participant were average encounter length (minutes), encounter frequency, modal role, clinical site assignment, and the number of times each CC was implemented. Separate 1-way analyses of variance were used to examine the relationships between role or clinical site and implementation of total number of CCs. Multiple linear regressions were used to determine how the average length and frequency of PEs were related to the average and total number of implemented CCs. Binary logistic regression models indicated how the length of each encounter, role of the participant, and type of clinical site related to the implementation of each CC. RESULTS: The roles of participants during PEs were related to their ability to implement the total number of CCs ( F = 103.48, P < .001). Those who observed were likely to implement fewer total CCs than those who assisted (M diff = -0.29, P < .001); those who assisted were likely to implement more total CCs than those who performed (M diff = 0.32, P < .001). Frequency of encounters was the only significant variable in the model examining all independent variables with CC implementation ( b4,32 = 3.34, t = 9.46, P < .001). CONCLUSIONS: The role of the student, namely assisting during PEs, and the volume of PEs should be considered priorities for students to promote greater CC implementation.

Preparation of the Professional Athletic Trainer: A Descriptive Study of Undergraduate and Graduate Degree Programs.

CONTEXT: The examination of the appropriate professional degree for preparation as an athletic trainer is of interest to the profession. Descriptive information concerning universal outcomes is needed to understand the effect of a degree change. OBJECTIVE: To obtain and compare descriptive information related to professional athletic training programs and a potential degree change and to determine if any of these factors contribute to success on existing universal outcome measures. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: We contacted 364 program directors; 178 (48.9%; 163 undergraduate, 15 postbaccalaureate) responded. INTERVENTION(S): The survey consisted of 46 questions: 45 questions that dealt with 5 themes (institutional demographics [n = 13], program admissions [n = 6], program outcomes [n = 10], program design [n = 9], faculty and staff [n = 7]) and 1 optional question. MAIN OUTCOME MEASURE(S): Descriptive statistics for all programs were calculated. We compared undergraduate and postbaccalaureate programs by examining universal outcome variables. RESULTS: Descriptive statistics demonstrated that 33 programs could not support postbaccalaureate degrees, and a substantial loss of faculty could occur if the degree requirement changed (553 graduate assistants, 642 potentially underqualified instructors). Postbaccalaureate professional programs had higher 2011-2012 first-time Board of Certification (BOC) passing rates (U = 464.5, P = .001), 3-year aggregate first-time BOC passing rates (U = 451.5, P = .001), and employment rates for 2011-2012 graduates employed within athletic training (U = 614.0, P = .01). Linear multiple-regression models demonstrated that program and institution type contributed to the variance of the first-time BOC passing rates and the 3-year aggregate first-time BOC passing rates (P < .05). CONCLUSIONS: Students in postbaccalaureate athletic training programs performed better in universal outcome measures. Our data supported the concerns that this transition could result in the loss of some programs and an additional immediate strain on current staff due to potential staffing changes and the loss of graduate assistant positions.