Immersive Clinical Education Experiences in Athletic Training: A Report From the NATA Professional Education Committee

• Athletic training programs have autonomy to structure immersive clinical education experiences, and there is variation in how programs implement these experiences for students.

• Many programs use immersive clinical experiences beyond what is required by accreditation standards.

• Program administrators should more closely consider the resources available to students during immersive clinical experiences to assist with financial and emotional strain.

• The ambiguity in accreditation standards may account for variations in the implementation of immersive experiences and suboptimal practices associated with length, coursework, and awareness of student resources.

Immersive clinical education experiences (ImCEs) in athletic training are defined as,

The purpose of implementing ImCEs into the curriculum was to provide students with opportunities that might be missed in the traditional model, such as administrative tasks, meetings, or collaboration.²  Additionally, ImCEs positively impact transition to practice and strengthen mentoring relationships with preceptors, which also affects professional socialization.^3,4 

Clinical experiences embedded within health profession curricula are crucial to students’ development of knowledge, skills, and socialization into the profession.⁵  The importance of clinical education is highlighted by their inclusion in accreditation standards of other health profession education programs.^1,6,7  Physical therapy accreditation requires clinical experiences integrated with didactic education and 1 full-time terminal experience after all didactic coursework with clinical applications.⁶  Occupational therapy students have level I and level II fieldwork.⁷  Level II is most similar to athletic training’s ImCEs, with the goal of preparing students for entry-level practice as an occupational therapist.⁷ 

Physical and occupational therapy programs precipitated athletic training’s movement to require ImCEs, which became part of the Commission on Accreditation of Athletic Training Education (CAATE) accreditation standards in July 2020.¹  The accreditation standards for all 3 professions are not prescriptive regarding the maximum length of immersion nor the placement of the ImCE in the curriculum, allowing academic programs freedom to use ImCEs in a manner that best suits their curriculum. For example, the specific structure and length of the immersive experience beyond the minimum are up to the program to determine.

As widespread ImCEs are relatively novel to athletic training, there is little to no research investigating Athletic Training Programs’ (ATPs’) approaches to incorporating and facilitating ImCEs in the curriculum. Additionally, the National Athletic Trainers’ Association (NATA) Reshaping Education document recommends the examination of models of clinical education for delivery and effectiveness to determine model practices.⁸  Previous research has explored the perception of ImCEs on student experience,²  preceptor perceptions,^4,9  perceived challenges,¹⁰  patient encounters,¹¹  and impact on transition to practice³ ; however, research has not explored specific structures and how programs are implementing ImCEs. It is important to investigate how academic programs are incorporating ImCEs to better understand how athletic training students are being professionally prepared. Therefore, the purpose of this study was to explore the structure of the immersion experience among ATPs and practices relating to developing and implementing ImCEs.

A cross-sectional web-based survey was used to investigate the characteristics of ImCEs in professional ATPs. This study was deemed exempt by the Marietta College Human Subjects Committee. All participants consented to participate before data collection. The Checklist for Reporting of Survey Studies checklist was used for data reporting.¹² 

Coordinators of Clinical Education (CCEs) at all ATPs (n = 265) were purposely recruited using contact information provided by the CAATE for all CCEs at the time of data collection. We sent recruitment emails to 265 potential participants, 7 of which were undeliverable. Of the 103 CCEs who started the survey (38.9% access rate), 99 (96.1% completion rate) answered all questions.

Due to the exploratory nature of this study, we developed a survey to examine program characteristics and practices for ImCEs during professional athletic training education. Survey sections included participant demographics (4 questions), program demographics (9 questions), clinical immersion details (7 questions), finding and establishing sites (7 questions), preceptor education and preparation (3 questions), and resources available to students (6 questions). After providing personal and program demographic information, participants provided details on each ImCE required by the program (eg, length of experience, timing in the curricular sequence, setting, location, and concurrent didactic coursework), how new immersive sites are established (eg, resources used and responsible party), administrative details (eg, affiliation agreements, clinical orientation and onboarding, and preceptor development), and student support resources (eg, financial support provided and health and well-being resources).

The instrument was reviewed by 4 athletic training educators with expertise in athletic training education research and survey development to establish face and content validity. Peer reviewers reviewed the survey instrument for clarity, relevance, and importance on a 4-point scale (1 = unclear, not relevant, or not important; 4 = very clear, highly relevant, or very important). We removed or edited questions scoring lower than 3 out of 4. We made minor changes to the wording for clarity and deleted 5 questions. The survey was pilot tested with 5 ATP administrators who provided qualitative feedback and timing information, resulting in further clarification of some question prompts and answer options, the addition of 1 question, and the deletion of 1 question.

Recruitment emails were sent to all professional program CCEs per the CAATE database in fall 2023 through Qualtrics. Two reminder emails were sent to those who had not yet accessed or completed the survey. Each email contained a link to a Qualtrics survey. Data were collected over 12 weeks from November 2023 to January 2024.

Data were downloaded, cleaned, and imported into IBM SPSS Statistics (version 29.0.2.0; IBM Corp) for analysis. We performed descriptive statistical analysis due to the exploratory nature of the study. Frequencies, means, and standard deviations were calculated to describe the structure of the ImCEs in ATPs and practices relating to identifying and developing ImCEs.

The survey was completed by 103 (women = 69, men = 29, 4 = prefer not to disclose, 1 = unanswered) of 265 (39.0%) CCEs. The average time since CCE certification was 20.3 ± 8.6 years (range, 2–44 years). CCEs from all 11 districts responded. Ten programs reported not yet having any cohorts go through an immersive clinical experience, whereas 3 CCEs reported clinical immersion experiences of less than 4 weeks. These 13 were removed from the analysis, and we were left with 90 programs for analysis. Table 1 shows distributional statistics for program and ImCEs for the remaining 90 programs.

Many programs (50.0%, 45/90) require only 1 ImCE, whereas 24.4% (22/90) require 2, 12.2% (11/90) require 3, 8.9% (8/90) require 4, 3.3% (3/90) require 5, and 1.1% (1/90) require 6. Most participants reported that their first ImCE occurred in the second year (81.1%, 73/90), whereas 18.9% (17/90) of experiences occurred in the first year of the curriculum. The length of reported ImCE ranged from 4 to 28 weeks.

Approximately one-third of participants (34.4%, 31/90) reported having ImCEs that are 4 weeks long; however, the majority have additional ImCEs across the curriculum. In total, 11.1% (10/90) of participants reported having only 1 4-week ImCE. Almost half of the participants (45.6%, 41/90) reported having at least 1 ImCE lasting at least 10 weeks, whereas 1 program had a full-year ImCE.

Spring (78.9%, 71/90; Figure 1) is the most common time for immersive clinical experiences, but the first ImCE is almost equally divided between fall (36.7%, 33/90) and spring (32.2%, 29/90). Some participants noted that timing varies based on student choice (eg, fall or spring). The college/university setting is most commonly used; 100% (90/90) of respondents reported using that setting (Figure 2). In total, 13.43% (12/90) of CCEs selected every setting, suggesting that they sent students anywhere a preceptor was available. Most participants (71.1%, 64/90) indicated that 1 or more of the ImCEs allow students to relocate to distant clinical education sites depending on student preference, 25.6% (23/90) indicated that 1 or more of the ImCEs require students to relocate, necessitating different housing, and 3.3% (3/90) indicated that students do not relocate.

Participants reported that 71.1% (64/90) of programs have students complete didactic coursework during at least 1 ImCE. This differed based on the length of clinical education experience, as some ImCEs with shorter experiences tended to have no classes, whereas longer experiences tended to use both asynchronous and synchronous courses. Most programs (75.0%, 48/64) use asynchronous online courses with no required meetings with due dates throughout the semester (Table 2).

When establishing new ImCE sites, participants reported requiring between 6 weeks and 12 months to establish contracts, finalize paperwork, and assign students. Most participants (52.2%, 47/90) reported that the process lasted between 2 and 6 months, whereas 32.2% (29/90) reported that it took between 6 months and 1 year. In total, 28.9% (26/90) of CCEs reported that they had administrative staff or legal counsel assistance in establishing affiliation agreements/program memoranda, but 88.9% (80/90) reported that the CCE was involved or overseeing the process. When finding ImCE sites, 51.1% (46/90) of CCEs reported that they and the student share responsibility to identify the ImCE site, whereas 24.4% (22/90) reported that it falls on them only, 18.9% (17/90) reported that it was the responsibility of the student, 4.4% (4/90) reported a combination of program faculty and student, and 1 program identified a separate clinical immersion site coordinator as the responsible party. Table 3 outlines resources used by CCEs and students to identify sites. Professional networks and current/previous preceptors were the most common resources.

When reporting financial assistance, 61.1% (55/90) reported only whatever financial aid the student receives, 46.7% (42/90) of CCEs reported that students do not receive financial assistance for ImCEs, 37.8% (34/90) reported that some support may be provided by clinical sites, and 5.6% (5/90) reported that a fund or scholarship was available for which students apply.

Most (90.0%, 81/90) participants reported formal methods in place to check in with students during ImCEs. Of those, 77.8% (63/81) reported asynchronous contact such as journal submissions or email, 64.2% (52/81) used 1-on-1 virtual meetings with the CCE or program faculty, 63.0% (51/81) reported synchronous virtual meetings, 34.6% (28/81) used 1-on-1 in-person meetings with the CCE or other program faculty, 28.4% (23/81) had synchronous in-person meetings, and 6 (7.4%, 6/81) reported other methods of formal check-ins. Most reported students having access to both institutional mental health (61.1%, 55/90) and health or wellness resources (51.1%, 46/90). However, a significant portion were unsure if students had access to mental health (32.2%, 29/90) and health or wellness resources (37.8%, 34/90; Figure 3).

Regarding the training and development of preceptors, 68.9% (62/90) used 1-on-1 live virtual training, 46.7% (42/90) used 1-on-1 in-person training, 45.6% (41/90) used group virtual training (eg, Zoom, Teams, and WebEx), 44.4% (40/90) said they used asynchronous learning management systems (eg, Blackboard, Canvas, and D2L), and 35.6% (32/90) used group in-person training. In total, 26.7% (24/90) of CCEs reported using different preceptor training for ImCEs.

Since the implementation of the 2020 CAATE educational standards, there has been much discussion of ImCEs, including what they are and how to implement the experiences to enhance student learning. Within athletic training, institutional autonomy enables program administrators to determine how ImCEs are structured as long as they meet the CAATE accreditation standards. However, it is unclear how programs structure these experiences; therefore, the purpose of our study was to explore the structure of the ImCEs among ATPs and practices relating to developing and implementing ImCEs. This is the first study to examine the structure and approach to ImCEs from a programmatic perspective in athletic training education.

Widespread ImCEs are still relatively new in athletic training, and the structure of these experiences is evolving. Our results found that ImCEs were reported from 4 to 28 weeks (full academic year). Although the minimum for athletic training ImCEs is 4 weeks, other professions such as physical therapy and occupational therapy currently require longer terminal clinical experiences. Physical therapy requires a minimum of 30 weeks,⁶  whereas occupational therapy requires 24 weeks.⁷  Athletic training preceptors and program administrators have reported that longer ImCEs are more beneficial for students.^9,13  Preceptors believe that it takes 3 to 4 weeks for students to be oriented/integrated into clinical sites,⁹  and there are few studies discussing orientation and time to acclimatize as a part of clinical education.¹⁴  One challenge with shorter ImCEs is that it takes time for the student to learn the role, integrate into the setting, and develop a relationship and gain the preceptor’s trust to be able to complete some of the “additional tasks” (eg, administrative, interprofessional and collaborative practice, and communicating with stakeholders).¹⁰  Additionally, short ImCEs do not allow students to see the “ebbs and flows” inherent in the athletic season.⁹  Longer exposure during ImCEs may facilitate the transition to practice by allowing students to gain more responsibility over time, progress toward autonomous practice, and fully understand the role of an athletic trainer (AT).¹³  Previous research suggests extending the length of the ImCEs beyond 4 weeks⁹ ; however, programmatic challenges exist to expanding ImCEs, such as decreasing time in the didactic setting to both teach and allow enough time for students to absorb the information.¹⁵  Program faculty have the opportunity to be creative in finding ways to structure the program to meet both didactic and clinical needs. Future research should examine the ideal length of time for ImCEs and how that impacts student outcomes (eg, patient encounters, impact on transition to practice, and Board of Certification scores).

Most program respondents have the first ImCE in the second year of the program; however, 17 programs reported the first ImCE occurring in the first year. Preceptors,⁹  students,²  and program administrators¹⁵  prefer ImCEs to occur in the second year so students have better knowledge and skills, and students are ready to be immersed into full-time practice as ATs.

There may be challenges in having enough time to teach and students adequately learn foundational coursework if ImCEs are placed early in the program. Recently, the American Council of Academic Physical Therapy Education provided best practice recommendations for clinical education, including implementing integrated clinical education experiences throughout the curriculum to prepare students to be successful in the terminal, full-time clinical experience.¹⁶  Additionally, nursing models scaffold the exposure to patient care gradually, increasing intensity and complexity through simulations and integrated field experiences and culminating with ImCEs.¹⁷  Through this approach, students were prepared to engage in the ImCE.¹⁷ 

Having requisite knowledge for clinical education, especially ImCEs, is important to optimize learning and provide safe patient care.^16,18  Physical therapy developed the Student Readiness Panel to explore the knowledge, skills, and abilities students should have before beginning their terminal clinical experience.¹⁹  Research should explore what baseline knowledge, skills, and attitudes athletic training students should possess before beginning ImCEs so students are ready for full-time clinical practice.

Anecdotally, some programs only use ImCEs, which has benefits and challenges. Students may not have the opportunity for immediate application inherent in the integrated model.¹⁵  For example, with an integrated model, students learn something in class and may have the opportunity to immediately apply that information in clinical education that day or week. With the block didactic/clinical model, students may need to wait to apply the information until they are in clinical education. Future research should explore the usefulness of incorporating both integrated and immersive experiences compared with only immersive experiences and the effects on student outcomes. Future research should also explore the timing of the ImCE to develop best practices in athletic training clinical education.

When considering timing, program administrators should use this as an opportunity to be creative when designing clinical education experiences.¹⁵  At the postbaccalaureate level, programs are not constrained with liberal studies courses and may have more flexibility with the academic calendar.²⁰  Our results showed that most ImCEs occur in the fall and spring semesters. Program administrators should evaluate learning objectives associated with each ImCE to determine optimal timing (eg, exposure to the reality of athletic training early versus transition to practice preparation toward the end of the program). Future research should explore student perceptions of their role and learning experiences in both the first and second year and student outcomes to determine best practices for timing.

Most of our participants reported offering ImCEs in the college/university and secondary school settings, whereas other sites were included less frequently. This is consistent with previous research examining patient encounters for both integrated and ImCEs that found that most clinical education experiences occur at the college/university and secondary school setting, despite the distribution of ATs across practice settings.¹¹  However, clinic settings have more observation experiences, and students play a less active role.¹¹  Future research should further examine patient encounters across settings to determine if students are truly getting the totality of care provided by an AT if they are in a clinic or physician setting.

When determining which clinical site to use, preceptor selection is key. Some participants reported that they would use any site with an AT to serve as the preceptor. One benefit of ImCEs is the ability to select preceptors based on their desire, skills, and knowledge instead of location.²¹  Program administrators report selecting preceptors who have some experience (eg, more than 2 years), have contemporary expertise that aligns with student learning objectives, and are willing to provide progressive supervision toward autonomy.¹³  Preceptors who are committed to teaching, create learning opportunities, and act as professional models are important characteristics of effective preceptors.²²  Program administrators are encouraged to gather feedback from students, patient encounter logs, clinical site visits, and preceptor discussions to ensure that the setting and preceptor are appropriate for student development.

Our study found that both students and CCEs are responsible for finding ImCE sites. As a part of the role, the CCE is responsible for assigning students to athletic training clinical experiences.¹  There are various factors that go into clinical site selection, including compliance with accreditation standards, feedback from stakeholders related to clinical sites and preceptors, quality of the experience, student aspirations, and access.²³  Student input is important when placing students at clinical education sites,²³  especially ImCE sites.²¹  Some nursing programs require students to secure clinical experiences, but there is still a CCE to facilitate course objectives.¹⁷  Historically, clinical education sites are often selected due to geographical convenience, but with ImCEs, there are more opportunities to select sites based on student goals and perspectives, quality of preceptor and site, and preceptor investment in student education.²¹  Due to the financial implications of ImCEs, students should have a voice in selecting ImCEs.¹⁰  Program administrators should work with students to determine the best ImCE site based on student needs and goals.

When finding potential clinical sites, program administrators and students are encouraged to continue using professional and alumni networks. Additionally, there are member organizations that have resources for finding clinical sites. At the time of this survey, several options were available. The NATA repository on Gather is designed for clinical sites to post their available experiences. The Association of Athletic Training Educators also has an ImCE site resource. However, both the NATA and Association of Athletic Training Educators resources are members only and therefore not open to all students. Some state associations (eg, North Carolina Athletic Trainers’ Association) also have websites where potential sites can post opportunities. The North Carolina Athletic Trainers’ Association website is open to the public but is not easily found if a student is unaware that it exists. Students and program administrators should use these resources when finding and establishing new sites. Although students might find potential clinical sites on websites such as Gather, Association of Athletic Training Educators, or state websites, students are encouraged to collaborate with the CCE to develop the clinical site because there are administrative details (eg, affiliation agreements) to consider. Program administrators are encouraged to develop policies and procedures guiding how immersive sites are found and established so students are aware of their role and input.

Most participants reported using the same preceptor initial training and development for integrated and immersive preceptors, including in-person, virtual, and asynchronous training. One challenge with using the same training is the needs are different between the types of experiences. Preceptors have reported insufficient training to successfully precept the immersive student, including not having enough information on the goals and objectives of the experience and not fully understanding the differences between the ImCE and integrated clinical experiences.⁴  Preceptor development assists preceptors in understanding their role and programmatic expectations; however, they often do not receive training on progressive supervision. Clinical education experiences should be scaffolded to allow for progressive autonomy, in which supervision occurs “along a continuum, moving students from interdependent to independent based on knowledge and skills and context of care.”¹  As students gain knowledge and develop skills, they are given more responsibility in the clinical setting, especially in the immersive setting.¹³  The nature of the ImCE is different, and thus preceptor needs may differ. Grimes et al recommended formal preceptor training to ensure that preceptors are aware of the role and expectations of being a preceptor.²  Future research should explore specific training and development needs of preceptors of ImCEs.

Our results found that most students do not receive any financial assistance for ImCEs beyond what financial aid the student receives. A few programs indicated that some clinical sites provide financial assistance, whereas 1 program stated that there was a program stipend to assist. The financial burden is a noted challenge for students during ImCEs, as many off-campus locations may require students to secure housing or travel long distances to the site.¹⁰  Additionally, students may not be able to manage a part-time job during clinical education to pay living expenses.¹⁰  This challenge is not limited to athletic training, as other graduate students in health care fields rely on loans to cover educational costs, which can negatively impact graduates regardless of how much educational debt they have.²⁴  Future research should explore financial aspects associated with clinical education (both immersive and integrated) and graduate programs and the long-term effects of educational debt to develop resources and educational programming to help students understand financial implications. Future research could explore creative ways in which programs can work to alleviate some of the stress associated with paying for related clinical education costs.

Mental health and well-being should be considered during ImCEs, as students have reported isolation¹⁰  and burnout.²⁵  In 1 study, nearly half of students engaged in a semester-long ImCE reported personal burnout.²⁵  Isolation is a challenge that has been reported during the ImCE, especially when sites are off campus.¹⁰  Asynchronous communication did not decrease the amount of isolation experienced.¹⁰  In our study, the majority of CCEs used formalized methods to check in with students; however, nearly one-third of those used asynchronous methods, such as journal submissions or emails. Most ImCE research explores the positive aspects of learning²  and transition to practice³ ; however, future research should explore student mental health and well-being, especially with distance and longer-duration ImCEs. Future research should also explore what type of communication or check-ins would be best to prevent feelings of isolation. Research should explore student needs while away at their immersive sites, such as check-ins, frequency of communication, virtual meetings, or site visits.

There were some emergent concerns within the results related to alignment with CAATE accreditation standards.¹  Previous research noted a lack of clear definitions for ImCE before the final release of the 2020 CAATE accreditation standards; however, programs still appear to have questions or confusion related to the definition.¹⁰  Program administrators reported selecting clinical sites to ensure they meet accreditation requirements, yet multiple programs reported concerning responses related to the length of clinical education experiences, courses requiring synchronous instruction during the ImCE, and student support.²³  Because of the amount of discussion and questions regarding ImCEs, we theorize that programs do not understand all the nuances of the experience instead of willfully disregarding the requirements in the standards. The CAATE currently does listening sessions where program faculty can discuss concerns; however, if questions are not brought up regarding some of these challenges (eg, synchronous classes during the ImCE and student access to health care resources), the CAATE cannot provide responses and clarification. More discussion and clarity on various aspects of ImCEs are warranted to ensure that programs are compliant with the standards.

Three programs reported ImCEs that were fewer than 4 weeks, which does not meet the definition and accreditation requirements of being a minimum of 4 weeks.¹  Potentially, the challenge, in this case, is not that programs are lacking evidence of compliance but instead are lacking a common language to communicate the types of clinical education experiences in which students are engaged. The American Council of Academic Physical Therapy found that definitions and a common language were necessary to reduce confusion.¹⁶  Within athletic training research, “traditional” clinical education experiences have been termed both integrated²⁶  and nonimmersive.¹¹  This leads to confusion and the need for clear definitions for all clinical experiences. For example, a program elects to use a 2-week, full-time experience, yet that does not meet the definition of immersive or integrated. The Strategic Alliance should explore the development of universal definitions related to clinical education to alleviate confusion.

Another emergent concern was the use of coursework during ImCEs, as 71.1% of programs reported having classes simultaneously. Although many reported using online, asynchronous coursework, approximately one-quarter of programs required synchronous meetings either virtually (21.9%) or in-person (4.7%). Per CAATE Standard 16, “Students must participate in the day-to-day and week-to-week role of an athletic trainer.”¹  If students are taking synchronous courses during this time, they may theoretically be missing an aspect of the day-to-day role of an AT. Unfortunately, this study did not provide an opportunity for participants to follow up and clarify if students were missing clinical education time to participate in class. Future research should explore the impact of having synchronous coursework and if it detracts from the nature of the ImCE. Additionally, more discussion and clarification from the CAATE may be warranted to ensure that programs comply with the standard.

Finally, one of the more concerning findings from a student health and well-being perspective is that more than one-third of participants were unsure if students in ImCEs were able to access institutional mental health or health and wellness resources. Standard 52 requires programs to ensure that students have “sufficient access to advising, counseling services, health services, disability services, and financial aid services,”¹  and it must be comparable for students engaged in clinical education at remote locations. Clinical coordinators who were unsure of the availability of health and wellness resources may not have students engaged in distance clinical education, but we are unable to confirm if this is the case. As discussed previously, students may experience feelings of isolation and burnout and therefore should have access to health services and counseling. Program administrators should determine if students have access as a way to protect the student and comply with the standard. Before engaging in clinical education, program administrators can have students fill out a self-emergency action plan to prepare themselves for ImCEs.²⁷  This includes compiling information related to common stressors and managing stress during clinical education. Students should consider where they will access health care (eg, physical, mental, dental, and vision) and compile insurance information, emergency contacts, and health history. Having this information compiled before going to a distant clinical education site can alleviate stress when students need to access health care.

This study is the first of its type in athletic training education, and although it produced useful information, it is not without limitations. The data presented represent 34% of programs, as we were limited by program responses, programs that had not yet implemented ImCEs, and programs that have ImCEs of less than 4 weeks. Although this is a good response rate for surveys in athletic training, it leaves out data for many programs. The survey was sent to all professional program CCEs in the CAATE directory. Five institutions had 2 CCEs listed, both of whom received an invitation to participate in this study. We cannot rule out that programs are represented twice; however, given the exploratory nature of our research, this is unlikely to have a significant effect on our findings. Additionally, the nature of survey research is to get a snapshot of what is occurring, and we were unable to ask follow-up questions for clarification. This was especially relevant for questions related to compliance with accreditation standards. Future research should use qualitative methods to gather more information about why programs structure ImCEs in the way that they do. Additionally, athletic training education is constantly evolving to meet educational needs.

Exploration of clinical education experiences is a priority for athletic training education, and model practices should be developed.⁸  Although the study provides an overview of what is happening in athletic training education currently, future research should examine the timing of ImCEs, progressive autonomy during clinical education, and preceptor engagement and development on student outcomes and transition to practice. Additionally, the integrated experience should also be explored to determine if they still have value and utility in athletic training education. Future research should also explore student perceptions of the process (eg, timing, needs, and emotional well-being).

The timing and duration of ImCEs vary widely across programs. The consistent use of college/university and secondary schools aligns with findings that students in these settings have more direct roles in patient care, aligning with the purpose of ImCEs.^1,11  Programs that require multiple ImCEs may want to consider requiring a culminating experience of a longer duration in a setting that emphasizes student autonomy and provides opportunities to engage in all 5 domains of athletic training practice. Programs with only 1 ImCE may want to consider the overall sequence of their curriculum and placement of the ImCE for the same reasons. Our finding that programs have ImCEs of less than 4 weeks, require synchronous instruction, and are unfamiliar with available student health and wellness resources leads us to conclude that the CAATE may need to clarify minimum standards and better differentiate types of clinical experiences to provide a common language to ATPs for discussion of the clinical experiences in which students are engaged.