Context Continuing education (CE) in athletic training is commonly achieved at multi-session conferences. Objectives To explore athletic trainers' (ATs') planning practices at multi-session conferences regarding format types, preferred domains of athletic training practice, and ideal number of concurrent sessions. Design Cross-sectional survey with quantitative and qualitative questions. Setting Web-based Patients or Other Participants 8660 ATs surveyed Intervention(s) We established content and face validity and piloted the tool before use. We distributed the survey via email weekly for 6 weeks. Trustworthiness of qualitative data was established with multiple-analyst triangulation and external auditing. Data were collected through a Web-based survey comprised of demographic questions and questions regarding CE choices. Main Outcome Measure(s) Quantitative data- measures of central tendency, standard deviations, and frequencies; qualitative- inductive coding method. Results 908 ATs responded (response rate = 10.5%) and 767 were included in analysis. Respondents (age, y = 38 ± 11; females = 367, males = 249, missing/prefer not to answer = 151; 15 ± 11 years of clinical experience) most preferred to attend workshops (78%, n = 598/767), large-group lectures (75.9%, n = 582/767), and small-group lectures (63.5%, n = 487/767). They were motivated to select preferred session formats by learning preferences (38.4%, n = 239/623) and interest in the topic (37.4%, n = 233/623). Examination, assessment, and diagnosis was the most preferred domain (80.7%, n = 619/767). Health care administration and professional responsibility was least preferred (41.9%, n = 321/767). Practical application was the main influencer (53.4%, n = 337/631) to attend sessions. Almost half (49.7%, n = 381/671) of respondents stated that their CE selection behaviors changed depending on the number of concurrent sessions. They prioritized sessions by interest when conflicts occurred (31.4%, n = 211/671). Conclusion Reducing feelings of indecision and ensuring applicable sessions for ATs is important. Multi-session conferences should include sessions that align with attendee preferences relative to domains of practice and session formats. However, attendee preferences provide faulty guidance for CE decision-making and should not be the only mechanism to drive planning.

Context Technology continues to change throughout the world, and higher education is not absent from the adjustment. Athletic training educators should adapt to online learning opportunities that enhance the curriculum for their students. Objective To explore athletic training students' thoughts and knowledge when learning through a distance education platform. Design Cross-sectional, mixed-methods survey. Setting Six professional postbaccalaureate athletic training programs. Patients or Other Participants A total of 55 second-year athletic training students. Intervention(s) One-week asynchronous eLearning module focused on the background and use of telemedicine in health care. Main Outcome Measure(s) Participants completed the technology acceptance model tool before and after the module to gather their perspectives about online learning. During the eLearning module, knowledge acquisition was assessed with quizzes. Finally, a transactional distance theory tool including 2 open-ended response items was delivered at the end of the eLearning module. Results We identified that participants had a low acceptance for technology at the onset of the study that improved after the eLearning intervention for the constructs of self-efficacy ( P = .010) and perceived ease of use ( P ≤ .001) of eLearning technologies. The transactional distance tool highlighted that the facilitator and readings were helpful, which was also indicative of the scores on the module quizzes. We also identified benefits to eLearning from the student perspective, which included previous experiences, learning on their own time, and feelings that the module was productive to their growth as students. Some participants stated that the eLearning module presented too much work and was missing interaction, whereas others were neutral relative to the comparison between traditional and online learning. Conclusions Overall, the results of this study identified that technology acceptance and transactional distance are important components of online learning. Athletic training educators should educate learners regarding the differences in online education requirements.

Context Telemedicine is the practice of providing diagnostic consultations and therapeutic interventions to patients at a distance using some form of technology. Typically, health care students do not have the opportunity to practice telemedicine. Objective To investigate athletic training students' ability to transfer telemedicine skills confidently and accurately in a standardized patient (SP) encounter. Design Single cohort. Setting Simulation center. Patients or Other Participants Fifty-five second-year athletic training students (age = 25 ± 3 years) from 6 professional master's athletic training programs volunteered for the study after a 1-week online learning experience about telemedicine. Intervention(s) We scheduled individual SP encounters that were completed at a distance using telepresence robots. Main Outcome Measure(s) Pre– and post–SP encounter validated confidence assessment and a 50-item content checklist (yes or no) scored by one evaluator. Results During the SP encounter, 87.3% of participants correctly diagnosed the SP actor with a lateral ankle sprain. We identified a significant improvement in confidence ( P ≤ .001) for using telemedicine technology. On the content checklist, participants scored poorly in the constructs of data gathering (mean = 7.44 ± 2.36 of 15, 49.58% ± 15.75%) and telemedicine (mean = 6.02 ± 2.74 of 14, 42.99% ± 19.56%), but scored well in the constructs of communication/interpersonal skills (mean = 12.05 ± 2.00 of 15, 80.36% ± 13.36%) and patient education (mean = 4.64 ± 1.06 of 6, 77.27% ± 17.67%). The mean sum score of all constructs on the SP encounter was moderate (30.15 ± 5.79 of 50, 60.29% ± 11.59%). Conclusions Exposure to telemedicine via an SP encounter improved confidence in performing the tech-based evaluation. Athletic training students performed well in demonstrating communication/interpersonal skills and patient education, yet struggled in their data gathering and telemedicine skills. Overall, participants accurately diagnosed a musculoskeletal condition using telemedicine.

Context Transition to practice is a pivotal period in an athletic trainer's (AT) career that includes higher-than-average job-related stress due to many changes. Objective To assess how early-career ATs from professional master's athletic training programs (PMATP) developed professional responsibility during their transition to practice. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants A total of 137 participants who graduated from a PMATP and who were board certified from 2016 to 2018 completed the study. Intervention(s) The Web-based survey asked which transition-to-practice tactics were used, if they were helpful, and how they were helpful with respect to preparation (formal coursework and clinical experiences), orientation, and mentorship. Main Outcome Measure(s) We calculated frequencies for each tactic in transition to practice, the tactic's helpfulness, and what the tactic specifically aided during the participant's transition. Results Overall, 78.8% (108/137) of participants perceived their PMATP prepared them to transition to practice. Regarding formal coursework, the majority indicated they discussed professional behaviors (78.1%, 107/137), which was very helpful (43.9%, 47/107) in developing professional communication (70.1%, 96/137). The most frequent tactics in clinical experiences included being encouraged to make patient-care decisions (82.5%, 113/137, extremely helpful = 76.1%, 86/113) and being provided feedback about performance (81.8%, 112/137, extremely helpful = 76.1%, 86/113), which developed confidence (75.9%, 104/137). Few participants (24.1%, 33/137) indicated they were exposed to formal orientation. Almost half reported having informal orientation by learning on the job (39.4%, 54/137). Few participants were assigned a mentor (25.5%, 35/137); those who were indicated that the mentor was extremely helpful (40.0%, 14/35) for understanding the role of an AT. Conclusions Early-career ATs perceived that their PMATP, informal orientation, and unassigned mentors were helpful in developing professional responsibility. Often these tactics were effective at developing confidence, but other tactics may be necessary to assist role understanding, managing patient load and administrative duties, and resolving conflicts.

Context Athletic trainers (ATs) who serve as preceptors for athletic training students must model, facilitate, and guide professional skills and behaviors, including medical documentation. Preceptors have the unique ability to combine skill practice with real-time patient encounters for athletic training students. Objective To describe the frequency of preceptors who allow athletic training students to complete medical documentation and rationale for their decisions. Design Cross-sectional. Setting Qualitative study. Patients or Other Participants Of 9578 ATs, 1150 responded to an electronic survey (access rate = 12.0%), and 385 of 1150 respondents who completed an electronic survey (33.5%) indicated being a preceptor for a professional athletic training program. Respondents (age = 34 ± 11 years, clinical practice experience = 11 ± 10 years) were predominantly female (53.8%, n = 207) and held a master's degree (67.3%, n = 259). Main Outcome Measure(s) A 3-member data analysis team coded the open-ended responses following the consensual qualitative research approach. Each member coded 50 responses and a consensus codebook was created. The principal investigator coded the remaining responses, and the data analysis team confirmed the findings. Data were organized into emergent domains and categories. Frequency counts were calculated for each category. Results A majority of preceptors (81.8%, n = 315) allowed their athletic training students to document patient care. Respondents indicated an intention for student involvement (domain 1), whereby they wanted students to engage in learning and develop knowledge (43.4%, n = 167) or practice and gain experience (41.3%, n = 159). However, others discussed deterrents (20.0%, n = 77) working against the preceptor's intentions. Respondents also indicated a need to mentor (domain 2). Specifically, they reported needing to manage the logistics of documentation (63.6%, n = 245) and the degree of oversight (48.8%, n = 188) needed during practice (either direct [79.8%, n = 150 of 188] or indirect [20.2%, n = 38 of 188]). Conclusions Although preceptors intend to integrate students into medical documentation, they may benefit from formal guidance from the academic program on how to best integrate athletic training students into documenting day-to-day patient care.

Context Athletic training programs blend didactic experiences with clinical practice opportunities with varied patient populations. Traditionally, clinical education relies heavily on the preceptor to supervise, instruct, and mentor the professional athletic training student (P-ATS) during clinical education. Objective To describe a preceptor-led educational technique focused on creating meaningful clinical experiences that guide the P-ATS to self-reflect and improve clinical decision-making. Background Preceptors are expected to create an effective learning environment at their clinical site that prepares the P-ATS for independent clinical practice, yet some authentic patient encounters and administrative tasks may not be possible because of the nature of the clinical site. By implementing novel clinical education techniques that mimic clinical practice, the P-ATS can engage in meaningful clinical experiences in a safe environment, which aids in professional readiness for independent clinical practice that address learner goals and deficiencies in areas with minimal opportunities for real-time encounters. Description The preceptor designed educational techniques to cultivate meaningful clinical experiences that included incognito standardized patient encounters, structured debriefing, and reflective journaling. Clinical Advantages A 3-fold benefit exists. First, the P-ATS engages in meaningful clinical experiences to enhance professional readiness for replication of independent clinical practice. Second, the P-ATS develops soft skills, such as metacognitive reflection and quality improvement strategies, after completing the debrief sessions and reflective journaling. Lastly, the preceptor shares contemporary expertise through designing and implementing instructional strategies that mentor the P-ATS through difficult conversations and unique patient presentations. Conclusions Implementation of novel instructional strategies within clinical education demonstrates the ability for the P-ATS to engage in real-time clinical experiences in a safe environment and under the guidance of the preceptor.

Context Standardized patient (SP) encounters have been incorporated into many healthcare education programs, including professional athletic training programs, yet there is little exploration about the use of SP encounters in postprofessional programs and continuing education opportunities. Objective To explore athletic trainers' translation of skills and reflections in clinical practice after an SP encounter and debriefing session. Design Qualitative action research. Setting One-on-one interview. Patients or Other Participants Fifteen learners from the same postprofessional athletic training degree program (males = 3, females = 12; age = 25 ± 5 years; certified experience = 3 ± 3 years) without previous SP experience participated in this study. All learners had to be employed full or part-time in a clinical setting. Main Outcome Measure(s) Sixty days after an SP encounter related to patient-centered care during an orthopedic evaluation and subsequent debriefing session, participants completed an online, audio-only interview after a 10-question, semistructured interview protocol. A 3-person primary coding team identified domains and categories using the consensual qualitative research tradition. Results Three main domains emerged from the study: (1) limitations of a novice SP experience, (2) practice transformation, and (3) promoting self-reflection. Participants reported that the initial SP encounter in their postprofessional education was a new experience through which they were able to implement new skills learned in their previous courses. Translation of newly learned ideas or ways of thinking to clinical practice varied among clinicians and their job settings. Collaborative thinking and self-reflection were key components. Participants were able to identify with their classmates' struggles and triumphs and to take away new learning experiences. Conclusions SP encounters are a useful instructional and assessment technique for athletic trainers in a postprofessional athletic training degree program to promote self-reflection and to translate newly learned skills to their clinical practice, while nerves and anxiety influenced the learners' ability to suspend reality.

Context Simulations are commonly used in medical education to facilitate instructional and assessment experiences for learners. Standardized patients (SPs) are a form of simulation with actors trained to present conditions that occur in health care. The most important feature in simulation-based education is feedback; one form of group feedback is debriefing, intended to improve learning, future performance, and patient outcomes. Objective To explore reflections on learning after an SP encounter and debriefing session. Design Action research design with consensual qualitative research tradition. Setting One Midwestern University. Patients or Other Participants Seventeen postprofessional doctor of athletic training students with no previous experience with SPs (age = 25 ± 4 years; male = 5, 29.4%, female = 12, 70.6%; highest degree earned professional bachelor's = 12, 70.6% and postprofessional master's = 5, 29.4%, experience = 24.8 ± 30.5 months). Main Outcome Measure(s) Participants completed 1 of 3 SP encounters and the following day engaged in a diamond-debriefing session. After both the SP encounter and debriefing session, participants completed a 5-item open-ended questionnaire. The open-ended questions asked participants to self-reflect on what they learned after the SP encounter and the debriefing session. The questions were evaluated by a panel of qualitative researchers for content and face validity. Consensual qualitative research data analysis approach was used to analyze all open-ended responses. Results Our qualitative analysis revealed that reflections after both the SP encounter and debriefing session revolved around 3 overarching themes: organization of clinical exam, vulnerability, and patient-centered care. Conclusions The SP encounter and diamond-debriefing technique did facilitate self-reflection and inform and motivate learners to alter their future approach to patient-centered care. Future research could explore if reflection would differ if it occurred immediately after an SP encounter or 1 day after SP encounter.

Context: Postprofessional athletic training programs continue to prepare advanced-practice leaders in the profession. As part of being leaders and clinical scholars within the field, it is important that students pursing postprofessional graduate education be exposed to curriculum and instructional theory, practice, and strategies. Objective: To describe an education technique focused on the curation of a simulation assignment as part of a postprofessional athletic training course as a means to develop an appreciation of instructional strategies as a clinical scholar. Background: The postprofessional athletic training student (PP-ATS) may be working as a full-time clinician, graduate assistant, or novice educator, or as an intern within an athletic training clinic. Regardless of employment status, PP-ATSs engage with several key stakeholders, ranging from parents and legal guardians to coaching staff and professional athletic training students. The PP-ATS may be tasked to provide education to these stakeholders in the form of patient participation status to a coach, describing the pathogenesis of a condition to a patient, and rationale for care to professional athletic training students. Description: The PP-ATSs were placed in learning communities of 3 to 5 students. The learning communities were tasked with the development of high- and low-fidelity simulations for learners (the other PP-ATSs in the course) to engage in during an intensive and focused learning session, facilitation of the experience, and a debrief encounter. Clinical Advantage(s): A 2-fold benefit exists. First, PP-ATSs are engaged in the design and development of a simulation experience as an instructional intervention. Second, simulation learners are gainfully engaged in low-stakes patient encounters that promote professional growth. Conclusion(s): Developing and implementing learner-curated simulation experiences exposes PP-ATSs to an innovative instructional strategy in athletic training.

Context: Technology, social media, and access to health care continue to grow simultaneously. There is limited research on the knowledge of athletic training students regarding the ethical and legal practice of protected health information using technology and social media. Objective: To explore social media use of athletic training students and to determine their knowledge of patient privacy regulations within social media and technology. Design and Setting: Online survey instrument and knowledge assessment. Patients or Other Participants: A total of 652 athletic training students. Intervention(s): A knowledge assessment of 12 items based on the governance and use of patient privacy compliance in health care within the context of athletic training students' clinical experiences. Main Outcome Measure(s): An instrument of 26 questions, including 14 demographic and 12 knowledge items, was developed and content validated using a Delphi panel of experts in athletic training, health care information technology, and risk management lawyers. Descriptive statistics and independent t tests were calculated. Results: Athletic training students stated they had received previous education (n = 587 of 637, 92.2%) regarding Health Insurance Portability and Accountability Act (HIPAA) regulations, and had an average of 6.81 ± 2.75 active social media accounts. Only 24.2% (n = 154 of 636) of respondents stated their professional athletic training program had a social media policy that was strictly enforced. We identified a lack of knowledge of best practice by athletic training students, with an average knowledge assessment score of 4.92 ± 1.7 out of 13 (37.8%). Total knowledge scores were significantly different ( P = .008) if the respondent had previous HIPAA education. Conclusions: The respondents scored poorly on the knowledge assessment despite previous education related to HIPAA regulations. Athletic training educators should seek out strategies to adapt professional or preprofessional curricula to incorporate health care informatics and ethics to adapt to the current culture of technology and social media.