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 ¼ 103.48, P , .001). Those who observed were likely to implement fewer total CCs than those who assisted (M diff ¼ À0.29, P , .001); those who assisted were likely to implement more total CCs than those who performed (M diff ¼ 0.32, P , .001). Frequency of encounters was the only significant variable in the model examining all independent variables with CC implementation (b 4,32 ¼ 3.34, t ¼ 9.46, P , .001).Conclusions: The role of the student, namely assisting during PEs, and the volume of PEs shou...

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 between injury-related fear, chronic pain, pain catastrophizing, 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 between 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 e-mail and social media, with a history of ankle sprain completed the survey; of those, 126 participants (age=32.69±4.38, female=84.92%, highly active=73.81%) were identified to have CAI and were included in the analysis. Main Outcome Measure(s): Demographics included gender identity, age, and physical activity level. Assessments encompassed the Identification of Functional Ankle Instability (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-FAAM (ankle function), and the modified Disablement in the Physically Active Scale (disability). Relationships between variables were explored through correlation and regression analyses. Results: After controlling 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) variance in function and 44.2% (P<.001) variance in disability. Conclusions: Greater instability, pain, greater pain catastrophizing, and greater injury-related fear were predictive of decreased function and greater disability in those with CAI. This is 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.

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.

Context Scholarship is a required element of the 2020 curricular content standards in professional athletic training education. Objective To explore the perceptions and experiences of implementing student scholarship within a professional program. Design Consensual qualitative research. Setting Individual phone interview. Patients or Other Participants Seventeen program directors of professional programs (professional bachelor's program = 12, 70.6%; professional master's program = 3, 17.6%; both = 2, 11.8%). Programs reported an average of 3 ± 1 core faculty (range, 1–5 faculty) supporting 37 ± 21 students (range, 3–96 students), with 3 ± 2 faculty (range, 1–8 faculty) involved in scholarship activities of their students. Data saturation guided the number of participants. Data Collection and Analysis Interviews occurred via phone using a semistructured interview guide. All interviews were audio-recorded and transcribed verbatim. Data were analyzed by a 3-person research team and coded into themes and categories based on a consensus process. Credibility was established by utilizing multiple researchers, an external auditor, and member checks. Results Two major themes emerged from the data: perceptions and mechanisms of scholarship. Student engagement in scholarship was perceived as valuable, but it was challenging to develop buy-in from students and preceptors. Participants felt that the term research carried a stigma, making it difficult to cultivate the value of scholarly clinical practice. When institutional culture embraced scholarship, participants indicated it was easier to integrate scholarly activities into the program. Participants reported students engaged in a variety of scholarly activities, including traditional research and evidence-based practice. Some scholarship experiences were singular, occurring once in the curriculum, while others were purposeful, sequenced, and integrated throughout the curriculum. Future scholarship endeavors included traditional theses and experimental research as well as practice-based, point-of-care research that might better integrate clinical practice and scholarship. Conclusions Participants perceived scholarship as important to professional preparation and required intentional action to integrate throughout the curriculum.

Context Athletic training program administrators have identified that it is important to incorporate a scholarship component into professional education curricula. Objective Explore the barriers to implementing student scholarship in professional programs and identify resources necessary to overcome the barriers. Design Consensual qualitative research. Setting Individual teleconference interview. Patients or Other Participants A total of 17 program directors of professional programs was interviewed. Programs reported an average of 3 ± 1 core faculty supporting 37 ± 21 students, with 3 ± 2 faculty involved in scholarship activities of their students. Data saturation guided the number of participants. Data Collection and Analysis Interviews occurred using a semistructured interview guide. All interviews were recorded and transcribed verbatim. Data were analyzed by a 3 person research team and coded into themes and categories based on a consensus process. Credibility was established by using multiple researchers, an external auditor, and member checks. Results Two major themes emerged from the data: (1) current challenges and shortcomings and (2) resources and strategies needed to achieve scholarship. Participants noted a lack of research or scholarship culture at their current institution and a lack of faculty time and expertise to implement and guide research throughout the curriculum as current challenges. Participants further identified that a lack of clear expectations for how much scholarship was necessary and lack of buy-in from faculty, students, and preceptors made it difficult to implement scholarly projects in the curriculum. Necessary resources to overcome barriers included institutional support in the form of faculty release, support, training, or all of the aforementioned. Participants identified that collaborative research opportunities as well as publicly available examples of completed student scholarly activity would further guide them in overcoming the curricular challenge of implementing scholarship. Conclusions Internal institutional support, external peer collaboration, and public examples of success are necessary to overcome barriers to scholarship integration in professional athletic training curricula.