Context: Appropriate methods for evaluating clinical proficiencies are essential in ensuring entry-level competence.Objective: To investigate the common methods athletic training education programs use to evaluate student performance of clinical proficiencies.Design: Cross-sectional design. Data Collection and Analysis: The institutional survey consisted of 11 items regarding institutional and program demographics. The 14-item Methods of Clinical Proficiency Evaluation in Athletic Training survey consisted of respondents' demographic characteristics and Likert-scale items regarding clinical proficiency evaluation methods and barriers, educational content areas, and clinical experience settings. We used analyses of variance and independent t tests to assess differences among athletic training education program characteristics and the barriers, methods, content areas, and settings regarding clinical proficiency evaluation.Results: Of the 3 methods investigated, simulations (n 5 191, 95.0%) were the most prevalent method of clinical proficiency evaluation. An independent-samples t test revealed that more opportunities existed for real-time evaluations in the college or high school athletic training room (t 189 5 2.866, P 5 .037) than in other settings. Orthopaedic clinical examination and diagnosis (4.37 6 0.826) and therapeutic modalities (4.36 6 0.738) content areas were scored the highest in sufficient opportunities for real-time clinical proficiency evaluations. An inadequate volume of injuries or conditions (3.99 6 1.033) and injury/condition occurrence not coinciding with the clinical proficiency assessment timetable (4.06 6 0.995) were barriers to real-time evaluation. One-way analyses of variance revealed no difference between athletic training education program characteristics and the opportunities for and barriers to real-time evaluations among the various clinical experience settings.Conclusions: No one primary barrier hindered real-time clinical proficiency evaluation. To determine athletic training students' clinical proficiency for entry-level employment, athletic training education programs must incorporate standardized patients or take a disciplined approach to using simulation for instruction and evaluation.Key Words: standardized patients, clinical competence, clinical instruction, evaluation barriers Key Points N Of 3 commonly used evaluation methods for student performance of clinical proficiencies (real time, simulations, standardized patients), simulations were used most frequently.N Opportunities for real-time evaluation were greater in high school and collegiate athletic training rooms than in other settings. Orthopaedic clinical examination and diagnosis, therapeutic modalities, conditioning and rehabilitative exercise, and risk management were the content areas most often evaluated in real time.N Athletic training education programs should either incorporate the use of standardized patients or take a disciplined approach to using simulation in clinical proficiency instruction and evaluatio...

Context Simulations and standardized patient (SP) encounters are used to provide clinical experiences for students. In athletic training, no research has examined the perceived educational benefits of these interventions. Objective To explore athletic training students' perceptions regarding small group SP encounters and individual case-based simulations (CBSs). Design Grounded theory. Setting One midwestern university. Patients or Other Participants Nine athletic training students (3 males, 6 females; 20 ± 0.833 years old) who enrolled in a lower extremity orthopaedic evaluation course during their first or second semester in an athletic training program. Main Outcome Measure(s) Semistructured interviews were recorded, transcribed verbatim, and analyzed using open coding and axial and selective coding (ie, to develop themes/threads). To ensure trustworthiness, we used member checks and peer debriefing. Results For both the small group SP counter and individual CBS, 2 themes emerged: (1) reflection-on-specific action and (2) increased confidence. Participants reflected on both experiences when providing patient care. Participants felt that both encounters could improve their confidence with regard to future clinical evaluations. Specific to the small group SP encounters, peer-assisted learning emerged as a theme. Participants felt they learned from and with each other when performing the evaluation together. Specific to the individual CBS, organization of thoughts emerged as a theme. During the individual CBSs, participants felt they developed, controlled, and organized their thoughts during the evaluation. Conclusions Both teaching encounters can be integrated into the curriculum of an athletic training program. Each strategy provides students with a nonthreatening educational experience with no harm to patients. In addition, each encounter can correspond to content taught in the classroom or laboratory. The long-term benefits of small group SP encounters and CBSs are unclear, and more research is needed.

Context Researchers have reported that interacting with standardized patients (SPs) is a worthwhile and realistic experience for athletic training (AT) students. These encounters enhance students' interviewing skills, confidence as a clinician, clinical skill development, and interpersonal communication. Objective To determine how SP encounters impacted students' confidence in performing clinical evaluations. Design Pretest-posttest survey design. Setting Athletic training simulation lab. Patients or Other Participants Thirty-five students from the junior (n = 20) and senior (n = 15) AT cohorts from a public liberal arts institution in the Southeast. Intervention(s) Athletic training students completed 2 SP encounters per semester throughout an academic year in the AT program, totaling 4 SP encounters. Main Outcome Measure(s) Each student completed a 17-item Likert scale (1 = strongly disagree, 5 = strongly agree) that rated confidence levels immediately before and after each SP encounter. The confidence rating assessed students' confidence regarding how the SP encounter affected their confidence in completing patient evaluations (eg, identifying history questions, interpreting results of special tests). We computed descriptive statistics for all items Wilcoxon signed rank tests determined differences in pre-encounter and should be postencounter confidence ratings. Results Overall, students from both cohorts reported that the SP encounter improved confidence in completing clinical evaluations. Specifically, students reported a significant increase from pre-encounter to postencounter confidence ratings after nutrition-based (Z = −2.991, P = .004), knee (Z = −3.261, P = 0.001), concussion (Z = −3.294, P = .001), psychosocial intervention (Z = −3.062, P = .002), and general medical (Z = −3.524, P > .001) SP encounters. Conclusions The authenticity and fidelity of the SP encounter provided the AT students a real-time clinical evaluation in a nonthreatening environment. Students reported that their confidence improved after each encounter. By providing these experiences, AT students can become comfortable interacting with patients in clinical evaluations.

Most clinical proficiencies are evaluated via simulations. The ACIs should maximize real-time situations to evaluate students' clinical proficiencies whenever feasible. Athletic training education program administrators should develop alternative methods of clinical proficiency evaluations.

Context: Continuing education (CE) is intended to promote professional growth and, ultimately, to enhance professional practice.Objective: To determine certified athletic trainers' participation in formal (ie, approved for CE credit) and informal (ie, not approved for CE credit) CE activities and the perceived effect these activities have on professional practice with regard to improving knowledge, clinical skills and abilities, attitudes toward patient care, and patient care itself.Design: Cross-sectional study. Setting: Athletic training practice settings.Patients or Other Participants: Of a geographic, stratified random sample of 1000 athletic trainers, 427 (42.7%) completed the survey.Main Outcome Measure(s): The Survey of Formal and Informal Athletic Training Continuing Education Activities was developed and administered electronically. The survey consisted of demographic characteristics and Likert-scale items regarding CE participation and perceived effect of CE on professional practice. Internal consistency of survey items was determined using the Cronbach a (a 5 0.945). Descriptive statistics were computed for all items. An analysis of variance and dependent t tests were calculated to determine differences among respondents' demographic characteristics and their participation in, and perceived effect of, CE activities. The a level was set at .05.Results: Respondents completed more informal CE activities than formal CE activities. Participation in informal CE activities included reading athletic training journals (75.4%), whereas formal CE activities included attending a Board of Certification-approved workshop, seminar, or professional conference not conducted by the National Athletic Trainers' Association or affiliates or committees (75.6%). Informal CE activities were perceived to improve clinical skills or abilities and attitudes toward patient care. Formal CE activities were perceived to enhance knowledge.Conclusions: More respondents completed informal CE activities than formal CE activities. Both formal and informal CE activities were perceived to enhance athletic training professional practice. Informal CE activities should be explored and considered for CE credit.Key Words: athletic trainers, professional advancement, lifelong learning Key Points N Athletic trainers engaged in both formal and informal continuing education activities to improve their knowledge, clinical skills or abilities, attitudes toward patient care, and patient care itself.N Athletic trainers participated in informal continuing education more often than in formal continuing education and preferred shorter-duration activities.N Formal continuing education was perceived to improve knowledge more than informal continuing education did, although the latter was perceived to improve clinical skills or abilities and to improve attitudes toward patient care more than the former. Both types were believed to improve patient care.