These results suggest the need for developing and implementing injury prevention programs targeted toward moderately active adults.

To help public health practitioners promote physical activities with a low risk of injury, this study determined the relation among type and duration of physical activity, cardiorespiratory fitness, and musculoskeletal injury in a sample of adults enrolled in the Aerobics Center Longitudinal Study. Subjects included 4,034 men and 967 women who underwent a baseline physical examination between 1970 and 1985 and who returned a mailed follow-up survey in 1986. At baseline, a treadmill graded exercise test was used to measure cardiorespiratory fitness. At follow-up, subjects reported injuries and type and duration of physical activity in the preceding 12 months. Polytomous logistic regression was used to estimate the association among physical activity type and duration, cardiorespiratory fitness, and injury. The risk of sustaining an activity-related injury increased with higher duration of physical activity per week and cardiorespiratory fitness levels. Results suggest that cardiorespiratory fitness may be a surrogate for unmeasured components of physical activity, such as exercise intensity. Among walkers, increasing duration of activity per week was not associated with an increased risk of injury. Results suggest that, for most adults, walking is a safe form of physical activity associated with a lower risk of injury than running or sport participation.

Objective: Each generation comes to college with varying characteristics that distinguish them from their predecessors. Teaching has evolved into a learning centered classroom that focuses on student learning rather than on teacher delivery. The purpose of this article is to introduce the Millennial Student and identify various characteristics that influence teaching and learning. Background: A new generation of learners has immersed themselves in the college classroom. They are determined, driven achievers who depend on technology and their support system. The method of teaching ten years ago is not the method to achieve learning with this generation. Their characteristics mimic the characteristics of the Silent Generation, those who were born between the years of 1925–1942, and are now grandparents to the Millennial. The Millennial are quite opposite of their predecessors, Generation X. Description: There are key descriptors of the Millennial Generation that define their characteristics as a society. These characteristics are identified with a strategy to understand and use as teachers implement learning. A paradigm shift is occurring, and higher education cannot ignore the needs of these students. Teachers are taking on various roles in and out of the classroom to achieve student learning and successful teaching. Athletic training education serves the Millennial Generation not only in the classroom, but in the clinical setting as well. A new understanding of this student allows educators to develop learning skills didactically and clinically. Advantages: Through the evolution of society, media, technology, and communication, teachers must understand their audience in order to develop instructional methods and delivery styles that will produce effective learning outcomes in the Millennial Student.

For healthy adults, walking at a brisk pace for 10-20 miles per week accumulates adequate moderate-intensity physical activity to meet national recommendations while minimizing the risk for musculoskeletal lower extremity injury. Clinicians may use this information to provide appropriate injury prevention counseling to their active patients.

The use of drugs and alcohol by National Collegiate Athletic Association Division I African American female basketball players and their reasons for using these substances were examined. The investigation is part of a broader study investigating the use of alcohol, weight-loss products, tobacco, amphetamines, and anabolic steroids by female college athletes. Of the 50 athletes in this study, 72% reported having consumed alcoholic beverages, and 46% had engaged in binge drinking. Only 8% reported using either weight-loss or tobacco products, and there were no reports of using amphetamines or anabolic steroids. Usage patterns indicated that the athletes in the study were aware of the short-term negative effects of alcohol and tobacco; those respondents who did use these products greatly reduced their consumption during the competitive season. Factors found to influence use include social and peer influences and coaches' rules.

Context: Workplace bullying (WPB) is a series of persistent negative interactions that affect a clinician's ability to perform his or her role. Although WPB has been studied in other health professions, to date, no information exists pertaining to WPB in athletic training.Objective: To determine the prevalence of WPB in the collegiate setting and examine factors that influence its occurrence.Design: Cross-sectional study. Setting: Collegiate setting.Patients or Other Participants: There were 723 (329 female, 394 male) athletic trainers (ATs) aged 37.5 6 10.4 years.Main Outcome Measure(s): We collected data via the validated and reliable online Athletic Training Environment Survey. Descriptive statistics were obtained to determine a bullying score for each AT and examine the prevalence of WPB. Chi-square analyses were performed to examine the differences between (1) sex, (2) academic degree level, (3) employment title, and (4) National Athletic Trainers' Association district.Results: A total of 106 participants (14.7%) had a score of 2 or higher, indicating they were bullied in the athletic training setting. Of those bullied, 47 (44.3%) were women and 59 (55.7%) were men. There was no difference between women and men with respect to having experienced bullying (v ; of these, 38.2% (n ¼ 39) were coaches, 17.6% (n ¼ 18) were supervisory ATs, and 8.8% (n ¼ 9) were coworker ATs.Conclusions: Bullying was experienced by both male and female ATs in the collegiate setting, and a higher number of bullies were male. More research is necessary to explore WPB in other work settings.Key Words: workplace violence, interpersonal conflict, harassment Key PointsOf athletic trainers working in the collegiate setting, 14.7% had experienced bullying. Coaches were identified as the most common perpetrators, and the majority of the perpetrators were men. The prevalence of bullying did not differ significantly between male and female athletic trainers.

Context: The cognitive process of making a clinical decision lies somewhere on a continuum between novices using hypothetico-deductive reasoning and experts relying more on case pattern recognition. Although several methods exist for measuring facets of clinical reasoning in specific situations, none have been experimentally applied, as of yet, to the profession of athletic training. The Diagnostic Thinking Inventory (DTI) has been used with medical doctors and medical students to determine their level of clinical reasoning as it applies to diagnosis making. Objective: To validate the DTI for Athletic Training (DTI-AT) and associated interview questions for use in the field of athletic training. Design: Mixed methodology. Setting: Online inventory and Skype-based interviews. Patients or Other Participants: Convenience sample of 25 senior-level athletic training students. Main Outcome Measure(s): Participants completed an online version of the DTI-AT which rated clinical reasoning tendencies on a 6-point Likert-type scale. Quantitative analysis consisted of determining means and ranges of scores along with reliability of total scores and subset scores. Randomly selected participants were interviewed online in order to provide validity of interview questions that were used to determine personal and professional activities that are either thought to enhance or hinder clinical reasoning. A secondary purpose was to solicit specific feedback that may enhance our understanding of the modified DTI. Results: A strong reliability was found for total DTI (r(41) = 0.846) and an acceptable reliability for flexibility in thinking (r(21) = 0.731) and structure of memory (r(20) = 0.771). Conclusions: The modifications of the DTI-AT demonstrated strong reliability and face validity. The DTI-AT may be an effective tool for determining clinical reasoning of athletic training students.

Context:Understanding the beliefs about and use of evidence-based practice (EBP) among athletic trainers (ATs) will help to determine appropriate strategies to improve implementation.Objective: To examine the ATs' beliefs about and use of EBP.Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: A total of 467 ATs responded to the survey request, a response rate of 11.67%. A total of 385 (9.6%) completed the EBP Beliefs Scale and 342 (8.5%) completed the EBP Implementation Scale.Main Outcome Measure(s): The EBP Beliefs Scale and EBP Implementation Scale were administered. The surveys collected demographic information in addition to information about participants' beliefs regarding EBP and implementation of EBP in clinical practice.Results: The ATs demonstrated a level of neither agree nor disagree (56.00 6 7.86) on the EBP Beliefs Scale. Belief scores were higher among those ATs required to document for thirdparty reimbursement (P ¼ .001), those with access to current research through professional journals other than the Journal of Athletic Training (P ¼ .02), and those with a doctoral degree (P ¼ .01). A low level of implementation (9.00 6 11.38), representing the implementation of EBP approximately 0 times in the previous 8 weeks, was found on the EBP Implementation Scale. Implementation scores were higher among preceptors (P ¼ .01), those required to document for third-party reimbursement (P , .001), those with access to current research through professional journals (P ¼ .002), and those with a doctoral degree (P ¼ .01).Conclusions: Participants had a positive attitude toward EBP; however, they were not implementing EBP concepts when providing patient care. This suggests that additional information and EBP resources are needed so ATs can better implement EBP in practice. To provide the best patient care and to promote EBP within the profession, clinicians should make EBP a priority and advocate for EBP implementation.Key Words: evidence-based medicine, clinical practice, survey research Key PointsOverall, athletic trainers were neutral toward evidence-based practice but believed it results in the best clinical care for patients and is important to the credibility of the profession. Athletic trainers' level of implementation of evidence-based practice was low. Additional information and resources are needed so athletic trainers can better implement evidence-based practice. To provide the best patient care, promote evidence-based practice within the profession, and gain credibility with other health care professions, athletic trainers should become advocates for evidence-based practice and make it a priority.