Context: The current trend in athletic training clinical education places greater emphasis on the quality of interactions occurring between Approved Clinical Instructors (ACIs) and athletic training students (ATSs). Among other attributes, the ability of ACIs to facilitate and direct quality clinical learning experiences may be influenced by the skill with which the ACI is able to use selected teaching strategies.Objective: To gain insight into ACIs' use of questioning as a specific teaching strategy during the clinical education experiences of undergraduate ATSs.Design: Qualitative case study design involving initial and stimulated-recall interviews, prolonged field observations, and audio recording of ACI-ATS interactions.Setting: The primary athletic training facility at one athletic training education program accredited by the Commission on Accreditation of Athletic Training Education.Patients or Other Participants: The 8 ACI participants included 3 full-time athletic training education program faculty members and 5 graduate-level assistants. The 24 ATS participants included 1 senior, 17 juniors, and 6 sophomores.Data Collection and Analysis: Transcribed data collected from 8 initial interviews, 23 field observations, 23 audio-recorded ACI-ATS interactions and 54 stimulated-recall interviews were analyzed through microscopic, open, and axial coding, as well as coding for process. The cognition level of questions posed by ACIs was analyzed according to Sellappah and colleagues' Question Classification Framework.Results: The ACI participants posed 712 questions during the 23 observation periods. Of the total questions, 70.37% were classified as low-level cognitive questions and 17.00% as high-level cognitive questions. The remaining 12.64% were classified as other.Conclusions: Although all ACIs used questioning during clinical instruction, 2 distinct questioning patterns were identified: strategic questioning and nonstrategic questioning. The way ACIs sequenced questions (their questioning pattern) appeared to be more important than the number of specific cognitive-level questions posed. Nonstrategic questioning appears to support knowledge and comprehension, whereas strategic questioning appears to support critical thinking.

The purpose of this article is to provide clinical instructors with information and ideas on how to utilize questioning and feedback during clinical experiences. Definitions, purpose, and examples of different questioning skills are provided. Corrective and directive feedback methods are defined with purposes and examples provided of each.

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.

The purpose of this literature review is to compare both clinical instructor and student perceptions of helpful and hindering clinical instructor characteristics, behaviors and skills in athletic training and allied health care settings. Clinical education in athletic training is similar to that of other allied health care professions. Clinical education is used to practice didactic information in a hands-on environment, with the goal of integrating theory and practice in a controlled setting. Students are taught skills, behaviors and attitudes required to enter into professional practice. Athletic training clinical education evolved from the medical education model for training physicians and is currently based on the nursing model. Other allied health care professionals employ similar practices. Objective: To provide an overview of helpful and hindering clinical instructor characteristics, behaviors and skills in athletic training and in other allied health professions. Data Sources: MEDLINE, Health Source: Nursing/Academic, PubMed, SPORTDiscus, Academic Search Premier, ERIC and PsychArticles served as the data sources for the allied health fields that included athletic training, nursing, medicine, optometry, clinical psychology, occupational therapy, physical therapy, speech and language pathology, radiography. Data Synthesis: Athletic trainer, allied health profession, and student perceptions of clinical instructor characteristics, behaviors and skills were reviewed and summarized. Conclusions/Recommendations: This review presents literature suggesting that clinical education, regardless of the profession or setting, contains similarities. Clinical instructor characteristics, behaviors and skills are important and need to be the focus of clinical education in order to promote helpful, while minimizing hindering, behaviors. Effective clinical instructors enhance the learning process. Focusing on improved supervisor and supervision services should be employed to teach athletic trainers helpful clinical instructor behaviors.

Objective: The primary objective of this paper is to present the evolution, purpose, and definition of direct supervision in the athletic training clinical education. The secondary objective is to briefly present the factors that may negatively affect the quality of direct supervision to allow remediation and provide higher quality clinical experiences for athletic training students. Background: Athletic training educators and clinical instructors often engage in discussions regarding the direct supervision of ATSs. These discussions tend to center around concerns about ATS preparation, and how the current level of preparedness differs from that of the past. Some believe that direct supervision, rather than unsupervised practice, retards the ATSs' development; however, there is no current literature to support this concept. Description: Supervision means to watch or direct, while mentoring means to tutor, instruct, or guide; therefore, mentoring may be more descriptive of the desired/intended interaction between an ATS and their clinical instructor (CI). The intent of supervision is for an ATS to refine and improve their clinical proficiencies under CI guidance. For this to occur, the CI must alter their interactions with the ATS as the student evolves. Clinical Advantages: Developing the CIs' understanding of the intent and continuum of expectations associated with direct supervision will allow them to maximize their students' education and position them to become highly skilled and confident Athletic Trainers.