You are the Athletic Trainer at a local high school.  While covering the Friday night football game one of the athletes suffers an apparent spinal injury and you determine that the patient needs to be transported to the hospital.  Should the athlete be spine-boarded?  If so, which spine-boarding method should be used?  Should all or any of the equipment be removed?  Can the helmet remain on if the patient needs a bag-valve mask?  How involved should EMS be in the patient’s care?

Emergency situations can either be a time for a clinician to confidently demonstrate their skills or a time where potentially hazardous mistakes for the patient could be made.  I can say with confidence that we as Athletic Trainers would do everything in our ability to provide the best care for our patients.  The real question still remains: are we really providing the best care to our patients? Spine-boarding, CPR and other skills that are not used in everyday practice are shown to decay over time when not practiced.  Another common issue with practicing clinicians is a knowledge gap: people do not realize what they do not know. So what does this mean for our patients?  Lack of clinician knowledge can lead to decreased patient outcomes.  As clinicians, we need to stay up-to-date on current evidence based practices or we are not actually providing the level of care that we may be led to believe.  

As part of my master’s thesis, I developed an educational assessment on various spine-boarding methods through descriptions as well as scenarios.  Athletic Trainers, Emergency Medical Technicians (EMT), Paramedics, as well as all the respective students were included within the participants.  The purpose of this study was to assess perceived knowledge and actual knowledge and determine the relationship that may exist.  Our research indicates that although clinicians in all disciplines were confident in their pre-test perceived knowledge, they scored poorly on the actual assessment.  Following the knowledge assessment, the participants scored their perceived knowledge on spine-boarding lower than their initial assessment.  Now that you know about knowledge gaps, what are you going to do to diminish this gap?  Seek CEU’s in areas you are not comfortable in.  Practice the skills you do not use every day.  Keep watching for updated information on spine-boarding and some of the many changes that are coming!


-Beth Neil, LAT, ATC

Sports are becoming more and more competitive in the middle school and high school settings.  Coaches and players have a desire to win the game, the championship, and obtain scholarships. This drive puts more pressure on the athlete both mentally and physically. Coaches are focused on the skills of the game and working with the players to master the techniques of the sport. What about the health and well-being of the athlete? Who is treating the injured athletes, the emergency room? Who is educating the athlete on how to maintain a healthy lifestyle, providing proper exercise regiments, and implementing injury prevention programs? 

An article published yesterday (November 18, 2014) in the Huffington Post is another voice in the growing chorus which argues that most high schools in the United States lack Athletic Trainers who help keep our children safe during sport participation. Checkout the column here

It is more important today than ever for secondary school settings to have an on-site Athletic Trainer. The Athletic Trainer is the first responder to injured athletes, assessing the injury and providing the immediate care necessary. The Athletic Trainer provides a treatment plan for the athlete and determines if referral is needed. The services of an Athletic Trainer can prevent unneeded trips to the emergency room. Athletic Training services do not stop after the game or the conclusion of practice. Athletic Trainers are available before and after practices/games to provide the athlete with the treatment and quality care that they need. In most cases at secondary schools, the nurse is the only other health care provider at the school and they usually leave school at the end of the school day. If there is not Athletic Trainer on site, there is no other medical coverage for the student athletes during athletic competition.

Educating and socializing middle and high school athletes, coaches, parents, and administrators to the important role Athletic Trainers play in overall physical health is the first step in expanding the reach of Athletic Training in the secondary school setting. The value of an on-site Athletic Trainer far outweighs the cost, when you consider the health and well-being of the student population; not to mention the peace of mind for the coaches, administrators, and parents knowing the athletes’ healthcare while participating in interscholastic activity is a priority and under the watchful eye of an Athletic Trainer.

-Bobby Vallandingham, LAT, ATC

We all know that building a solid rapport with your athletes is a vital role for incoming athletic trainers.  They not only build a trusting relationship but also patient comfort during evaluations allowing us to get a full and proper evaluation.  The key question to reflect on though is how much is too much?

The other day I was driving back after a physician’s visit that didn’t go so well, and I remembering thinking of how having to constantly give athletes bad news would be kind of depressing.  It wasn’t until after that thought was said out loud I realized in a sense we have to do that as athletic trainers as well.  If we are required to do that why did I think the two scenarios were so different?  The answer…Professional disconnect from the patient.  The physician doesn’t deal with the patient on a daily level and the rapport that they build is built solely on a professional level of trust and comfort.  This is the same kind of rapport that we should strive to have with our athletes.  I believe the reason we don’t quite make the distinction has a lot to do with amount of contact and our age as young professionals.  We work to build great rapport as new practitioners and inadvertently our line between friendship and professional relationship becomes a hazy line. 

So how do we fix this and demonstrate our professionalism?  I think it starts with setting specific guidelines for things as simple as communication.  Not allowing phone calls or contact by any means after a certain time, unless impending emergency.  If you happen to be spending a night out and you see an athlete you shouldn’t go visit them and see how their night is going.  This seems trivial to even say, but we all know it has happened and most of have been in that situation before.  There is a lot of talk on the importance of work-life balance and I believe it ties into professional disconnect as well.  When we are able to have a healthy disconnect from our athletes the personal life doesn’t seep into the relationship built we will be held to higher standard.  I believe this is a simple yet necessary step for us as young professionals to assert ourselves into the athletic training community and to make a step in the future of our profession.


Austin Krause LAT, ATC

As the leaves start to fall and the temperature begins to drop, we as Athletic Trainers we begin to switch our focus. This time of year is tough. There is a lot going on with the end of fall sports and the start up of the winter sports. As graduate students, we are also busy with studying for finals and finishing class projects. Our time is limited. We dedicate our time to the athletes and a lot of the time give up spending holidays with our own family. As the Thanksgiving and Christmas holiday season begins to approach, I think it’s necessary for us all to reflect on why we are Athletic Trainers.

     A recent post by Business Insider listed the top 20 majors that turned into meaningful careers with Athletic Training at #5. The article looked at the Payscale’s College Salary Report for 2012-2013. It compared the percentage of job satisfaction with starting salaries and average mid-career salaries. Athletic Trainers rated their job as 78% satisfying. I would have to agree with this statistic. The most satisfying part of my job is when I work with an athlete after an injury and return them to play.

Even though most would agree that Athletic Training is a satisfying job, there have been days when I question if Athletic Training is worth the time commitment. During this Thanksgiving, let’s take time to remember why we started in Athletic Training. Let’s look beyond the hectic days and find the silver lining. For myself, I aspired to be an Athletic Trainer because I love helping people. I’m not in this profession solely for salary or for recognition, but because I want to make a difference in the lives of the athletes that I come in contact with. What are you #thankful for?

Here is a link to the article from Business Insider

http://www.businessinsider.com/majors-that-lead-to-meaningful-careers-2012-9?op=1 

-Marissa Yorgey LAT, ATC

My research thesis is in regards to transition to practice in athletic training. My passion lies in understanding how well our athletic training students are prepared for the workplace, especially within one-year post graduation and passing the Board of Certification exam. As the profession continues to expand with emerging practice settings, athletic trainers are required to know more and do more. Transitioning to practice includes both the anticipatory socialization and the organizational socialization. Job orientation in healthcare, which is typically organizational socialization, should be constructed so that employees are trained for the culture, standards and goals of a company. Evidence in literature show that our educational outcomes may come from clinical preceptor evaluations, patient outcomes and cumulative grade point average (GPA) but these are collected when students are still in school. The only seemingly important outcome measure of readiness is emphasized in passing of the Board of Certification (BOC) examination. However, literature in athletic training is lacking cumulative data from students after graduation, especially from the employers’ perspective. Employers play a key role because they usually observe first-hand the challenges of their new employees. Therefore, in my study, I am measuring readiness of newly certified athletic trainers through their supervisors.

The data collection is currently ongoing. One of the biggest challenges is figuring out how to measure intangible qualities into a survey. I found a validated workplace readiness questionnaire that has been used in the nursing profession. The primary objective of this research is to look at soft skills, to help us better identify the broader educational needs in the profession, which may lead to better patient care. We may gain an understanding of what is expected from employers, how to provide necessary initial on-the-job training, and what is expected from the athletic training education program. Current report shows some interesting data and we will be analyzing the data soon. My hope is that this pilot study can lead to further awareness and studies in transition to practice in athletic training, and how important it is for us to continue to gather outcome measures of our athletic trainers post graduation for the betterment of our profession.

Denny Wongosari LAT, ATC

An increasing number of states are now permitting athletic trainers to bill for services. As a result, it is possible that positions for athletic trainers in the clinic setting may rise.  However, we still face barriers with insurance companies who will not pay for an athletic training evaluation or pay a lower rate for the same rehabilitation services as other providers. 

Do insurance companies really feel that we do not provide the same level of care as other healthcare professionals? When it comes to orthopedic and functional rehabilitation, athletic trainers may better meet the goals and the needs of the patient compared to other health care providers and if states are willing to recognize this, we need to collectively help insurance companies come to the same realization.

One of the potential barriers to influencing insurance companies may be our classification by the federal government as technicians.  Although it is not definitively defined by degree level, it seems other healthcare professionals who achieve professional masters or doctoral degrees do not face our same issues.  On the contrary, those with bachelors degrees (nurses) are able to bill for care without facing the big bad insurance companies.  So, what’s the deal?

The NATA has recently launched a pilot program in which Indiana is participating. Within this pilot program, all athletic trainers regardless of setting are encouraged to bill for services and are monitored in doing so. I personally struggle to see how traditional athletic training settings will effectively bill for service due to the nature of care, but I am hopeful that all athletic trainers will have the rights to do so.  However, we (collectively and regardless of setting) must do a better job of measuring patient outcomes, using objective criteria for progression and return to activity, and document our care consistently and accurately.   #TogetherWeMustDoBetter

Stephen Edwards LAT, ATC

Many of the current issues in Athletic Training involve our overall well-being as health care providers. We struggle to maintain work-life balance in which we actually get to have a family and life outside of work. We are constantly working towards a salary that is respectable for the work that we do. Finally, we are constantly battling for respect from coaches and other health care providers.  So what is the solution? Perhaps the solutions lies in who we are hired by/working under.

At both the high school and collegiate setting, there exist medical services for students to access anytime they need while on campus. With this system already in place, why are Athletic Training services not being encompassed with these other medical services?

I believe that the medical model is necessary for multiple reasons. First, if we are housed under athletics, our medical decisions are subject to pressure and bias from coaches. This compromises the well-being of student-athletes and forces us to sacrifice job security every time we make an unpopular decision. Check out this story from the Chronicle. (http://chronicle.com/article/Trainers-Butt-Heads-With/141333/)

Those that have moved their athletic training services to the medical model at the collegiate level have had great success. They have experienced increase in salary, manageable hours, and even improved patient care. They achieve these goals by setting clinic hours that they are available to treat patients and/or cover practices. They also classify practices and determine if it is necessary for an Athletic Trainer to be present. Finally, they have enjoyed the communication with other healthcare providers that they are able to collaborate with and share medical records. For more information check out this article from the NATA  (http://www.nata.org/sites/default/files/Collegiate-Healthcare-Model-Article.pdf)

At the high school setting, Athletic Trainers are often hired by hospitals to work at local high schools. I have seen this model be used in two different ways. In one model the Athletic Trainer is hired by the hospital and assigned to one specific high school. This allows the Athletic Trainer to focus on patient care without being forced to pursue other responsibilities that a person hired by the actual high school might. In another model, the Athletic Trainer is hired by a hospital system to work in the clinic. They are then outsourced to provide game coverage to all high school games in the area. While this might provide an adequate salary and/or work-life balance, patient care may be compromised. Athletic Trainers may come in with no idea what occurred during the week. It almost seems like they are only at these events to provide acute care. Where is the continuity of care?

I believe that Athletic Training needs a balance act between providing high quality patient care and maintaining work-life balance. We need to change the old-school tradition/thought of making ourselves available all day. We need to maintain a close relationship with athletics but we need to remember that we are health care providers. Should we not be employed under a medical network with other health care providers that make up the Sports Medicine team?

Michael Neal LAT, ATC