Interprofessional Education (IPE) occurs when educators and learners from 2 or more health professions jointly create and foster a collaborative learning environment.1,2 The intention is to develop knowledge, skills and attitudes that result in interprofessional team behaviors and competence.1,2  IPE is intended to improve patient care by enhancing the quality of care, decreasing cost, decreasing patients’ length of stay and reducing medical errors.1,3-6   The Institute of Medicine suggests that patients receive safer, high quality care when health care professionals worked effectively in a team, communicated productively, and understood each other’s roles.1

At this point it should be easy to understand… if we all worked well with one another, our patients can get better faster and without error.  But how many times have you had a patient come to you and say… well my previous PROVIDER said (insert whomever/whichever suits your fancy)… and instead of embracing the previous health care provider and his/her findings and/or treatment plan, we decide he or she was wrong…  Interprofessional, collaborative practice requires that we incorporate those other providers into our patient care, because even if we might not agree, something can be gleaned from his/her findings and care. 

So, how do we get there… how do we get to a place where we have mutual respect and understanding for each other’s disciplines? This is where IPE comes in… taking a collaborative learning environment facilitated by faculty and practitioners from various disciplines can help students understand how to complement one another’s skills and scopes of practice.  At Indiana State University, we try to help students understand collaborative practice early in the curriculum, engaging them in case studies in our Introduction to Health Professions Course.7  Then, as they approach the professional stage of the Athletic Training Program, they engage in teambuilding activities8 and are evaluated on their ability to work within a team to earn admission.9  At various stages throughout the curriculum, they engage in activities forcing interaction with other health care and wellness professions through an IPE day,10 a mass casualty event, and an Emergency Medicine Collaborative.11  Whether the activities are large or small, they are connected to the core competencies of interprofessional practice (IPP), to help them work toward understanding the values and ethics of IPP and the roles and responsibilities of collaborative practice, while honing skills in interprofessional communication, interprofessional teamwork and team-based care.12 

Well many of us think we know what other professions do… research suggests otherwise.11,13  We need to do a better job of working well together, but also working toward understanding our roles more thoroughly, so we can transition patients to the expert provider when appropriate.  The patients need us to do a better job of knowing who is best for them.  Aren’t they the reason we got into this business in the first place?

If you are interested in knowing more about IPE and IPP, follow @GamesKenneth and @isuathltraining while we attend the All Together Better Health Conference in Pittsburgh, PA this week.  Have questions about IPE, IPP and Athletic Training, use #at4at.


References

1.       Institute of Medicine Committee on the Health Professions Education Summit. Health Professions Education: A Bridge to Quality. Greiner AC, Knebel E, eds. 2003; National Academy Press, Washington, DC. 11. Andrus NC, Bennett NM. Developing an interdisciplinary, community-based education program for health professions students: the Rochester experience. Acad Med. 2006;81(4):326-331.

2.       Center for Advancement of Interprofessional Education (CAIPE). http://www.caipe.org.uk. Accessed November 6, 2013.

3.       Barr H, Koppel I, Reeves S, Hammick M, Freeth D. Effective Interprofessional Education: Argument, Assumption & Evidence. Oxford, UK: Blackwell; 2005.

4.       Brashers VL, Curry CE, Harper DC, et al. Interprofessional health care education: recommendations of the National Academies of Practice expert panel on health care in the 21st century. Issues in Interdisciplinary Care: National Academies of Practice Forum. 2001;3(1):21-31.

5.       Freeth D, Hammick M, Reeves S, Koppel I, Barr H. Effective Interprofessional Education: Development, Delivery & Evaluation. Oxford, UK: Blackwell; 2005.

6.       TeamStepps: Strategies and Tools to Enhance Performance and Patient Safety, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. http://teamstepps.ahrq.gov. Accessed November 6, 2013.

7.       Games KE, Eberman LE, Kahanov L. Integrating IPE into “Pre-Professional” Educational Experiences Using Case Studies.  Presented at the All Together Better Health VII Conference, Pittsburgh, PA on June 7, 2014.

8.       Eberman LE, Kahanov L, Games KE. Teamwork Competence… As Important as Our Clinical Competence. Presented at the All Together Better Health VII Conference, Pittsburgh, PA on June 6, 2014.

9.       Eberman LE, Kahanov L, Young A, Games KE. Interprofessional Admissions Approach Using Team Dynamics Evaluation. Presented at the All Together Better Health VII Conference, Pittsburgh, PA on June 6, 2014.

10.   Kahanov L, Eberman LE, Games KE. Comparison of Differing Interprofessional Education Activities to Assess Student Outcomes. Presented at the All Together Better Health VII Conference, Pittsburgh, PA on June 7, 2014.

11.   Eberman LE, Jaeger JE, Landis M, Williams DJ, Livingston LB, Kahanov L. Emergency Medicine Collaborative: Interprofessional Practice in Emergency Care. Presented at the All Together Better Health VII Conference, Pittsburgh, PA on June 8, 2014.

12.   Interprofessional Education Collaborative. Core Competencies for interprofessional collaborative practice. 2011.

13.   Coffey D, Eberman LE, Kahanov L, Southard E. Interprofessional Practice: What Health Care Provider Students Know about other HCPs. J Interprof Care. 2014 (In Process). 

All the Athletic Trainers for the Boston Marathon and similar venues are volunteers.  What have you done recently to volunteer?  Your medical knowledge is a great way to give back to the community.  There are numerous opportunities available for you.  During the summer, each state hosts their own Special Olympics Summer Games.  These athletes need athletic trainers too.

Below is the link to the main Special Olympics page.  Within you can find your state contact them about the needed medical help. http://www.specialolympics.org/

As we know, many youth sports leagues are not yet covered by athletic trainers.  Coordinating care for an event may be the start to these events always being covered by a staff position.  Local YMCA youth leagues also could always use coverage!  In addition, the NATA can use help with the upcoming convention in Indianapolis! See the link below for more information. http://convention.nata.org/get-involved/​

With the summer coming up find a 5k, marathon or triathlon to volunteer for!  Let's get athletic trainers out into the community these next few months.

Elizabeth Neil, LAT, ATC

In light of the recent 1 year anniversary of the bombings during the Boston Marathon, ESPN released a well written article featuring athletic trainers.  So often we as Athletic Trainers are quick to criticize media for not using the correct terminology or “guessing” on what injury may occur.  “Athletic Trainers Just Did Their Job” was published the past Monday and has been shared across numerous social media sources.  Please use the link below to read the article. 

http://espn.go.com/boston/story/_/id/10818360/2014-boston-marathon-athletic-trainers-just-did-their-jobs?src=mobile

Behind the scenes of almost all sporting events is a team of medical personnel including athletic trainers.  When tragedy struck, these once barely noticed people became heroes for the nation but I believe that ESPN stated it well; they were all just “doing their job”.

Outside The Lines, a featured presentation broadcasted on ESPN first aired the following video in October 2013. The following is the story of Devin Wang, a Boston University athletic training student and her experience in the 2013 marathon. 

http://espn.go.com/espn/feature/story/_/id/9868852/portrait-rescue


Beth Neil, LAT, ATC

When people are put into a new and unfamiliar situation, they tend to shut down and become cautious about every move and statement they make. While it is important to be accommodating, it is also vital that equal opportunity and respect is applied to all.

Individuals with disabilities working within athletic often face serious challenges entering the profession. The real issues begin at the athletic training education. A 2006 study of program directors noted that 70% of ATEP programs had admitted a least one student with a disability, yet the number of athletic training majors with a disability nationwide was well below the 9% of general population college students with a disability. A vast majority of the athletic training students with disabilities were diagnosed with a learning disability with rare instances of hearing, vision, motor or emotional disabilities.  But we need to have open access to our healthcare profession for everyone.

With that said, naysayers will argue that there are just some things that can’t be accommodated for to have effective outcomes in this profession. With only 10% of Athletic Training education programs having a policy for individuals with a disability applying for admission into the program, the shift of power is given to the ADA (American Disability Act) officer on campus for the institution. The NATA released eight technical standards that ATEP’s could use when admitting students in 2010. The eight standards include: mental capacity to distinguish deviations from the norm, postural/neuromuscular control to perform physical examinations and safely use equipment, communicate effectively and speak English, ability to record examination and treatment plans, maintain composure during high stress, perseverance and commitment to complete the program, flexibility with changing situations and affective skills and demeanor.

While I have seen job qualifications listing ‘able to lift up to 50 lbs’ and ‘ability to stand for long periods of time’ as requirements, you have to wonder, who gets to decide 1) whether these are appropriate requirements for a highly skilled position and 2) if cleared by a physician, why discrimination still occurs, by employers and future colleagues? This blog post is to remind you to have respect, respect for others and respect for the process. With the growing number of students with disabilities in Athletic Training education programs, inclusion is in our future, and we need to be on board.

In researching this topic, I interacted with an athletic trainer that is deaf and he described his hearing impairment as something that is valuable to him because he can tune out the distractions and focus on the task at hand. At the end of the day, the person is an athletic trainer and should not be referred to as the deaf athletic trainer. This disability does not define them and we should not attempt to define them by it either. A person with a disability is just as capable, intellectually, emotionally, and physically.  In fact, empathy and compassion for patients might surpass those without disabilities.  

Zach Winkelmann LAT, ATC

As I am about to head into my last year of my graduate degree, I sit and think to myself “where do I want to begin my career as a young professional Athletic Trainer?” I storm through many ideas throughout the day but by the end, my answer is always the same, professional baseball. My career goal is to become an AT in professional sports.

According to the National Athletic Trainers Association, the percentage of female ATs to male ATs is 53.53% to 46.4% as of February 2014. And out of all the settings in AT; collegiate, hospitals, recreational/youth sports, secondary schools, clinics, marketing, health clubs, military/law enforcement, professional sports, and others, only 2.31% of ATs are working in the professional sports. Just hearing that number makes it seem impossible.

However, it is not only the math stacked against me, but I’m also a female. The literature says there are stereotypical gender roles of women; that being supportive caring, and nurturing, “indicates incongruity between the roles of being female and being an AT”(O’Connor et. al 2010).  In addition, the resistance to females in male locker rooms and the male athlete’s perceptions of female ATs also contributed to the underrepresentation of women in head athletic training positions.

But, why? Why are female ATs different than male ATs? Because we are more nurturing than males? We are all held to the same Standards of Practice and bylaws. We all receive the same entry-level education, and most of us continue on to graduate education. And we all live by the same mission statement of the NATA which states “The mission of the National Athletic Trainers’ Association is to enhance the quality of health care provided by certified athletic trainers and to advance the athletic training profession.”

Dorthy “Dot” Cohen became the first female member of the NATA 16 years after the NATA was founded. Gail Weldon became the first female hired by the US Olympics in 1979 to cover the Pan America Games and was the first female chief AT for the 1980 U.S. Olympic team. Other great women have graced AT including Sherry Bagagian, Janice Daniels, Eve Becker-Doyle, Karen R. Toburen, Marje Albohm, and Julie Max. But breaking the barrier of female ATs into professional sports came by Michelle Leget. She was the first female assistant AT hired by the Houston Rockets in 1997. Following her was Janet Panek, female assistant AT for the Washington Wizards.  Then in 2002 Ariko Iso became the first female assistant AT in the NFL for the Pittsburg Steelers. Then the biggest barrier yet was broken by Sue Falsone of the Los Angeles Dodgers in 2012 as the first female head AT in the MLB.

All of these women have great things in common… but beyond their gender, they are just great ATs… but consider the math again… There are almost 40,000 members of the NATA, and I can only tell you about FIVE serving in professional sports. Women are just as qualified as men and we should have access to whatever position we want.   

So… we have to continue to break barriers, fight for equality, do the RIGHT and LEGAL thing… and allow the most qualified candidate access to professional AT positions… because I’m coming after those jobs and expect to be considered for my skills and not my gender.

Emilie Miley, LAT, ATC

Certified Athletic Trainers are consistently underpaid. Athletic Trainers are healthcare providers that work to prevent, diagnose, and rehabilitate acute and chronic athletic related injuries and illnesses. Our minimum requirements for education include a Bachelor’s degree from a CAATE accredited program (with more than 70% holding a Master’s degree) and Continuing Education Units due every two years. Athletic Trainers are also required to pass the Board of Certification before practicing and many state’s regulate the profession via state licensure. These credentials are similar to that of many other health care providers, including nurses, respiratory therapists, physicians’ assistants, and yes… even physical therapists. 
 
Despite our education and qualifications, we are still earning an average salary of $34,000 to $52,000 annually. 
 
Not only are athletic trainers underpaid, a majority of athletic trainers RARELY work 40 hours a week. When a sport is in season, we often travel to every location with the team. We could be on the road for 4 out of the 7 days a week during mid-season. Athletic Trainers are passionate about what they do, and this causes us to give in and take lower salaries. However, in our previous blog posts, we know we have retention issues… and I think we can all ascertain WHY! 
 
We are going to lose great Athletic Trainers if they are not paid fairly. But part of this, is standing for what is or isn’t appropriate… healthcare isn’t free… don’t be underpaid and overworked… you make it harder for the rest of us! 
 
Emilie Miley LAT, ATC & Michael Neal LAT, ATC

A ballet dancer’s sprained ankle.  A torn ACL of a high school basketball player. A concussion sustained in boot camp.  An industrial worker who has hurt his back.  What do all these patients have in common?  These are all injuries that were treated by an Athletic Trainer.  Traditionally Athletic Trainers worked with sports teams whether in the high school, collegiate or professional setting.  However, there is a growing trend of emerging practices in which Athletic Trainers are employed.  Athletic Trainers, now more than ever, are employed in the emerging settings.  The skills and knowledge of Athletic Trainers are not limited to athletes and we have the ability to effectively treat diverse patients.  Additional skills may be needed to adapt to the unique job demands but all are within an Athletic Trainers scope of practice.  Settings such as the performing arts, hospital, occupational and hospitals are just a few of the “different” places that athletic trainers are now being employed.  At the end of the day, an ankle sprain is still an ankle sprain no matter who sustained it.  Athletic Training… Health Care for Life and Sport.

Beth Neil LAT, ATC

As the Athletic Training profession continues to grow, so does the global awareness of our profession. Practicing Athletic Trainers currently exceed 40,000 in the United States with more practicing internationally. Athletic Training education programs are beginning to spread across the globe with student exchange programs present in countries such as Taiwan (Republic of China), Japan, Germany, England, Ireland, and more. Also, we are seeing an increase in job openings available globally that are recruiting Athletic Trainers.

We would like to take the opportunity to promote the World Federation of Athletic Training and Therapy (WFATT). The purpose of WFATT is to promote quality health care worldwide for active populations. WFATT functions in collaboration with national health care organizations in the fields of sports and exercise science and sports injury treatment and prevention. WFATT currently has member organizations in a range of countries including, the United States, Canada, England, Ireland, Spain, Italy, Japan, and more. WFATT aims to create a global forum between national health care organizations so that they may share information pertaining to academic preparation and professional practice. They also aim to promote research opportunities between member organizations. WFATT hopes to improve the awareness of professions and organizations that deliver health care to active populations internationally as do we.

As we continue to advocate for our name and profession domestically we should also  promote what we do internationally. Better global awareness of who we are and what we do will help us to continue to grow as a profession and will benefit us as we gain respect from other health care organizations and practitioners around the world.

Stephen Edwards LAT, ATC

Spreading ourselves too thin.  Stand Proud… We are Athletic Trainers First and Foremost.

The Youth Sport Safety Alliance, Student-Athlete Bill of Rights, and increasing concussion legislation is creating a platform to promote Secondary School Athletic Training and potentially a greater need.  However, barriers still exist… 

Although Athletic Trainers are highly educated health care professionals, much like nurses, some states still require things like a teaching credential to practice… why is that? Is it because a teaching credential enhances our ability to provide medical care to the physically active? Or is it because employers still want ways to ask Athletic Trainers to do two jobs for the price of one?

Career counselors, conferences, job postings, Athletic Trainers and even professional program directors may suggest that having a teaching certification upon completion enhances marketability. The Journal of Athletic Training even published original research on this in 1995 with program directors advising students to take advantage of the courses while in their athletic training program and get certified if you have any desire to work in the secondary school setting. This is fundamentally wrong… and in the current climate where even dual credentialing as another health care provider carries its own added pressures, why can’t we just be who we are? Athletic Trainers? Students in our programs need to be focusing on their future careers in ATHLETIC TRAINING!

This is not to say we don’t think Athletic Trainers could also be teachers, if that’s what they want.  But, don’t think you should be compensated for both, be trained adequately at both? Just a warning though; Athletic Trainer/Teachers work 60-70 hours per week and risk the same retention issues of those in college/university athletics.

Now, it is time to advocate! Educate school principals, superintendents and athletic directors about the roles you play as an Athletic Trainer. We should be hired for what we are; healthcare professionals who are not a by-product of a teacher (a skilled job in and of itself), but a necessity for quality care of secondary school students and student-athletes.

Zachary Winkelmann LAT, ATC

Over the course of the profession Athletic Trainers have been called trainers, so what does that really mean? According to Merriam-Webster a trainer is “a person who teaches or coaches athletes or animals: a person who treats animals.” I don’t know about the other Athletic Training professionals, but I don’t see my daily practice as training and treating animals. There is also the entire conversation explaining that you don’t just help the athletes get stronger, and that you are not a personal trainer. 

The National Athletic Training Association defines Athletic Training as “healthcare professionals who collaborate with physicians." Athletic Trainers provide services in injury prevention, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions.

Then what is the big deal of calling ourselves Athletic Trainers and not trainers? Athletic Trainers must graduate from an accredited bachelors or master’s program, pass a Board of Certification exam, and complete continuing education requirements. These requirements are what we should use to push the term Athletic Trainer and not trainer. We are educated healthcare professionals who treat and prevent injuries and treat medical conditions. The next time your team asks for a “trainer” stand proud and introduce yourself as an Athletic Trainer.

Austin Krause, LAT, ATC