Context Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training. Objective To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the difference in PK after AK assessment. Design Knowledge assessment. Patients or Other Participants Two thousand athletic trainers received the survey via e-mail; 152 (7.6%) responded. Intervention(s) The AK assessment included 7 items based on the use and implementation of airway adjuncts based on the National Athletic Trainers' Association educational competencies. Perceived knowledge was measured using a well-established PK questionnaire, which also included 1 item to rate likelihood to pursue continuing education (CE). Main Outcome Measure(s) Perceived knowledge was compared pre- and posttest. Our demographic variables assessed how often lifesaving skills were used. We used total scores of the AK assessment to measure AK. We employed dependent t tests to determine the pre- and posttest differences in PK and likelihood to pursue CE. We used a correlation analysis to determine the relationship between PK and AK. We calculated separate analyses of variance to determine differences in AK between the frequencies of lifesaving skill use. Results We identified no significant change (t150 = −0.91, P = .37, 95% confidence interval = −0.17 to 0.06) in likelihood to pursue CE. Greater PK was weakly associated with greater AK (r = 0.36, P < .001). We found a significant difference (F1,145 = 4.63, P = .03, effect size = 0.031, 1 − β = 0.57) between the frequency of use of lifesaving skills and AK. Conclusion We identified a knowledge gap among athletic trainers in the use of airway adjuncts. Although the likelihood to pursue CE score was high, the score did not significantly increase after completing the assessment. Participants who use lifesaving skills more frequently scored higher on the AK assessment, suggesting that the more frequently athletic trainers utilize a skill, the more knowledgeable they are.

Reference/Citation: Roos KG, Marshall SW. Definition and usage of the term ''overuse injury'' in the US high school and collegiate sport epidemiology literature: a systematic review. Sports Med. 2014;44(3):405À421.Clinical Question: What is the current context of the term overuse in the epidemiologic sports injury literature?Data Sources: The authors performed a database search of PubMed and SPORTDiscus. The Boolean phrases athletics AND injury and overuse OR epidemiology were searched.Study Selection: Studies were included in the review based on the following criteria: (1) epidemiologic in nature, (2) involved US high school or collegiate athletes, and (3) published in English between 1996 and 2012. In addition, a study was classified as epidemiologic in nature if appropriate exposure data were collected in order to calculate injury incidence rates. One reviewer initially read the titles or abstracts of the studies to determine their relevance for the systematic review. Studies were excluded if they (1) were biomechanical or anatomical in nature, (2) were clinical in nature, or (3) assessed the effectiveness of an intervention.Data Extraction: The reviewer extracted statistics and definitions of the word and phrase overuse and no contact. The reviewer adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines as much as possible.Main Results: A total of 5182 titles of articles were initially identified in the databases searched. Then 232 studies were read to determine if they included overuse statistics. A total of 35 articles were included in the final review. Two main surveillance programs were used in these studies, with the authors of 12 articles (n ¼ 12/35, 34.3%) using data from the High School Reporting Information Online (RIO) and the authors of 13 articles (n ¼ 13/35, 37.1%) using data from the National Collegiate Athletic Association's Injury Surveillance System (ISS). One group (n ¼ 1/35, 2.9%) used both surveillance systems, whereas 9 groups (n ¼ 9/35, 25.7%) used other surveillance systems. Articles were categorized as (1) high school or collegiate studies using neither ISS nor RIO data, (2) high school studies using RIO data, or (3) collegiate studies using ISS data. The authors of only 1 article of the 35 (2.9%) provided a comprehensive definition of the word overuse. Collectively, 14 groups classified overuse as a mechanism of injury, 7 classified it as a category of diagnosis, and 8 classified it as both a mechanism of injury and a category of diagnosis. Specifically, 12 of the 35 articles combined overuse with other terms such as chronic, gradual onset, and repetitive stress, whereas 4 of the 35 articles defined overuse in the context of no-contact injuries.Conclusions: A great deal of inconsistency exists within the sports injury epidemiological literature regarding the term overuse. The authors of the systematic review recommended using the term overuse when referencing the mechanism of injury. A working definition of the term overuse should be used...

Context: Clinical education is a foundational component of healthcare education by which students acquire, practice, and demonstrate competency in clinical proficiencies through classroom, laboratory, and clinical experiences. Currently, the most common practice of clinical education in athletic training is clinical integration. Objective: The purposes of this article are to describe how athletic training and similar health professions implement clinical education and to present clinical immersion as an alternative to clinical integration. Background: Clinical education is delivered differently across healthcare disciplines. Some disciplines use clinical immersion, while others use clinical integration. Some professions have specific requirements, while others are left to the discretion of the program administrators. However, few professions are measuring the effectiveness of each, leading to questions about best-practice models in clinical education. Description: Clinical integration occurs when students complete clinical and didactic course work concurrently, while in the clinical immersion model, students are immersed in patient care full time with little or no didactic course work. A hybrid model of clinical education includes both integration and immersion. Clinical Advantage(s): Preliminary research within nursing suggests that students engaged in clinical immersion perform better on certification examinations than do those from an integration model. The clinical immersion model is enhanced by the implementation of standardized patients and simulations to prepare students for immersive experiences. These encounters provide an opportunity for students to demonstrate competency before engaging in patient care, which promotes patient safety. Conclusion(s): Program administrators have the opportunity and professional responsibility to explore different curricular models and to ultimately develop better methods of preparing future athletic trainers. Moreover, educators have a responsibility to measure and report outcomes to help provide a body of knowledge regarding best practices in clinical education.

Context: The doctor of athletic training degree (DAT) is a new concept in athletic training. Athletic trainers (ATs) currently pursue the degree, but little is known about why they choose the DAT. Objective: To explore ATs' motivations to pursue the DAT degree. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Twelve first-semester DAT students (6 males, 6 females; age = 32.2 ± 5.2 years; athletic training experience = 9.1 ± 5.7 years) participated. Main Outcome Measure(s): Each individual telephone interview was transcribed verbatim and all identifying information was redacted. Two members of the research team used a phenomenological approach to complete data analysis. Constant comparison was used throughout data analysis to ensure consistency among individuals. A third investigator served as an external consultant to verify themes and accuracy of coding. Her review also confirmed discontinuation of interviews upon reaching data saturation. Trustworthiness of the data was established using multiple-analyst triangulation and peer review. Results: Four themes emerged affecting DAT student motivations for pursuing the degree: (1) personal motivators, (2) program-specific motivators, (3) initial perceived challenges, and (4) supportive factors. Participants indicated that intrinsic pursuit of lifelong learning, professional advancement, future employment opportunities, improved value within their workplace, and mentors' influence impacted them to pursue a DAT. Participants were motivated to develop professionally and advance knowledge and skills while also selecting programs based on program and faculty reputation and engagement in professional advocacy. While time commitment, work-life balance, cost, and online learning expectations were anticipated challenges, participants perceived that family, employers, peers, organization, and time management were supportive factors that would help them be successful. Conclusions: Students are pursing the DAT degree because of both intrinsic and extrinsic motivators. Individual program characteristics also influence the pursuit of the DAT. Students do anticipate challenges but surround themselves with supportive factors to help them be successful.

Context Continuing education (CE) is a form of professional development intended to improve knowledge and skill beyond entry-level practice; however, we lack data to understand how athletic trainers (ATs) choose to implement CE experiences into clinical practice. Objective To explore ATs' motivators for pursuing professional development through CE and how they choose to implement CE experiences in clinical practice. Design Qualitative study. Setting Individual telephone interviews. Patients or Other Participants Fourteen ATs (5 male, 9 female; age = 33 ± 11 years, experience = 11 ± 11 years) participated voluntarily. Main Outcome Measure(s) Interviews were audio recorded and transcribed verbatim, redacting all personal information. After transcription, 2 members of the research team used a consensual qualitative research approach to analyze data. Both members were engaged in constant discussions to ensure consistency in analysis. A third member served as an external reviewer to ensure accuracy in coding and confirm data saturation. Results We identified 4 major themes regarding ATs' motivation and implementation of CE: (1) perceived benefits of CE, (2) factors influencing CE selection, (3) improving CE, and (4) implementation of CE learning into clinical practice. Among perceived benefits of CE, participants discussed maintenance of evidence-based practice and lifelong learning. Participants were motivated to choose CE sessions based on patient population, perceived need for CE, or area of interest, whereas they chose conferences based on travel distance and cost. Participants provided a variety of suggestions for CE improvement including handouts, discussion of barriers, and more hands-on sessions. Within implementation, participants discussed barriers, their confidence in integrating skills, and their patients' responses. Conclusions Although ATs are completing required CE, how they choose opportunities and subsequently how they implement learning is limited. We must consider an alternative mechanism for identifying CE needs to improve patient care focused on patient needs and outcomes, while still considering the financial and time barriers to attendance.