Context: Providing opportunities to develop clinical decision-making skills, including clinical reasoning, is an important aspect of clinical education. The learner-centered technique of summarizing the history and findings, narrowing the differential, analyzing the differential, probing the instructor about uncertainties, plan management, and selecting an issue for selfdirected study (SNAPPS) is used in medicine to express clinical reasoning.Objective: To investigate the effects of SNAPPS on the clinical reasoning, reflection, and 4 case presentation attributes (length, conciseness, case summary, and expression of clinical reasoning) in athletic training students.Design: Randomized controlled clinical trial. Setting: Three undergraduate programs accredited by the Commission on Accreditation of Athletic Training Education.Patients or Other Participants: We randomly assigned 38 athletic training students (17 men, 21 women; age ¼ 21.53 6 1.18 years, grade point average ¼ 3.25 6 0.31) who had completed at least 1 year of clinical education and all orthopaedic evaluation coursework to the SNAPPS group or the usual and customary group using a stratification scheme.Intervention(s): The SNAPPS group completed four 45-minute clinical reasoning and case presentation learning modules led by an investigator to learn the SNAPPS technique, whereas the usual and customary group received no formal instruction. Both groups audio recorded all injury evaluations performed over a 2-week period.Main Outcome Measures: Participants completed the Diagnostic Thinking Inventory and Reflection in Learning Scale twice. Case presentations were analyzed for 4 attributes: length, conciseness, case summary, and expression of clinical reasoning.Results: Case presentations were longer (t 18.806 ¼ À5.862, P , .001) but were more concise (t 32 ¼ 11.297, P , .001) for the SNAPPS group than for the usual and customary group. The SNAPPS group performed better on both the case summary subscale (t 32 ¼ 2.857, P ¼ .007) and the clinical reasoning subscale (t 25.773 ¼À14.162, P , .001) than the other group. We found a time effect for Diagnostic Thinking Inventory scores (F 1,34 ¼ 6.230, P ¼ .02) but observed no group effects (F 1,34 ¼ 0.698, P ¼ .41) or time-by-group interaction (F 1,34 ¼ 1.050, P ¼ .31). The Reflection in Learning Scale scores analysis revealed no group-by-time interaction (F 1,34 ¼ 1.470, P ¼ .23) and no group (F 1,34 ¼ 3.751, P ¼ .06) or time (F 1,34 ¼ 0.835, P ¼ .37) effects.Conclusions: The SNAPPS is an effective and feasible clinical education technique for case presentations. This learnercentered technique provides the opportunity for the expression of clinical reasoning skills.Key Words: learning styles, metacognition, clinical education Key PointsThe expression of clinical reasoning and uncertainties is possible in the athletic training environment with the learner-centered technique of summarizing the history and findings, narrowing the differential, analyzing the differential, probing the instructor about uncertainties, plan ...
During preseason practices, the DII players drinking water at water breaks replaced the same volume of fluid (66% of weight lost) as NFL players with constant access to both water and sports drinks.
Context: The flipped classroom is an educational approach that has become popular in higher education because it is student centered. Objective: To provide a rationale for a specific way of approaching the flipped classroom using a blended course design and resources necessary to help instructors be successful. Main Outcome Measure(s): Three class components are important to the flipped classroom: before-, during-, and after-classroom sessions. Each is important in helping instructors deliver content in ways that will engage students to use all levels of the Bloom taxonomy on a consistent basis. Implementing each component using a blended course delivery will allow faculty to meet the students where they are in their learning as well as maximize class time. Conclusions: Athletic training educators can successfully use flipped classroom principles in blended courses to create student-centered classes. Educators should strategically think about the course objectives and activities for each of the 3 components. Being deliberate in this approach will ensure the educator is both an expert and a facilitator helping students achieve all levels of the Bloom taxonomy to maximize student learning.
Context: Athletic training students (ATSs) are involved in various situations during the clinical experience that may cause them to express levels of frustration. Understanding levels of frustration in ATSs is important because frustration can affect student learning, and the clinical experience is critical to their development as professionals.Objective: To explore perceived levels of frustration in ATSs during clinical situations and to determine if those perceptions differ based on sex.Design: Cross-sectional study with a survey instrument. Setting: A total of 14 of 19 professional, undergraduate athletic training programs accredited by the Commission on Accreditation of Athletic Training Education in Pennsylvania.Patients or Other Participants: Of a possible 438 athletic training students, 318 (72.6%) completed the survey.Main Outcomes Measure(s): The Athletic Training Student Frustration Inventory was developed and administered. The survey gathered demographic information and included 24 Likert-scale items centering on situations associated with the clinical experience. Descriptive statistics were computed on all items. The Mann-Whitney U was used to evaluate differences between male and female students.Results: A higher level of frustration was perceived during the following clinical situations: lack of respect by studentathletes and coaching staffs, the demands of the clinical experience, inability of ATSs to perform or remember skills, and ATSs not having the opportunity to apply their skills daily. Higher levels of frustration were perceived in female than male ATSs in several areas.Conclusions: Understanding student frustration during clinical situations is important to better appreciate the clinical education experience. Low levels of this emotion are expected; however, when higher levels exist, learning can be affected. Whereas we cannot eliminate student frustrations, athletic training programs and preceptors need to be aware of this emotion in order to create an environment that is more conducive to learning.Key Words: scaffolding, professional socialization, athletic training education Key PointsAthletic training students perceived having higher levels of frustration about how they are respected by various constituents, their performance of and ability to remember skills and information, the opportunity to apply skills daily, and the demands of the clinical obligation. Whereas frustration cannot be eliminated, athletic training programs and preceptors should recognize these frustrations, discuss strategies to help mitigate their occurrences, and help create more conducive environments for learning and student success.
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