Assessing medical care availability for student athletes of a large urban high school district

Salzman, Garrett; Burke, Rita V.; Muller, Valerie; Spurrier, Ryan G.; Zaslow, Tracy; Upperman, Jeffrey S.

doi:10.1016/j.jpedsurg.2014.10.058

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…To our knowledge, we are the first to examine the availability of AT services at the secondary school level in California. Salzman et al 13 reported that 76% of schools in 1 large high school district in California did not provide ATs for practices and 45% did not provide ATs for home games, similar to the low rates of overall availability that we observed. Researchers [8][9][10]12,14 have attempted to determine the availability of ATs in secondary schools using national samples or in specific states, such as Arizona, Oregon, South Carolina, and Wisconsin.…”

Section: Discussionsupporting

confidence: 81%

Access to Athletic Trainer Services in California Secondary Schools

Post

Roos

Rivas

et al. 2019

Journal of Athletic Training

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Context California is currently the only state that does not regulate who can and cannot call themselves athletic trainers (ATs). Therefore, previous national or state-specific investigations may not have provided an accurate representation of AT availability at the secondary school level in California. Similarly, it is unknown whether the factors that influence AT availability in California, such as socioeconomic status, are similar to or different from those identified in previous studies. Objective To describe the availability of ATs certified by the Board of Certification in California secondary schools and to examine potential factors influencing access to AT services in California secondary schools. Design Cross-sectional study. Setting Online survey. Patients or Other Participants Representatives of 1270 California high schools. Main Outcome Measure(s) Officials from member schools completed the 2017–2018 California Interscholastic Federation Participation Census. Respondents provided information regarding school type, student and student-athlete enrollment, whether the school had ATs on staff, and whether the ATs were certified by the Board of Certification. The socioeconomic status of public and charter schools was determined using the percentage of students eligible for free or reduced-price lunch. Results More than half (54.6%) of schools reported that they either did not employ ATs (47.6%) or employed unqualified health personnel (UHP) in the role of AT (7.0%). Nearly 30% of student-athletes in California participated in athletics at a school that did not employ ATs (n = 191 626, 28.9%) and 8% of student-athletes participated at a school that employed UHP in the role of AT (n = 54 361, 8.2%). Schools that reported employing ATs had a lower proportion of students eligible for free or reduced-price lunch than schools that did not employ ATs and schools that employed UHP (both P values < .001). Conclusions With ongoing legislative efforts to obtain regulation of ATs in California, secondary school administrators are encouraged to hire ATs with the proper certification to enhance the patient care provided to student-athletes and improve health outcomes.

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Section: Discussionsupporting

confidence: 81%

Access to Athletic Trainer Services in California Secondary Schools

Post

Roos

Rivas

et al. 2019

Journal of Athletic Training

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“…This is higher than previously reported rates of AT coverage in secondary school athletics, which have ranged between 50% and 78%. [4][5][6][7][8] This is evidence of the increased recognition of the importance of ATs at the secondary school level and the progress the athletic training profession and secondary schools have made in providing coverage to their student-athletes. However, our results suggest that limited resources may be a primary factor in the medical coverage decisions of the schools that do not provide an AT.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Medical organizations such as the American Medical Society for Sports Medicine, the American Academy of Pediatrics, 2 and the National Athletic Trainers' Association 3 have all recommended that secondary schools employ certified ATs to ensure that their student-athletes are receiving proper medical care. Extensive efforts have focused on determining the proportion of US secondary schools using the services of an AT, with recent estimates [4][5][6][7][8] indicating that 50% to 78% of high schools relied on an AT for at least some events or practices.…”

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confidence: 99%

School and Community Socioeconomic Status and Access to Athletic Trainer Services in Wisconsin Secondary Schools

Post

Winterstein

Hetzel

et al. 2019

Journal of Athletic Training

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Context Secondary schools have made significant progress in providing athletic trainer (AT) coverage to their student-athletes, but the levels of access at schools with ATs may vary widely. Socioeconomic disparities in medical coverage and access have been noted in other health care fields, but such disparities in the level of access to AT services have not been thoroughly examined. Objective To determine if (1) access to AT services or (2) the level of access (AT hours per week and athletes per AT hour) differed based on the socioeconomic characteristics of secondary schools. Design Cross-sectional study. Setting Mailed and e-mailed surveys. Patients or Other Participants High school athletic directors and ATs from 402 Wisconsin high schools. Main Outcome Measure(s) Respondents provided information as to whether their school used the services of an AT and the number of hours per week that their school had an AT on-site. The number of athletes per AT hour was calculated by dividing the total number of athletes at the school by the number of hours of AT coverage per week. The socioeconomic status of each school was determined using the percentage of students with free or reduced-cost lunch and the county median household income (MHI). Results Schools without an AT on-site were in lower MHI counties (P < .001) and had more students eligible for a free or reduced-cost lunch (P < .001). Lower levels of AT access (fewer hours of AT access per week and more athletes per AT hour) were observed at schools in the lowest third of the county MHI and with the highest third of students eligible for a free or reduced-cost lunch (P < .001). Conclusions Socioeconomic disparities were present in access to AT services. New models are needed to focus on providing a high level of AT access for all student-athletes, regardless of socioeconomic status.

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“…Orthopaedic surgeons have the privilege of providing medical coverage for a diverse range of athletic events and are among a growing range of providers who share these responsibilities: certified athletic trainers, physical therapists, emergency medical technicians, nurses, and nonoperative physicians. 18 While caring for athletes on the field, these providers may need to treat a broad array of injuries not limited to the musculoskeletal system, [6][7][8]10,11,13,14,17 despite the fact that the education and training for each type of provider varies greatly. 3,5,20,22,23,25 Many orthopaedic residency programs require residents to work as independent or assistant sideline physicians, but the training needed to effectively treat the wide variety of conditions, clinical situations, and ethical dilemmas 12 encountered is not standardized.…”

mentioning

confidence: 99%

Orthopaedic Resident Preparation and Confidence in Treating On-Field Injuries

Hodax

Sobel

DeFroda

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Orthopaedic surgery residents may cover athletic events, although the training provided to prepare residents for this role and oversight from attending physicians during these activities is not well understood.Purpose:To survey orthopaedic residents about the training provided by their residency program for on-field athletic coverage and to understand their levels of preparation for this role and confidence in treating commonly encountered on-field conditions.Study Design:Descriptive epidemiology study.Methods:An anonymous survey was emailed to residents in all American College of Graduate Medical Education–accredited, allopathic, nonmilitary orthopaedic surgery residency programs. This survey queried residents about their demographics, the opportunities their residencies require or allow for athletic coverage, their level of preparation for serving an on-field physician, and their comfort level with treating a number of on-field conditions. Likert-type scales were used to assess resident comfort level for treating 13 orthopaedic and nonorthopaedic conditions as well as their perceived level of preparedness.Results:Of 148 residency programs contacted, 57 programs responded (39%). Of the 57 programs responding, 51 (89.5%) allowed or required residents to cover athletic events, and 27 of 51 (52.9%) reported that training to prepare for this role was provided. Only 6 of 24 programs without training available (25%) had direct attending supervision of residents at all athletic events. Residents who answered that their residency programs mandate training prior to their participation in athletic coverage activities reported a higher level of preparation for this role than those with no training, optional training, or those who were unsure of their training requirement (P < .0001, P = .035, and P = .013, respectively). In addition, the more senior the resident was, the higher the level of confidence was in treating all orthopaedic and some nonorthopaedic conditions. Residents who had mandatory training displayed a higher comfort level in treating on-field orthopaedic and nonorthopaedic conditions than those without training.Conclusion:Formal training of orthopaedic residents prior to their covering athletic events can improve confidence in treating orthopaedic and nonorthopaedic conditions. Many programs do not ensure that residents are familiar with key and potentially life-saving equipment. An opportunity exists to improve resident education.

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Assessing medical care availability for student athletes of a large urban high school district

Cited by 7 publications

References 13 publications

Access to Athletic Trainer Services in California Secondary Schools

Access to Athletic Trainer Services in California Secondary Schools

School and Community Socioeconomic Status and Access to Athletic Trainer Services in Wisconsin Secondary Schools

Orthopaedic Resident Preparation and Confidence in Treating On-Field Injuries

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