Psu cp tutorial vairo

CLINICAL PRECEPTOR TUTORIAL

Penn State

Athletic Training Education Program

Lauren C Kramer, PhD, ATC

Program DirectorJohn L Vairo, PhD, ATC

Clinical Education Coordinator

DEFINITIONS RELATED TO ACCREDITATION AND CLINICAL EDUCATION

Primer

National Athletic Trainers’ Association (NATA)

• Professional membership association of athletic trainers (ATs) that acts in the interest of its members

• Does not certify ATs• Does not accredit athletic training

education programs (ATEPs)

Organizations Influencing Entry-Level Athletic Training Education

• BOC– Board of Certification

• CAATE– Commission on Accreditation for Athletic

Training Education

• PEC– Professional Education Committee

BOC

• Mission: To protect the public by identifying competent athletic training practitioners

• Devising credentialing examinations

• Monitoring of continuing education standards for ATs

CAATE

• Oversees accreditation of education programs in athletic training

• Establishes standards and guidelines for entry-level ATEPs– Standards: requirements– Guidelines: examples for interpreting the

standards

PEC

• Acts as a "clearinghouse" for educational policy, development and delivery for entry-level, graduate, specialty and continuing education.

• Establish competencies and proficiencies that ATEPs must teach and assess.

CLINICAL PRECEPTOR PRINCIPLES & CLINICAL EDUCATION MODEL

Module 1

What is an ATEP Clinical Preceptor?

• A clinical preceptor (CP) is a health care professional who has completed CP the corresponding tutorial administered by the ATEP.

• The CP is recognized by the CAATE as adjunct faculty in the ATEP.

Penn State ATEP Clinical Preceptor Tutorial Mission

• To provide CPs with an education-based model and related strategies for interfacing with ATSs while operating in a clinical context to be able to successfully serve as effective instructors, supervisors and mentors.

CAATE Clinical Preceptor Qualifications

• Be credentialed in a medical or allied health care profession

• Not be currently enrolled in the entry-level ATEP at the institution

• Receive planned and ongoing education form the ATEP deigned to promote a constructive learning environment

CAATE Clinical Preceptor Responsibilities

• Supervise ATSs during clinical education• Provide instruction and assessment of the current

knowledge, skills and clinical abilities designated by CAATE

• Provide instruction and opportunities for the ATS to develop clinical integration proficiencies, communication skills and clinical decision-making during actual patient/client care

• Provide assessment of ATSs’ clinical integration proficiencies, communication skills and clinical decision-making during actual patient/client care

• Facilitate the clinical integration of skills, knowledge and evidence regarding the practice of athletic training

• Demonstrate understanding of and compliance with the ATEP’s policies and procedures

Deliberate Mentorship

• Intentionally demonstrate and describe complex professional skills

• Seize opportunities for instruction through story-telling; disclose salient personal experiences as a means of teaching, reassuring and connecting with the ATS

• Offer ATSs a model of coping, not a model of mastery

• Confront self-defeating, unprofessional or career-inhibiting student behavior

• Encourage innovative thought and creative problem solving

Clinical Education Coordinator

• A faculty member within the ATEP responsible for overseeing administrative matters related to clinical education such as:

• ATS clinical progression • ATS evaluation• Clinical site evaluation • CP training • CP evaluation

CAATE Clinical Education Requirements

• Clinical education must follow a logical progression that allows for increasing amounts of clinically supervised responsibility leading to autonomous practice upon graduation.

• The clinical education plan must reinforce the sequence of formal instruction of athletic training knowledge, skills and clinical abilities, including clinical decision-making. – Clinical education is the planned clinical

integration of the knowledge, skills and abilities taught and evaluated in the classroom.


• Clinical education must provide ATSs with authentic, real-time opportunities to practice and integrate athletic training knowledge, skills and clinical abilities, including decision-making and professional behaviors required of the profession in order to develop proficiency as an AT. – Clinical education is the real-world

development of the ATS.


• Clinical education must allow ATSs opportunities to practice with different patient populations, care providers and in various allied health care settings relative to the ATEP’s mission statement.

• Clinical education assignments cannot discriminate based on sex, ethnicity, religious affiliation or sexual orientation.


• ATSs must gain clinical education experiences that address the continuum of care that would prepare an ATS to function in a variety of settings with patients engaged in a range of activities with conditions described in athletic training knowledge, skills and clinical abilities, the role delineation study and standards of practice delineated for an AT in the profession.

• Examples of clinical experiences must include but should not be limited to:

» Individual and team sports » Sports requiring protective equipment (e.g., helmet and shoulder pads)» Patients of different sexes» Non-sport patient populations (e.g., outpatient clinic, emergency room,

primary care office, industrial, performing arts, military)» A variety of conditions other than orthopedics (e.g., primary care,

internal medicine, dermatology)


• All clinical education sites must be evaluated by the ATEP on an annual and planned basis and the evaluations must serve as part of the ATEP’s comprehensive assessment plan.

• An AT certified by the BOC who currently possesses the appropriate state athletic training practice credential must supervise the majority of the ATS's clinical coursework. The remaining clinical coursework may be supervised by any appropriately state credentialed medical or allied health care professional.


• ATSs must be officially enrolled in the ATEP prior to performing skills on patients. – ATSs must be instructed on athletic training clinical skills prior to

performing those skills on patients. – All clinical education must be contained in individual courses

that are completed over a minimum of two academic years. Clinical education may begin prior to or extend beyond the institution’s academic calendar.

– Course credit must be consistent with institutional policy or institutional practice.


• All clinical education experiences must be educational in nature.– The ATEP must have a written policy that delineates a

minimum/maximum requirement for clinical hours.– ATSs must have a minimum of one day off in every seven-day

period.– ATSs must not receive any monetary remuneration during this

education experience, excluding scholarships.– ATSs will not replace professional athletic training staff or

medical personnel.


• The ATEP must include provision for supervised clinical education with a CP. – There must be regular communication between the ATEP and

CPs.– The number of ATSs assigned to a CP in each clinical setting

must be of a ratio that is sufficient to ensure effective clinical learning and safe patient care.» A maximum ratio that has been suggested is 8:1.

– ATSs must be directly supervised by a CP during the delivery of athletic training services. The CP must be physically present and have the ability to intervene on behalf of the ATS and the patient/client.

Penn State ATEP Clinical Education Model

• Prepare ATSs to be critical thinkers through the process of graded autonomy and progression of learning experiences in the clinical setting.

• Provide formalized instruction and specific feedback to ATSs during their clinical experiences through management of real cases or through scenarios.

• Serve as a mentor (through advice and modeling) for ATSs to prepare them for the practical aspects of the profession of athletic training while emphasizing the foundational behaviors of the profession.

• Encourage ATSs to become engaged learners by requiring students to come prepared to their clinical sites with specific goals (weekly, monthly or semester) and by setting clear expectations for each ATS.

Penn State Clinical Education Exposure Emphases

• Upper extremity intensive

• Lower extremity intensive

• Equipment intensive

• General medical

• Both genders

• Off campus/High school setting

Penn State ATEP Faculty

• Lauren C Kramer, PhD, ATC– Instructor of Kinesiology & Program Director

• John L Vairo, PhD, ATC– Instructor of Kinesiology & Clinical Education Coordinator; – Co-Director, Sports Medicine Clinical Research Agenda

• WE Buckley, PhD, MBA, ATC– Professor of Exercise & Sport Science and Health Education

• Sayers John Miller, PhD, PT, ATC– Assistant Professor of Kinesiology

• Alison R Krajewski, MS, ATC– Instructor of Kinesiology;– UOC Clinical Coordinator;– SCAHS Head AT

Entrance to Athletic Training Major

• Students identify an interest in AT major (wait list)

• Prerequisites– KINES 202: Anatomy– KINES 135: Intro to AT– KINES 231: Clinical AT

Skills I– KINES 233: Emergency

Care in AT

• Competitive admission (Sophomore fall)– Cumulative GPA > 2.5– Prerequisite GPA > 3.0– Feedback from clinical

preceptors– Entrance interview

• Max of 36 students admitted at the end of each fall semester– Usually 15-25

Sophomore Spring Semester

• KINES 232: Clinical Athletic Training Skills II– Instructors: Kramer & Krajewski

• Basic rehabilitation & modality skills• Limited AT clinical rotations

• KINES 334: Lower Extremity Physical Exam– Instructor: Vairo

Junior Fall Semester

• KINES 395F: Practicum in Athletic Training– Instructors: Kramer & TBD

• Seminar• Athletic training clinical rotation• Physical therapy clinic observation

• KINES 335: Upper Extremity Physical Exam– Instructor: Vairo

• KINES 434: Lower Extremity Therapeutic Exercise– Instructor: Miller

Junior Spring Semester

• KINES 395G: Practicum in Athletic Training– Instructor: Buckley

• Seminar• Athletic training clinical rotation• Strength and conditioning observation

• KINES 336: General Medical Aspects in Athletic Training– Instructor: TBD

• KINES 435: Upper Extremity Therapeutic Exercise– Instructor: Miller

• KINES 436: Therapeutic Modalities in Athletic Training– Instructor: Vairo

Senior Fall Semester

• KINES 395I: Practicum in Athletic Training– Instructor: Buckley

• Seminar• Athletic training clinical rotation• General medical observation (orthopaedic surgery)

• KINES 438W: Administration and Issues in Athletic Training– Instructor: Buckley

Senior Spring Semester

• KINES 495F: Field Practicum in Athletic Training– Instructors: Kramer & TBD

• Seminar• Athletic training clinical rotation• General Medical Rotation (Primary Care/Allied

Health Care)

EDUCATIONAL COMPETENCIES

Module 2

Competency and Competent

• Competent– Properly or sufficiently qualified; capable

• Competency– Competencies are knowledge and skills

that serve as instructional goals for a curriculum

Bases of the Athletic Training Educational Competencies

• Provides ATEP personnel and others with the knowledge, skills and clinical abilities to be mastered by ATSs enrolled in related professional preparation programs.

• Mastery of these competencies provides the entry-level AT with the capacity to provide athletic training services to clients and patients of varying ages, lifestyles and needs.

• Serve as instructional goals that should be used to structure the curriculum.

• Developed by the PEC of the NATA.

Association Between Educational Competencies and Role Delineation Study

• Role Delineation Study– Performed by the BOC as a means to define the

minimal knowledge, skills and behaviors necessary for BOC certification as an AT.

• Educational competencies encompass the Role Delineation Study but are broader and more specific. – Ensures the growth of our profession and

heightened abilities of future AT professionals.

What is the Structure of the Educational Competencies?

• Competencies are categorized according to eight content areas comprising the knowledge and skill set of the entry-level AT.

• Additionally the competencies contain the clinical integration proficiencies that are used to structure the clinical component of an AT’s athletic training education.

Content Areas

• Evidence-Based Practice• Prevention and Health Promotion• Clinical Examination and Diagnosis• Acute Care of Injuries and Illnesses• Therapeutic Interventions• Psychosocial Strategies and Referral• Healthcare Administration• Professional Development and Responsibility

Content Areas

• Additionally, the competencies contain Foundational Behaviors of Professional Practice.– Permeate every aspect of professional practice and represent

the common values of the athletic training profession. – Seven foundational behaviors are:

• Primacy of the Patient

• Teamed Approach to Practice

• Legal Practice

• Ethical Practice

• Advancing Knowledge

• Cultural Competence

• Professionalism

Caveat to Educational Competencies

• Clinical Integration Proficiencies (CIPs) have become more global in nature with a greater emphasis on the evaluation of clinical integration instead of isolated skills seen in the previous iterations of the clinical proficiencies.

• Proficient– To perform with expert correctness and facility

• Proficiency– The synthesis and integration of knowledge, skills and

clinical decision making into actual patient/client care.

Clinical Integration Proficiencies and the Clinical Preceptor

• Clinical evaluations should become more global in nature, allowing the CP to more easily evaluate the ATS as a clinician.

• The ATS can easily be evaluated multiple times on his/her clinical proficiencies throughout the academic program.

• Less simulated evaluations and testing; more ‘real world’ evaluations over the course of the ATSs clinical responsibilities.

Clinical Integration Proficiency 1

• PREVENTION & HEALTH PROMOTION– The ATS can administer testing procedures to obtain baseline data

regarding a patient’s/client’s level of general health (including nutritional habits, physical activity status and body composition).

– Use this data to design, implement, evaluate and modify a program specific to the performance and health goals of the patient. This will include instructing the patient in the proper performance of the activities, recognizing the warning signs and symptoms of potential injuries and illnesses that may occur and explaining the role of exercise in maintaining overall health and the prevention of diseases.

– Incorporate contemporary behavioral change theory when educating patients/clients and associated individuals to effect health-related change. Refer to other medical and health professionals when appropriate.


• PREVENTION & HEALTH PROMOTION– The ATS can select, apply, evaluate and modify appropriate

standard protective equipment, taping, wrapping, bracing, padding, and other custom devices for the client/patient in order to prevent and/or minimize the risk of injury to the head, torso, spine, and extremities for safe participation in sport or other physical activity.


• PREVENTION & HEALTH PROMOTION– The ATS can develop, implement and monitor prevention

strategies for at-risk individuals (e.g., persons with asthma or diabetes, persons with a previous history of heat illness, persons with sickle cell trait) and large groups to allow safe physical activity in a variety of conditions.

– This includes obtaining and interpreting data related to potentially hazardous environmental conditions, monitoring body functions (e.g., blood glucose, peak expiratory flow, hydration status) and making the appropriate recommendations for individual safety and activity status.


• CLINICAL ASSESSMENT & DIAGNOSIS / ACUTE CARE / THERAPEUTIC INTERVENTION – The ATS can perform a comprehensive clinical examination of a patient with

an upper extremity, lower extremity, head, neck, thorax and/or spine injury or condition.

– This exam should incorporate clinical reasoning in the selection of assessment procedures and interpretation of findings in order to formulate a differential diagnosis and/or diagnosis, determine underlying impairments and identify activity limitations and participation restrictions.

– Based on the assessment data and consideration of the patient’s goals, provide the appropriate initial care and establish overall treatment goals.

– Create and implement a therapeutic intervention that targets these treatment goals to include, as appropriate, therapeutic modalities, medications (with physician involvement as necessary) and rehabilitative techniques and procedures.

– Integrate and interpret various forms of standardized documentation including both patient-oriented and clinician-oriented outcomes measures to recommend activity level, make return to play decisions and maximize patient outcomes and progress in the treatment plan.


• CLINICAL ASSESSMENT & DIAGNOSIS / ACUTE CARE / THERAPEUTIC INTERVENTION – The ATS can perform a comprehensive clinical examination of a

patient with a common illness/condition that includes appropriate clinical reasoning in the selection of assessment procedures and interpretation of history and physical examination findings in order to formulate a differential diagnosis and/or diagnosis.

– Based on the history, physical examination and patient goals, implement the appropriate treatment strategy to include medications (with physician involvement as necessary).

– Determine whether patient referral is needed and identify potential restrictions in activities and participation.

– Formulate and communicate the appropriate return to activity protocol.


• CLINICAL ASSESSMENT & DIAGNOSIS / ACUTE CARE / THERAPEUTIC INTERVENTION – The ATS can clinically evaluate and manage a patient

with an emergency injury or condition to include the assessment of vital signs and level of consciousness, activation of emergency action plan, secondary assessment, diagnosis and provision of the appropriate emergency care (e.g., CPR, AED, supplemental oxygen, airway adjunct, splinting, spinal stabilization, control of bleeding).


• PSYCHOSOCIAL STRATEGIES & REFERRAL– The ATS can select and integrate appropriate psychosocial

techniques into a patient’s treatment or rehabilitation program to enhance rehabilitation adherence, return to play and overall outcomes.

– This includes, but is not limited to, verbal motivation, goal setting, imagery, pain management, self-talk and/or relaxation.


• PSYCHOSOCIAL STRATEGIES & REFERRAL– The ATS can demonstrate the ability to recognize and refer at-

risk individuals and individuals with psychosocial disorders and/or mental health emergencies.

– As a member of the management team, develop an appropriate management plan (including recommendations for patient safety and activity status) that establishes a professional helping relationship with the patient, ensures interactive support and education, and encourages the AT’s role of informed patient advocate in a manner consistent with current practice guidelines.


• HEALTH CARE ADMINISTRATION– The ATS can utilize documentation strategies to effectively

communicate with patients, physicians, insurers, colleagues, administrators and parents or family members while using appropriate terminology and complying with statues that regulate privacy of medical records.

– This includes using a comprehensive patient-file management system (including diagnostic and procedural codes) for appropriate chart documentation, risk management, outcomes and billing.

Clinical Skill Development

• After initially learning how to perform the skill, more learning must take place.

• Necessities for mastery of a skill:– Continued practice of skill in lab settings and in

clinical practice settings.– Integration of particular skill with other related skills

(e.g. Lachman’s test with comprehensive knee evaluation).

– Decision-making in clinical context.

EVALUATION OF STUDENT PERFORMANCE AND FEEDBACK

Module 3

Clinical Integration Proficiencies

• CIPs represent the synthesis and integration of knowledge, skills and clinical decision-making into actual patient/client care.

• CIPs have been reorganized into this section to reflect their global nature.

• In most cases, CIP assessment should occur when the ATS is engaged in real patient/client care and may be necessarily assessed over multiple interactions with the same patient/client.

• In a few instances, assessment may require simulated scenarios, as certain circumstances may occur rarely but are nevertheless important to the well-prepared practitioner.

• The incorporation of evidence-based practice principles into care provided by ATs is central to optimizing outcomes.

• Assessment of ATS competence in the CIPs should reflect the extent to which these principles are integrated.

• Assessment of students in the use of Foundational Behaviors in the context of real patient care should also occur.

Formal Evaluation of Clinical Integration Proficiencies

• Must be done by an ATEP CP who is physically present during the evaluation.

• Must be in a 1:1 ATS-to-CP ratio.• Ideally performed in a ‘live’ clinical context

with patients/clients.• Alternative methods for assessing the CIPs

may consist of case study examinations and objective structured clinical examinations.

Evaluating Clinical Skills

• CP must evaluate performance of the essential components of clinical skills.

• More than one right way to perform most clinical skills.– There are definitely wrong ways!

• Example: Lachman’s Test– Skill is initially taught, practiced and formally evaluated in KINES

334.– Skill is practiced and reinforced in clinical setting

• Teachable moments by CPs• Integration of skill into clinical practice under mentorship of the CP

– Skill is formally assessed again in a clinical context

Clinical Evaluation

• Clinical evaluation is not a one-time ‘check-off’ assessment.

• ATSs are to be evaluated on their ability to utilize their knowledge and skills in the management of real patients.

• This is done by observing and interacting with ATSs while they provide real AT services.

• It is understood that some clinical proficiencies do not lend themselves to ‘real world’ practice, but most do.

Clinical Evaluation

• A CP cannot be an expert in everything. • All teachers must continually learn in order to

fairly evaluate. Some proficiencies may require additional learning by the CP prior to ATS evaluation; if a CP is unsure regarding a CIP, he/she should contact the clinical education coordinator for clarification.

• The clinical evaluation must be performed by the CP assigned to the ATS.

Clinical Evaluation

• Proficiencies that are listed for a particular practicum level in an ATS’s booklet must be evaluated prior to the end of the semester.

• The responsibility for ensuring this is both the ATS’s and the CP’s. The CP must be willing to allow the ATS to be involved in patient care and the ATS must be willing to be involved.

• If a proficiency does not naturally occur, then it is acceptable to use mock scenarios for ATS evaluation.

Clinical Evaluation

• Not everything an ATS does in the clinical setting gets evaluated.

• There are many duties that an ATS will perform that are a necessary part of the clinical experience (i.e. cleaning coolers, folding towels, etc.). – It is important for the ATS’s professional development

that he/she is involved in these duties; however, these duties should be performed in addition to the ATS’s clinical proficiencies development not instead of them.

Clinical Evaluation

• The ATS will be evaluated twice during a clinical rotation. Once at midterm as a formative evaluation and once at the end of the rotation as a summative evaluation of their clinical proficiency.

• If only a few of the clinical proficiencies are evaluated at the midterm a plan of action for the remainder of the rotation must be developed.

Clinical Evaluation

• CIPs that have been evaluated during a previous rotation are subject to re-evaluation on all subsequent rotations.

• These should be re-evaluated only as they naturally occur.

• If an ATS receives an unsatisfactory mark, the proficiency MUST be repeated in a subsequent evaluation.

Clinical Evaluation Errors

• Evaluating ATSs on skills and knowledge prior to formal instruction and evaluation in the classroom or lab.

• Failure to evaluate the ATS on clinical skills and just ‘giving’ the ATS a grade.

• Using an evaluation scoring system other than the one described on the evaluation document.

• Using mock scenarios and discussions for the majority of clinical evaluations.

• Allowing other unqualified persons to conduct the ATS’s evaluation.

Documentation of Clinical Integration Proficiencies

• ATS Portfolios– Course syllabi– Skill sheets – Practical exams– Assignments

• Clinical documentation and administrative exercises• Critically-appraised topics• Plans of care• Case studies

– Evaluations by CPs

Clinical Preceptor Comprehensive Critique of Athletic Training Students

• ATSs overall clinical education performance gauged at midterm and end of the semester.

• Created to measure the Foundational Behaviors of ATSs as well as competence in knowledge and skills.– Use ATS expectation sheets as one measure of

progression with emphasis on assessing the following characteristics:

• Universal traits• Clinical skills• Psychosocial qualities

Athletic Training Student Self-Appraisal & Evaluation of Clinical Preceptors and Sites

• Completed online via Penn State Qualtrics software program.

• Use feedback from ATSs to assist them in establishing individual goals and expectations

• Use input as a means to improve the performance of CPs and clinical education sites.

LEARNING STYLES AND INSTRUCTIONAL SKILLS

Module 4

Learning Styles

• Comprise different approaches or ways of learning.

• It is proposed that specific individuals prefer a particular method of interacting with, taking in and processing stimuli or information.

• Approximately 70 different models of learning styles have been developed.

• Learning is a complex process and learning style models are often an attempt to simplify that process; thus, the models are by nature incomplete and evolving.

Learning Styles

• The VARK model describes learning preferences based on mode of information input.

• The VARK model describes four basic types of learners.– Visual learners (learn by seeing)– Auditory learners (learn by hearing)– Reading/writing learners (learn by processing text)– Kinesthetic learners (learn by doing)

Learning Styles and Clinical Instruction

• Since ATSs have different learning preferences and many have mixed learning preferences, information in the clinical setting should be presented using all four components of the VARK model.– Demonstrate skills to promote Visual learning.– Discuss information to promote Auditory learning.– Provide and suggest sources to promote

Reading/Writing learning.– Allow ‘hands on’ practice to promote Kinesthetic

learning.

Effective Clinical Instruction

1. Demonstrate skills while the ATS observes.2. Closely supervise the ATS as he/she

practices skills.3. Monitor the ATS as he/she independently

performs skills (taking into account to not allow harm to come to the patient).

4. Assist the ATS by discussing skills before they are attempted and constructively evaluating the ATS afterwards.

Using Andragogy & Pedagogy

• Pedagogy = teaching children (novices)

• When using the pedagogical style, the instructor decides what is taught and how it is taught.

• The learner is motivated by grades and rewards.

• The teaching focus is building a foundation of knowledge or skill.

Using Andragogy & Pedagogy

• Andragogy = teaching adults (experienced)

• When using the andragogical style, the instructor serves as a facilitator and resource for the learner.

• The learner is motivated by the internal desire for competency.

• The teaching focus is appropriate integration of knowledge, skill and professional behavior.

Effective Clinical Preceptors

• An effective CP should use both styles of teaching in the clinical setting.

• At times, the CP needs to take control of the learning process to ensure the ATS has a solid skill and knowledge base (Pedagogy).

• At other times, the CP must allow the ATS to direct the learning experience based on the ATS’s self-assessment of his/her competence (Andragogy).

ATEP AND INSTITUTIONAL POLICIES & PROCEDURES

Module 5

Athletic Training Education Program Handbook

• Please familiarize yourself and keep current with ATEP and related Penn State policies, procedures and protocols stated in the provided handbook before accepting ATSs to your clinical site.

• Abide by and enforce these regulations to remain in compliance with associated governing bodies.

• Contact the program director or clinical education coordinator regarding questions with as necessary.

SUPERVISION, MENTORING AND ADMINISTRATION

Module 6

Clinical Supervision

• The process of observing the ATS as he/she develops clinical abilities in athletic training.

• Can only occur with interaction between the CP and the ATS.

Clinical Supervision Responsibilities

• Direct supervision of the ATS during formal acquisition, practice and evaluation of the Entry-Level Athletic Training Clinical Integration Proficiencies.

– The ATS must be supervised by the CP(s) assigned to the ATS.

• Intervention on behalf of the patient/client if the ATS might put the patient/client at risk or harm.

• Encouragement of the ATSs to arrive at clinical decisions on their own according to their level of education and clinical experience.

• Provide feedback to ATS from information acquired from direct observation, discussion with others and from review of patient/client documentation.

• Presentation of clear performance expectations to ATSs at the beginning and throughout the learning experience.

• Treat the ATSs' presence as educational and not as a means for providing additional staff.

Clinical Preceptors as Mentors

• A mentor is an experienced and trusted advisor.

• Mentoring an ATS goes beyond teaching and providing feedback regarding an ATS’s clinical learning.

• Being a mentor involves giving the ATS advice and counsel as an expert in the field that the ATS cannot get from didactic materials.

Mentoring Responsibilities

• Be a good professional role model.• Listen to the ATSs.• Be available.• Be honest.• Share your opinions.• Be positive.• Care about your ATSs and your patients.• Introduce ATSs to other professionals.

Clinical Education Administration

• Performing the duties required by the ATEP to ensure required policies and procedures are followed.

Clinical Education Administration

• Complete the ATSs’ evaluation forms required by the ATEP in a timely fashion.

• Provide the program director and/or clinical education coordinator with requested materials as required for the accreditation process.

• Collaborate with ATSs to arrange quality clinical education experiences which are compatible with the ATS’s academic schedule

• Application of the clinical education policies, procedures and expectations of the ATEP.

• Inform the ATSs of relevant policies and procedures of the clinical setting.

LEGAL AND ETHICAL CONSIDERATIONS

Module 7

Athletic Training in Pennsylvania

• The practice of athletic training in Pennsylvania (PA) is regulated by the State Board of Medicine.

• Any individual who wishes to perform the duties of an AT must obtain a license from the State Board of Medicine prior to doing so.

• No individual may use the title of AT in PA without first obtaining a related license.

• Practicing athletic training in PA without a license is a criminal misdemeanor.

Athletic Training in Pennsylvania

• Obtaining a license in PA requires the submission of verification materials along with an affidavit of moral character and a written protocol with a physician licensed in PA.

• Performing health care duties other than those described in the protocol may constitute malpractice.

• Individuals licensed to practice in PA are acknowledged with the initials ATC, LAT.

• Information regarding licensure in PA may be found at: http://www.portal.state.pa.us/portal/server.pt/community/state_board_of_medicine/12512/licensure_information/599413

http://www.portal.state.pa.us/portal/server.pt/community/state_board_of_medicine/12512/licensure_information/599413



NATA Code of Ethics

• Written to make the membership aware of the principles of ethical behavior that should be followed in the practice of athletic training.

• Primary goal is to assure a high quality of health care.

• Standards set forth presents aspirational standards of behavior that all members should strive to achieve.

• The principles cannot be expected to cover all specific situations that may be encountered by the practicing AT but should be considered representative of the spirit with which ATs should make decisions.

• Written generally and the circumstances of a situation will determine the interpretation and application of a given principle and the Code as a whole.

• When there is a conflict between the Code and legality, the law prevails.

• Guidelines set forth in this Code are subject to continual review and revision as the athletic training profession develops and changes.

NATA Code of Ethics

• Principle 1: Members shall respect the rights, welfare and dignity of all individuals.– 1.1: Members shall not discriminate against any legally protected

class.– 1.2: Members shall be committed to providing competent care

consistent with both the requirements and the limitations of their profession.

– 1.3: Members shall preserve the confidentiality of privileged information and shall not release such information to a third party not involved in the patient’s care unless the person consents to such release or release is permitted by law.

NATA Code of Ethics

• Principle 2: Members shall comply with the laws and regulations governing the practice of athletic training. – 2.1: Members shall comply with applicable local, state and

federal laws and institutional guidelines. – 2.2: Members shall be familiar with and adhere to all NATA

guidelines and ethical standards. – 2.3: Members are encouraged to report illegal or unethical

practice pertaining to athletic training to the appropriate person or authority.

– 2.4: Members shall avoid substance abuse and, when necessary, seek rehabilitation for chemical dependency.

NATA Code of Ethics

• Principle 3: Members shall accept responsibility for the exercise of sound judgment. – 3.1: Members shall not misrepresent in any manner, either

directly or indirectly, their skills, training, professional credentials, identity or services.

– 3.2: Members shall provide only those services for which they are qualified via education and/or experience and by pertinent legal regulatory process.

– 3.3: Members shall provide services, make referrals and seek compensation only for those services that are necessary.

NATA Code of Ethics• Principle 4: Members shall maintain and promote high standards in the

provision of services. – 4.1: Members shall recognize the need for continuing education and participate

in various types of educational activities that enhance their skills and knowledge.

– 4.2: Members who have the responsibility for employing and evaluating the performance of other staff members shall fulfill such responsibility in a fair, considerate and equitable manner, on the basis of clearly enunciated criteria.

– 4.3: Members who have the responsibility for evaluating the performance of employees, supervisees, or students, are encouraged to share evaluations with them and allow them the opportunity to respond to those evaluations.

– 4.4: Members shall educate those whom they supervise in the practice of athletic training with regard to the Code of Ethics and encourage their adherence to it.

– 4.5: Whenever possible, members are encouraged to participate and support others in the conduct and communication of research and educational activities that may contribute knowledge for improved patient care, patient or student education and the growth of athletic training as a profession.

– 4.6: When members are researchers or educators, they are responsible for maintaining and promoting ethical conduct in research and educational activities.

NATA Code of Ethics

• Principle 5: Members shall not engage in any form of conduct that constitutes a conflict of interest or that adversely reflects on the profession. – 5.1: The private conduct of the member is a personal matter to the

same degree as is any other person’s except when such conduct compromises the fulfillment of professional responsibilities.

– 5.2: Members of the NATA and others serving on the Association’s committees or acting as consultants shall not use, directly or by implication, the Association’s name or logo or their affiliation with the Association in the endorsement of products or services.

– 5.3: Members shall not place financial gain above the welfare of the patient being treated and shall not participate in any arrangement that exploits the patient.

– 5.4: Members may seek remuneration for their services that is commensurate with their services and in compliance with applicable law.

Ethical Practice of Athletic Training

• Know your professional code of ethics.• Recognize situations where ethical concerns are present.• Consult whenever there are questions.• Refer when the concern is beyond your legal scope of practice or

competence.• Refer if you might become a primary party in an ethical dilemma.• Document carefully and often.• Reflect and consider prior to making ethical decisions.• Fully disclose your roles to patients.• Allow patients to make their own fully informed choices.

Patient Confidentiality Considerations in Clinical Education

• Care must be taken by the CP and the ATS to ensure patient confidentiality.

• ATSs should only be allowed access to information necessary for effective patient management.

• Inform patients of the ATSs’ role in providing healthcare.

Ethical Behavior Considerations in Clinical Education

• The relationship between the CP and the ATS is a teacher-pupil relationship.

• Relationships beyond this may lead to unethical or the perception of unethical behavior.

EFFECTIVE COMMUNICATION IN CLINICAL EDUCATION

Module 8

Effective Communication

• Quality clinical education requires effective communication between CPs, ATSs and the ATEP.

Need to Define Athletic Training Student Responsibilities

• Establish acceptable AT responsibilities in the athletic training/sports medicine facility and at practice.

• Establish acceptable ATS responsibilities when traveling to away events.– (See Travel Policy)

Communication with ATEP Administration

• CPs must communicate with the Program Director and Clinical Education Coordinator regarding ATS progress towards clinical education goals at regularly scheduled intervals determined by the ATEP.– To ensure adequate instruction and evaluation, effective

communication must exist between CPs and ATEP administrators.

• Clinical education coordinator will have presence in the clinical settings via scheduled site visits.

Communication Skills in Clinical Education

• CPs must use appropriate forms of communication to clearly and concisely express him/herself to ATSs, both verbally and in writing.

• Effective learning requires timely and constructive feedback.

• Often clear verbal instructions and feedback are sufficient but at times written instructions and feedback will be necessary to adequately instruct and evaluate the ATS.

Constructive Critiquing

• CPs must provide appropriately timed and constructive formative and summative feedback to ATSs.– Formative feedback = developmental feedback for future

practice and skill development– Summative feedback = final evaluation

• To effectively develop clinical skills, ATSs must be given formative feedback throughout a clinical rotation. – Evaluation of an ATS at the end of a clinical rotation without

giving the ATS formative evaluations and practice opportunities throughout does not allow the ATS to fully develop the skills prior to the final evaluation. This does not allow the ATS to change his/her behavior and makes the final summative evaluation biased.

Facilitating Communication in Clinical Education

• CPs must facilitate communication with ATSs through open-ended questions and directed problem solving.– Full evaluation of the ATS’s clinical ability is evaluated by

gaining knowledge of the ATS’s cognitive and psychomotor abilities relative to a clinical proficiency.

– This is accomplished through questioning and problem solving along with skill observation.

Professional Discourse

• CPs must ensure time for on-going professional discussions with the ATS in the clinical setting.– Professional development of the ATS requires regular input from the

CP.

– A CP that is not available for discussion creates a stand-offish atmosphere that discourages professional involvement by the ATS.

• CPs must communicate with ATSs in a non-confrontational and positive manner.– The CP must remember that the ATS is a student and not an employee;

accordingly, the ATS is developing skills and abilities.

– Positive constructive communication gives the ATS a sense of their strengths and weaknesses as an AT.

– Negative, confrontational communication is not effective in promoting improved clinical performance.

Clinical Preceptor Feedback

• CPs will receive feedback from the program director and clinical education coordinator as well as ATSs.

• A CP must be prepared to receive constructive input from the program director and clinical education coordinator as well as feedback from the ATSs.

• The purpose of this feedback is to assist the CP in identifying their areas of strength and weakness in clinical education and supervision.

INTERPERSONAL RELATIONSHIPS IN CLINICAL EDUCATION

Module 9

Positive Interpersonal Relationships in Clinical Education

• As a CP, you will be closely observed by ATSs who desire to become an AT; therefore, it is extremely important that you demonstrate interpersonal relationships that encourage ATSs regarding the profession of athletic training.

Clinical Preceptor and Athletic Training Student Relationships

• CPs must form appropriate and professional relationships with ATSs.

• The CP must be seen as a professional supervisor by the ATSs. Any relationship beyond that is inappropriate.

Clinical Preceptor Relationships

• CPs must model appropriate and professional interpersonal relationships when interacting with colleagues, patients/clients and administrators.

• An effective CP must demonstrate appropriate relationships with the individuals that he/she interacts with while performing his/her professional duties.

• Inappropriate relationships discourage future professionals and may constitute unethical behavior.

Advocating for Athletic Training Students

• CPs should appropriately advocate for ATSs when interacting with colleagues, patients/clients and administrators.

• The ATS represents the future professional.

• The effective CP should advocate for ATSs when discussing their involvement in the health care of patients/clients.

Clinical Preceptors as Positive Role Models

• CPs are a positive role model and mentor for ATSs.

• The CP who does not serve as a positive role model discourages future ATSs from entering the profession.

• Athletic training is an allied health care profession; thus the CP’s behavior and interpersonal relationships should reflect this.

Nondiscrimination and Demeanor

• CPs must demonstrate respect for gender, racial, ethnic, religious and individual differences when interacting with people.

• Allied health care providers provide quality services to all individuals; hence, CPs must demonstrate this to ATSs by their words and actions.

• CPs must have an open and approachable demeanor to ATSs when working in the clinical setting.

• ATSs want to learn from CPs. A CP that is not open and approachable creates an atmosphere where the ATS feels that he/she is not welcomed and therefore will not seek the CP’s instruction and evaluation.

Managing Problems with Athletic Training Students

1. Initial communication between CP(s) and ATS– Documentation recommended

2. Contact clinical education coordinator if repeated problems occur or severity of incident is extreme

– Documentation recommended

3. Schedule meeting(s) between CPs, ATS, clinical education coordinator and program director to discuss conflict resolution

– Documentation required

FOUNDATIONS OF CLINICAL KNOWLEDGE AND SKILLS

Module 10

Clinical Proficiency of the Clinical Preceptor

• CPs must demonstrate a solid basis for clinical knowledge and skills that meet or exceed the athletic training clinical proficiencies.

• An individual that does not meet or exceed the clinical proficiencies should not serve as a CP.

Clinical Instruction and Evaluation

• CPs must be capable of instructing and evaluating the clinical proficiencies that are particular to their practice setting.

• CPs must read and understand the CIPs prior to accepting an ATS. Any remediation or clarification in the clinical area must take place prior to the acceptance of an ATS for supervision.

• If a CP is uncertain as to how to evaluate a clinical proficiency, the Program Director or Clinical Education Coordinator should be contacted prior to attempting the assessment.

Current Skill Sets and Evidence-Based Practice

• The CP’s clinical skills must be current and reflect care decisions supported by a scientific foundation and evidence-based practice.

• As allied health care practitioners, ATs must utilize current related methodologies and be prepared to justify clinical management decisions based on evidence that the intervention is safe and effective.

Continuing Education and the Clinical Preceptor

• The CP must continually learn in order to stay current with his/her clinical knowledge base and skill set through participation in continuing education programs.

• Participation in continuing education programs, related presentations and self-study are a necessity for the AT to become and remain an effective CP.

THANK YOU FOR YOUR TIME AND ATTENTION TO THIS

INFORMATION

ATs will receive a certificate for 5.0 BOC continuing education

units.