Assess Your Individual Learning Strategies

By Cherie Trimberger

Communications Coordinator

As an Athletic Trainer, you’ve spent years in school learning subject matter required for both your degree and BOC certification.  Throughout your education, it may not have occurred to you that your learning strategies might be different from the person sitting next to you.

Learning strategies are those techniques or specialized skills that the learner has developed to use in both formal and informal learning situations.1 There may have been subtle signs about your learning strategies, like your preference for a class or instructor, but you may not have really understood the reason behind your preferences.

Now as you work to finish your continuing education (CE) for the Board of Certification (BOC) reporting period ending December 31, 2015, it’s a good time to consider how your individual learning strategy could play a factor in your CE decisions.

For nearly 2 decades, educators studied the concept of learning styles to explore differences in learners with instruments to measure these differences.  Many in the field of adult education began to research the concept of learning strategies as a way to better understand individual differences among learners.1

Modern studies suggest that distinct groups of learners do exist. Inquiries at 2 universities in the United States led to research related to learning strategies and to the development of Assessing The Learning Strategies of AdultS (ATLAS).1  ATLAS can be used for self-assessment to quickly identify your approaches to learning a task.  According to Development of a user-friendly instrument for identifying the learning strategy of adults, ATLAS breaks down learners into 3 categories.

  • Navigators: Navigators are focused learners who chart a course for learning and follow it. These learners initiate a learning activity by looking externally at the utilization of resources that will help them accomplish the learning task and by immediately beginning to narrow and focus these resources.  Full description available at (893-894)
  • Problem Solvers: Problem Solvers rely on critical thinking skills. Like Navigators, Problem Solvers initiate a learning activity by looking externally at available resources; however, instead of narrowing the options available, they immediately begin to generate alternatives based on these resources. Full description available at (894)
  • Engagers: Engagers are passionate learners who love to learn, learn with feeling, and learn best when they are actively engaged in a meaningful manner with the learning task; ‘‘the key to learning is engagement – a relationship between the learner, the task or subject matter, the environment, and the teacher.’’ Full description available at  (894)

Understanding your learning strategies can help when selecting your CE program.  Consider taking the ATLAS evaluation to better understand your individual learning strategies.  You can find the ATLAS evaluation here:  The ATLAS evaluation is just one more tool you can use to help get the most out of your education.



Know Your Worth: Athletic Training Internships

By Devon Serrano, MS, LAT, ATC

As the number of professional-level master’s programs increase, more Athletic Trainers and athletic training students are looking for options to further their clinical education before diving into a full-time job.  Internships and advanced residencies and fellowships are popping up across the country, offering Athletic Trainers the opportunity to improve themselves as clinicians.  As great a concept as it is, there is a deadly catch: these opportunities come at a price.  Many do not offer medical benefits or housing assistance and most offer very low wages..

Now don’t get me wrong: not all internships are evil places that lure unsuspecting young professionals to a year of crazy hours and little pay.  The higher paying internships, fellowships and residencies can range from $18,000 to $30,000, according to a recent search on the NATA career center.  However, some are offered for far lower – from $15,000 all the way to unpaid.  Imagine trying to live in a major city such as New York, Chicago or Washington, DC with the constant fear of having to choose between paying for rent and transportation or buying groceries.

The return of internships is a great thing.  Going back to the start of the profession, internships allow for Athletic Trainers to become better clinicians with a bit of a safety net still available in case they fall.  In order to make this route successful and ultimately improve the profession of athletic training as a whole, Athletic Trainers must demand more for themselves.

Let’s compare internships for doctors versus Athletic Trainers.  During a doctor’s internship, they are still doctors and are paid as such.  They work long hours with a great deal of responsibility assigned to them.  However, they don’t usually worry about being able to make rent that month.  Not many Athletic Trainers can say they felt financially comfortable during their internships.

Athletic Trainers need to recognize their worth and demand recognition by their employers.  When looking for their first job or placement right after school many young Athletic Trainers will take the first job they’re offered without doing their research.

When considering your first position out of school, consider these questions:

1. What is the cost of living in that area?

2. How many teams are you assigned to?

3. Are you responsible for paying your own licensure fees, insurance, NATA dues, CE fees, etc?

4. Is your pay taxed at the time or not?

After a while, things add up. You don’t want to pay to be an intern.

As a profession, we need to embrace the changes that are upon us.  I wouldn’t be surprised if internships take the place of Graduate Assistants in post-professional clinical education in the coming years.  If we as professionals know our worth and are willing to fight for it, we will continue to see an improvement in athletic training’s reputation.  It is important for us to teach the future generations of Athletic Trainers to know their worth and refuse to work for pennies.

Top 5 Injury Risks for Volleyball Athletes

By Devon Serrano, MS, LAT, ATC

Fall semester is upon us, along with the attack of everything pumpkin spice and tailgates.  Indoor women’s volleyball is in full swing as their sand and male counterparts prepare for off-season tournaments.  Focusing specifically on women’s indoor volleyball, some of the top risks involve the foot, ankles, knees, back and shoulder.


The foot is commonly injured because of the overall lack of protection for the foot during play. Often players suffer contusions and fractures of the phalanges and metatarsals from either being stepped on by teammates in the course of a rally or by an opponent coming under the net after a block or a hit.  Although the up and down referees are assigned the responsibility of watching for players going under the net, sometimes athletes still cross the line and cause injury to themselves or others.  In terms of prevention, it is important front row players are taught to land so their feet are not at greater risk of being injured by an opponent.


The ankles are the bane of every Athletic Trainer’s existence, especially those who work volleyball.  The majority of collegiate coaches require all athletes to wear ankle braces bilaterally during every game and practice.  However, they put little emphasis on ankle strengthening, leading to moderate to severe ankle sprains out of the braces.  It is important that athletes participate in a strengthening program for their ankles to help with prevention.  , Start with the basic 4-way ankle exercise and work from there.


The knee, especially in female athletes, is always a hot topic. The constant jumping in volleyball is a risky activity for knees.  Many athletes will suffer from patellar tendonitis, also known as jumper’s knee. In some cases, athletes will experience injury to the ligaments or “terrible triad,” which includes the ACL, MCL and medial meniscus.  Implementation of a lower extremity strengthening program and proper jumping mechanics are key in helping to decrease the severity of injury and possibly the rate of injury as a whole.


Due to the nature of the ready position used in volleyball throughout play, the back is constantly under stress.  The lumbar spine is in a forced lordosis while the thoracic spine tends to have more kyphosis.  Core and back strengthening and stabilization tend to help decrease pain, but it is critical that, in addition to proper form, athletes demonstrate good posture throughout the day.


The shoulder is always at risk with hitting or overhead serving athletes.  The supraspinatus is commonly stressed and suffers strains.  Similar to the ankle, implementing a strengthening program for the shoulder can help with overall injury prevention and performance enhancement.  The use of the shoulder “big four” – including exercises like extension, punches, internal and external rotation – is a good starting point that can be implemented either in the athletic training facility or with the help of a strength and conditioning coach.

Volleyball is a sport that benefits from preventative strengthening due to the repetitive nature of the sport’s actions.  Although typically considered an upper extremity sport, an overall approach to the body is preferred to address all the areas at risk.

Self-Assessment Exam Can Help Identify the Right CE Program for You

By Cherie Trimberger

Communications Coordinator

The holidays, the New Year’s Eve ball drop and the BOC’s reporting period deadline are fast approaching.  The current BOC reporting period ends December 31, 2015.  Have you selected your continuing education (CE) programs yet?

When making decisions on what CE to take, practical concerns regarding cost and location are often the first things that come to mind.  Although those factors may be important, you might be missing the big picture when making educational decisions affecting your certification.

As an Athletic Trainer (AT), CE programs are an important part of keeping you at the top of your game.  Through CE programs, you’re given the opportunity to learn new things, keep current on industry changes and sharpen your skills.

Sometimes it can be difficult to determine what program topic would truly benefit you in your practice.   If you are currently struggling with what CE program would be a right fit for you, consider taking the BOC online self-assessment exam.

On the BOC website, self-assessment exams are available to ATs seeking an assessment of their CE needs.  Content experts who develop the BOC exam created the questions within the self-assessment exams.  These exams will assist in determining potential areas of strength and weakness in athletic training to help you identify your CE needs.

The BOC offers self-assessment exams in study and exam modes.  Each self-assessment exam includes 75 questions that are representative of the question types on the BOC exam, including multiple-choice, multi-select, drag-and-drop, hot-spot and focused testlets.

When you are ready to take a self-assessment exam, simply create a User Account, purchase the exam and begin testing.  To take a self-assessment exam now, follow this link

The self-assessment exams are available via the internet 24 hours a day, 7 days a week. You will have 365 days from the purchase date to complete a self-assessment exam once you have paid for an exam.

Determining your strengths and weaknesses is important for you to get the most out of your education.  Make your BOC recertification count by ensuring your CE program is in line with topics that will benefit you in the long run.

Workplace Bullying - Awareness and Prevention

By Mackenzie Simmons, ATC

The definition of a bully is, “a person who uses superior strength or influence to intimidate someone, typically to force him or her to do what one wants.” October was National Bullying Prevention Month and brings to mind the struggles we all face with bullying.  Many people view bullying as an issue mostly experienced by children and young adults; however, bullying can happen into adulthood and throughout one’s life.  Bullying can even happen on the job in athletic training, regardless of how noticeable it is or is not.

As a young professional, I had a bullying experience a few weeks ago.  Currently, I am a second year academic graduate assistant and usually try to get as much clinical experience as possible.  I was working at a local high school football game and was standing on the sideline with water.  The team was losing, and the angered head coach approached me to get a drink.  He came up to me and said, “How does it feel that you have wasted all this money on education to stand on a high school sideline and hand out water bottles?”

I am not going to lie; it hurt.  I was shocked a person I was supposed to be on a team with would speak to me in such a manner.  That experience was eye-opening for me and made me realize that even as a professional you can experience bullying on the job.  Athletic Trainers or any other professionals should not be subject to bullying or any other negative conversation.  After a few days of thinking about this experience, I decided I would never allow a coach or colleague to speak to me in a disrespectful way again.  I have worked hard to be in the athletic training profession, and I deserve respect on and off the field.

Bullying awareness and prevention encompasses more than Athletic Trainers, and I challenge everyone to take a stand and fight for the respect you have earned.  If you are working with a coach, colleague or other individual who is constantly undermining you or trying to overrule your decisions, make an effort to change the relationship.

We are healthcare professionals; we are educated and trained in the prevention of injuries, rehabilitation, immediate care, evaluation and administration.  The coaching staff, parents and athletes should honor our thoughts and actions.  Athletic Trainers should never feel undermined or threatened on the job. Take a stand for yourself and others around you and put this type of bullying to an end.

World Pediatric Bone and Joint Day 2015 – Focus on ACL Tear Prevention

Claudia Curtis, MS, ATC, LAT

This year’s focus for World Pediatric Bone and Joint Day on October 19 was anterior cruciate ligament (ACL) injuries in the knee.  The American Academy of Pediatrics has acknowledged that in the past 20 years there has been a sharp increase in ACL tears due to a variety of reasons, including increased sport participation, increased detection with medical technology and education advances, and increased focus on intense training to develop athletic skills at a young age.  While these factors have little effect on young children, this changes dramatically as children begin puberty and clinicians begin to see a sharp increase in ACL tears in the pubescent athlete.1

As clinicians, we know prevention of all injuries is not possible. A tear of the ACL is one injury that continues to occur despite our best efforts.  One of the main reasons ACL injuries continue lies in the fact that these injuries are multifactorial.  Researchers have identified intrinsic factors (anatomical, hormonal, biomechanical and neuromuscular) and extrinsic factors (level/type of athletic participation, playing surface, environmental factors and equipment).2,3  Understanding that there are so many contributing factors, where do we begin to address the issue?

Immediately, we can recognize there are certain factors we have no control over, such as: female sex, bony geometry of the knee joint (femoral notch and tibial plateau characteristics) and congenital knee joint laxity.3 The main factors athletes have the ability to modify include neuromuscular control at the hip and knee and postural stability.1 Extensive research has looked at jumping and landing mechanics and pathomechanics in athletes who have sustained ACL tears.  Many researchers have developed prevention programs based on neuromuscular and biomechanical training, as these are modifiable risk factors that as clinicians we can focus on to decrease ACL tear or re-tear risk.  Attention has been paid to the effect puberty has on these factors and the importance of retraining the hips and knees as the alignment changes in females.  None of this is news to clinicians cued in to the pulse of ACL injuries.

So if we’re looking for something more novel, what about continuing up the kinetic chain?  The Washington Post has put out a series of articles looking at students in schools at the elementary and middle school level.  While these articles are focused on the cognitive realm, including concentrating in class and ADD/ADHD among students, their findings indicate a physical cause: core weakness or poor postural control.  Postural assessments of these students demonstrate increased forward head, protracted scapulae and increased lumbar lordosis.  Many of these students cannot truly engage their deep core musculature with abdominal exercises. Muscle imbalances begin at a very young age as a result.  If athletes are heading into puberty and the prime years of athletic participation without core strength or postural control, are we setting up athletes for ACL tears that could be prevented?


1 LaBella CR, Hennrikus W, Hewett TE. ACL Injuries: Diagnosis, Treatment, and Prevention.  Pediatrics.  May 2015. 133(5): 1437-50.

2 Hewett TE, Myer GD, Ford KR. Anterior Cruciate Ligament Injuries in Female Athletes Part 1, Mechanisms and Risk Factors. Am J Sports Med February 2006 vol. 34 no. 2 299-311.

3 Smith HC, Vacek P, Johnson RJ et al. Risk Factors for Anterior Cruciate Ligament Injury A Review of the Literature — Part 1: Neuromuscular and Anatomic Risk. Sports Health. 2012 Jan; 4(1): 69–78.

Washington Post article accessed at:


Water: The Elixir of Life

Desi Rotenberg, MS, ATC, LAT

Dehydration is a normal process of life that arises when biological beings do not replenish their water sources.  Dehydration can compromise athletic performance as well as normal activities of daily living.  It can also increase the risk of exertional heat illness.  Semantics will tell us dehydration is the “act or process of becoming hypo-hydrated” (  The key concept of hydration is our body must maintain a stable, homeostatic environment and cannot do so without the regular intake of water.

As an anatomy teacher at the high school level, one of the first presentations I give covers basic human needs.  The most important concept we discuss is water and replenishment.  Rather than just teaching the concepts, I make it a rule in the classroom that students will not bring any beverages to class other than water.  Furthermore, I encourage my students on a regular basis to bring a water bottle to school and refill it several times throughout the day.  It is recommended we drink eight, 8-ounce glasses per day.  Most of the high school students and athletes I have been around do not even reach half that number.

It amazes me that a basic human need can elude so many young individuals.  As Athletic Trainers, we ensure our athletes are well hydrated and know how much water to drink and when.  However, I believe we tend to overlook the non-athletes.

Working with 190 students at the public school level, I administered a survey that revealed only 70 of the 190 (36%) students carried a water bottle with them to school.  Of the other 120 students who did not carry a bottle with them, only 50 students stated they drank water regularly (more than twice) throughout the course of the school day.   The results of the survey showed nearly 36% of my students did not have a daily water-replenishment routine.

My tentative plan for intervention:

Every student will be required to bring a water bottle to my class.  Some of them will forget, but if I keep reminding them, eventually, persistence will beat resistance.  This is my attempt to help students overcome the long term negative symptoms of chronic dehydration.

Drinking water regularly can lead to better immune function, better cognitive and mental capacity, better memory, more energy and better digestion.  Globally, water is essential to survival because every cell in our body is made up of about 70-75% water.

Preventing the negative effects of dehydration is about education and creating a constant awareness.  We must continue to take our knowledge and help as many people as we can beyond our athletic teams, clinics, high schools and gyms.


NATA Position Statement: Fluid Replacement for Athletes

VIDEO: Continuing Education and Certification Maintenance Requirements - Your Questions Answered

In the latest virtual Town Hall Meeting, BOC Executive Director Denise Fandel answers questions about continuing education and certification maintenance requirements due December 31, 2015.  The questions discussed in the meeting are listed below.  Tune in and Be Certain ™ your questions are answered!



Questions Answered in Virtual Tour Hall Meeting

1. If I was certified in 2014, do I need to pay the 2014 certification maintenance fee?

2. Can I pay both NATA and BOC fees together?

3. Why are our state licenses so expensive?

4. Why are CEUs so expensive?

5. Can ATs take an online ECC course?

6. Does being an instructor of a CPR course count for my ECC requirement?

7. Do ATs earn CEUs for taking a CPR instructor course?

8. Do ATs earn CEUs for ACLS certification?

9. What should an AT do if they have lost their ECC card?

10. What happens if an AT has a lapse in their ECC certification?

11. How do ATs enter their ECC cards onto their reporting form?  Do we need to continue to send in our updated ECC card every two years?

12. What is a contact hour?

13. How was the number of 50 CEUs decided on?

14. If I have recently become certified (in 2015), how many CEUs do I have to complete and by when?

15. How was the number 10 determined for required EBP CEUs?

16. How do you balance time dedicated to being an AT versus time that is needed to get required CEUs?

17. Can ATs carry over extra CEUs to the next CE reporting period if they earn more than the required number of CEUs for the current reporting period?

18. How do ATs know what category to report CEUs in?

19. Do ATs earn CEUs for teaching courses about athletic training?

20. Do ATs earn CEUs for speaking?

21. Do ATs earn CEUs for writing articles related to athletic training?

22. What type of college courses are acceptable for BOC CEUs?  Do ATs need to submit their official transcript?

23. Do non-approved CEUs count towards the 50 total required CEUs?

24. How does the BOC’s continuing education requirements compare to similar professions?

25. Do you recommend specific online organizations to obtain CEUs from?

26. I attended a CE course that was not great quality, or I am concerned that they wasted my time.  What do I do?

27. I would like to see more CE programs available for ATs that work in non-traditional fields that could include industrial and ergonomic topics.

28. I would like to see more local providers approved in my area.  What can I do to encourage CE providers to apply?

29. Please elaborate on the EBP requirement and why it is now a requirement.

30. My concerns relate to the amount of opportunities for learning related to the evidence based requirement.

31. Where can a NATA member find free CEUs in EBP?

32. How do you know if a course meets the EBP requirement or if it is approved for EBP CEUs?

33. If I took a program that is not on the EBP approved list, can I submit it for consideration?  My program title includes the word “evidence.” Does it count for the EBP Category?

34. I have taken EBP college courses at my university.  Will these count for EBP CEUs?

35. I am a retired AT. Do I need to complete the EBP requirement?

36. Will the NATA clinical symposium in 2016 offer live EBP CEUs?

37. I attended a district meeting that had EBP sessions.  What’s the best way to report these?   Is there a specific code?

38. Should ATs submit all of their CEUs at once?  Can ATs report them as they are earned throughout the 2-year period?  Are ATs required to enter a specific number of CEUs each year?

39. Where do ATs look to see how many CEUs they have entered?

40. I want to report a college course that meets the requirements for Category C.  What is my date of completion?

41. I have graduated from a post professional CAATE accredited program.  Can I count both EBP CEUs and individual courses in Category C?

42. I have recently changed my name. Will a name change this late in the reporting year cause problems?

43. What documentation should I keep in case I am audited?

44. What is the most common mistake ATs make when reporting CEUs?

45. How are ATs selected for the audit?

46. I have had a few life changes occur over the last two years and I would like to request an extension.  What is the process to do so?

47. Will I lose my certification if I don’t get my requirements completed by December 31, 2015?

48. If you are currently not working as an Athletic Trainer, can you put a hold
on your credentials?

49. Can ATs retire their certification and come back at a certain point and practice as a BOC Certified Athletic Trainer?

50. Looking ahead to the 2016-2017 reporting period, will there be any changes?

The Yin to my Yang: Privacy and Confidentiality in the Athletic Training Facility

By Adaeze Teme, JD, PE-ATC

If home is really where the heart is, then the athlete is certainly at home in an athletic training facility.  The notoriety of the facility rivals that of a panic room because of its ability to shelter the athlete’s health information against third parties.  The facility is not merely a functional hub for information gathering; indeed, it is the epicenter of the athlete’s pertinent health history.  Whether it is discussing injury status, treatment or surgery updates, the facility possesses content that must be kept confidential to maintain its integrity and to protect the privacy of the athletes and the Certified Athletic Trainer (AT) in the facility.

In so many ways, confidentiality is the yin to privacy’s yang, and though used interchangeably, they could not be more different in application.  At first glance, the 2 terms seem similar, but understanding confidentiality and privacy is appreciating the legal significance of both terms.

Confidentiality is a core ethical duty in the athletic training profession that is essential to the athlete and AT relationship.  Confidentiality, in this setting, refers to personal information shared between an athlete and AT that cannot be disclosed except by the express consent of the athlete.  Essentially, confidentiality between the athlete and the AT is perpetual or until otherwise agreed to or breached.  Although courts do not expressly recognize a confidentiality privilege between athletes and ATs, they will, however, uphold confidentiality agreements between the 2 parties.

On the other hand, privacy is not just a prerogative, but a protected Constitutional right that grants freedom from interference into a person’s personal affairs.  For instance, there is a reasonable expectation of privacy during pre-participation physicals, as they are conducted in seclusion and away from the public view.  Privacy, as it relates to the athletic training profession, is an obligation to protect the athlete, while maintaining their dignity during evaluation, treatment and rehabilitation.

If you have any concerns about privacy and confidentiality in your athletic training facility, then take a look at the BOC Facility Principles document and Facility Principles Assessment Tool.  There you will find easy-to-use checklists with more information on accessibility, privacy and confidentiality, employee safety, safe handling of hazardous materials, emergency preparedness and more.

*This blog only reflects the author’s views on this subject and not the confidentiality or privacy agenda of the US FDA.

Adaeze Teme, JD, PE-ATC is an orthopedic physician extender and certified athletic trainer.  She serves as Regulatory Counsel at the U.S. Food and Drug Administration (FDA) in the Center for Devices and Radiological Health (CDRH).


1. Gary Stuart, The Ethical Duty of Confidentiality, ETHICS LAW.COM, (last visited Aug. 24, 2015).

2. OHIO REV. CODE ANN. §1347.15 (A)(1) (West 2009); Is there a Difference Between Confidentiality and Privacy? THOMSONREUTERS.COM, (last visited Aug. 24, 2015).

3. Jere Webb, A Practitioner’s Guide to Confidentiality Agreements, STOEL.COM, (last visited Aug. 24, 2015).

4. “[T]estimonial privilege, is a concept from the law of evidence and present in common law and statutes of the fifity states . . . [that] appl[ies] in judicial and other proceedings in which a lawyer may be called as a witness or otherwise required to produce evidence concerning a client.” Sue Michmerhuizen, AMERICANBAR.COM, (last updated May 2007).

5. Eric Weiss and Debra Slifkin, Enforceability of Rule 26(c): Confidentiality Orders and Agreements, FEDERATION.ORG, (last visited Aug. 24, 2015).

6. Griswold v. Connecticut, 381 U.S. 479, 483 (1965).  Right to privacy as a right to "protect[ion] from ... in the "penumbras" and "emanations" of other constitutional protections.

7. Sanchez Scott v. Alza Pharmaceuticals, Cal.Rptr. 2d 410, 414 (Cal. Ct. App. 2d 2001) (“ [R]easonable expectation of privacy in the medical examination room . . .”).



Did your state make the Top 10 list?

During the election for BOC Athletic Trainer Director, we have been keeping track of the percentage of Athletic Trainers in each state who voted during the election.  Online voting closed on Thursday, October 15, 2015 at 11:59pm CT.

Congratulations to Montana for taking first place!  Louisiana was in second place, and Oregon was close behind in third place.  Nebraska, Wyoming, Arkansas, Oklahoma, Hawaii, North Dakota and Kentucky all made the Top 10 list.  Thank you to everyone who voted in this election!

The BOC is also pleased to announce the election of a new Athletic Trainer Director to the Board of Directors.  Kimberly Detwiler, MS, LAT, ATC, CSCS, will take office January 2017, following a year of mentorship and learning as an AT Director-elect. Detwiler, who serves as Assistant Athletic Trainer at the University of Texas at Austin, said she is honored to have been elected to the board and is excited to be part of the BOC.  Learn more at