Archive for March, 2014

Improve Patient Outcomes with Evidence Based Practice

Monday, March 31st, 2014

Providing the best possible patient care involves staying up-to-date on advances in the healthcare profession. That’s why the BOC added a new continuing education (CE) category beginning in 2014. The Evidence Based Practice (EBP) category helps Athletic Trainers (ATs) infuse the best new evidence into clinical decision-making, with the goal of improving patient outcomes.

By completing activities in the EBP category, ATs learn how to find and analyze the most current research evidence available. Then, with research in hand, ATs can use clinical expertise and their patients’ own values to make healthcare decisions.

To assure that ATs have the opportunity to learn about new healthcare research, the BOC now requires a certain number of EBP continuing education units (CEUs) to maintain certification.

Requirements for Certification Maintenance

ATs are required to complete a minimum number of EBP CEUs to maintain their BOC certification. All CEUs are due by December 31, 2015.

  • ATs certified before 2014 must complete 50 CEUs, including at least 10 EBP CEUs
  • ATs certified in 2014 must complete 25 CEUs, including at least five EBP CEUs

BOC Approved EBP programs are listed on the BOC website. Approved programs are updated monthly

Two types of EBP programs are available:

  • Foundations of EBP - programs help clinicians understand EBP methodology, find and evaluate evidence, and apply it to their clinical practice
  • Clinical EBP - programs are organized around a clinically appraised topic, such as evaluation, treatment and rehabilitation of injuries and illnesses. These programs follow a five-step EBP process

Only those programs listed on the BOC website are eligible for EBP Category CEUs, and programs are only eligible for credit on or after their approval date.

EBP Course Approval

Some CE programs may appear to follow EBP principles. However, only programs that have been approved by the BOC for the EBP Category are eligible for credit in this category. Providers, not ATs, are responsible for getting BOC approval.

BOC Approved Providers who would like to offer EBP Category programs are invited to submit the activity for BOC approval. The application asks providers to follow a five-step EBP process during program development to ensure that basic EBP principles are followed.

Once a program is submitted, it will undergo peer review to ensure basic EBP principles are incorporated into the program. The BOC then lists approved programs on its website .

For complete information on the EBP category, check out the new 2014-2015 Certification Maintenance Requirements document.

Written By:
Melissa Breazile
MelissaB@bocatc.org

History of Women in Athletic Training

Thursday, March 27th, 2014

March is full of important awareness events, including Women’s History Month. Since the passage of Title IX in 1972, there has been exponential growth of participation of females in sports at all levels as well as an increase of women in the athletic training profession.

Gail Weldon - NATA Hall of Fame 1995

Iconic Women in the Profession

In 1972, Sherry Bagagian became the first woman to sit for the certification exam given by the National Athletic Trainers’ Association (NATA) at that time (now it is given through the Board of Certification (BOC)). According to archive records with the NATA, not long after Bagagian sat for the exam, Gail Weldon sat for the NATA exam. Weldon became an icon of women in the athletic training profession with a wide array of accomplishments. She was the first female Athletic Trainer (AT) hired  by the US Olympic Committee in 1976, the first female Head AT for the 1979 Pan American Games, and the first female chief AT for the 1980 US Olympic Team. She was also the director of athletic training and physical therapy for the 1984 Olympic Games, and was selected again by the Committee as the Medical Director for the 1991 US Olympic Festival.

In 1980, Weldon left her position as the Head Women’s AT at UCLA to become the founder and owner of Women’s Training Room and Conditioning Center. Weldon was the first woman inducted into the NATA Hall of Fame in 1995, four years after her death. Today, the NATA holds a Gail Weldon Award of Excellence, which recognizes one AT each year who displays a "commitment to mentoring, professional development and life balancing for women athletic trainers or significant contributions to improve the health care of females provided by ATs." Weldon is known as one of the most influential pioneers in the athletic training profession and serves as a role model for all women, paving the road for women to become active members of the NATA and hold a strong position in the profession.

Majorie J. Albohm is also recognized as a pivotal female figure in the profession of athletic training. She was one of the first women to be certified along with Gail Weldon and Sherry Bagagian. In addition, she was the first female AT at Indiana University and was also an original member of the NATA Foundation Board and Foundation President. In 2007, Albohm was elected to be the president of the NATA, the second woman to hold this position after Julie Max.

Read more about the chronicle of women in the profession in The Role of Women in Athletic Training: A Review of the Literature.

Breaking the Glass Ceiling

In recent years, more women have been joining the athletic training profession than men. In 2005, 47.6 percent of NATA members were women, but in 2011 that number climbed to 50.9 percent. Student memberships illustrate the trend even more, with 60 percent of those held by women.

Even though women are now a majority in the industry -- a result of women coming into the business during the past decade -- they hold just a few of the most lucrative jobs. Although certain areas of the profession are based around the quality of care and not by gender of the provider, there are still some areas of athletic training that remain gender biased.

Sue Falsone

Sue Falsone was the first female Head AT for the Los Angeles Dodgers when hired in 2012. Falsone broke through the glass ceiling with working for a major professional team, a job that is conspicuous in Major League Baseball, a male-dominated sport where women who aren't reporters are rarely seen on the field and in the clubhouse. She remained the only woman in a head spot with a baseball team until she made the decision to step down last October to consult and pursue other projects.

Other women who have broken through the glass ceiling include Judy Seto, who works for the Lakers, and Ariko Iso, who was an Assistant AT for the Steelers and is now the Head AT at Oregon State University, her alma mater.

Alyssa Alpert, a 26-year-old AT, has been named the Head AT for the New York Cosmos, a legendary team in its second season in the North American Soccer League. Alpert's older sister Alana works for Clarkson as an AT for the hockey team. Read more about their story in "Female athletic trainers making strides," from ESPNw.

Much of the credit for the continued growth of women in the athletic training profession goes to the female ATs who have faced gender bias and discrimination and broken down many of the professional barriers.

Written By:
Brittney Ryba
BrittneyR@bocatc.org

 

Return To Play Post-Concussion: Who’s Calling The Shots?

Friday, March 21st, 2014

With the explosion of lawsuits shining a harsh light on a history of poor concussion management in professional sports, it’s no surprise that neurological and sporting associations are rushing to pour effort and resources into developing policies and procedures. These plans guiding sideline personnel on when to approve an athlete’s "return to play" are not only being developed at the professional level, but all the way down to the elementary school level as well.

All of these policies and plans boil down to one absolute point: the Athletic Trainer (AT) should be calling the shots on return to play. ATs are the most qualified members of a sideline team, with the training, expertise and, most importantly, hands on experience to spot the sometimes subtle symptoms of a concussion.

(1) Why are ATs like Paul Welliver being fired for refusing to return students to play after concussion? Trained medical professionals are being ignored, bullied and dismissed when trying to do the right thing for their athletes.

Who is really calling the shots?

Putting the Power Back in The ATs Hands

The American Academy of Neurology (AAN) feels that concussion management to be a team effort (2), but is that the right call? Being part of a team carries the danger of pressure to conform to group think, to support the best interest of the team over the best interest of the athlete.

The most obvious solution to the lack of consistent implementation of concussion management is to place complete and total authority on return to play decisions into the hands of the AT directly involved with the athlete.

Many ATs believe that they should be a distinctly separate unit, not a part of the coaching staff. The distinction must be made that they are, first and foremost, medical providers whose primary focus is the care of injured athletes. And until all ATs and administrators are able to differentiate between those two roles, they believe that their professionals "will never be supported the right way to make the unpopular decisions required for the safety of our athletes"(3).

While taking on the collective goliath of professional, collegiate and high school sporting associations to bring about change to concussion management should be the ultimate goal, ATs at every level can affect change much more simply.

How? With education.

ATs should be working to educate athletes on the long-term consequences of concussions. Parents should be enlightened on the dangers of relying on medical personnel lacking comprehensive and hands-on concussion management experience. Coaching staff need to learn that concussions aren’t just "bumps on the head" and that the signs can be difficult to read to the untrained eye. And associations need to learn that athletic trainers aren’t there to cost them money, or to be difficult.

Most of all, what everyone needs to learn is to trust and respect the training, skills and expertise of certified ATs. Their number one priority is the athlete.

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About the Author:

Amy-lynn Engelbrecht is the Online Content Specialist at HomeCEUConnection.com. HomeCEUConnection.com offers quality online continuing education courses for Athletic Trainers, Certified Strength and Conditioning Specialists, Massage Therapists, Physical Therapists, Physical Therapist Assistants, Occupational Therapists, Occupational Therapist Assistants, and Speech Language Pathologists.

1. "Athletic Trainer Removed from Post for Standing Ground on Concussions", Dustin Fink, The Concussion Blog, March 1st, 2013

2. "Summary of evidence-based guideline update: Evaluation and management of concussion in sports", Neurology June 11, 2013 vol. 80 no. 24 2250-2257 March 18, 2013.

3. "Coach Makes the Call", Brad Wolverton, The Chronicle of Higher Education, September 2, 2013.

 

Program Director Highlights: Christine Odell

Tuesday, March 18th, 2014

Program Director Highlights from the Spring 2014 PD Update Program Director – Christine Odell
Metropolitan State University of Denver

1) What is the name of your institution? 

Metropolitan State University of Denver

2) How long have you been a PD at this institution? Seven years

3) How many students are currently in your program(s)? There are 32 students in the clinical portion.

4) Do you teach any class(es)?  If so, which one(s)? I teach Upper Extremity Injury Evaluation, Foundations of Athletic Health Care, Anatomical Kinesiology, General Medical Topics in Athletic Training, Therapeutic Modalities in Athletic Training and Administrative and Research Topics in Athletic Training.

5) Do you use the BOC Self Assessment Exam(s) as tools to assist your students in preparing for the exam? How? Yes. I encourage my students to purchase at least one, and I use the small free example to show students how questions are formatted. We go through these as a group and discuss how the question is written. I try to focus their attention away from wanting to know their ‘score’ on these exams.

6) How do you prepare your students for the BOC exam?

I actually bring up the BOC web site and I do NOT log in. I then take them through all the information that is public. I start with the Candidate Handbook, move to the scheduling area and then the style guide. We discuss the style guide in depth. After this, all students are required to purchase the RD/PA6 because we use it to create assignments. I do not hold study/review sessions. I only hold reviews in content delivery. I feel when they reach this point, they have to learn how to organize their own studying. Therefore, my job is to focus on what they cannot control: knowing what they can and cannot take into the exam room, how the exam is formatted, etc. I take that unknown out of the equation so they can focus on studying the actual content.

7) What study materials do you recommend to your students? I recommend all the text books used in our curriculum and having access to the RD/PA6 and a good medical dictionary – either Tabor’s or Steadman’s. Otherwise I feel it is very overwhelming for students.

8) Please provide some tips for how you prepare your students for entering the real world (e.g. completing the BOC paperwork post-exam; state licensure/registration/certification; NPI numbers).

During the admin class this is actually one of our final discussions. I go over the BOC web site again and go through the "Certified" section and log in with my credentials and show them what I have to do.

9) Do you have any tips, suggestions or questions for other PDs? If you have not already, explore the BOC web page. It holds all essential information. If you do not understand something, call the BOC office. It is always surprising when you think you have very unique situation and they say, "It happens all the time. Here is what you need to do…"  They are extremely approachable and helpful.

If you are a PD who would like to be considered for inclusion in the Featured Program Highlights, please submit an email with your interest to StacyA@bocatc.org.

 

How important is nutrient timing?

Friday, March 14th, 2014

We have all heard how important it is to eat a meal after a workout, and that there is an ideal time frame post workout to replenish glycogen stores, but how important is that window?

According to this article from Precision Nutrition, nutrient timing is not that important.  That is not to say that eating after a workout is not important and that our athletes should not be doing it. It just means that they do not have to eat the minute they hit the locker room. They have time to go get a healthy meal and do not have to rely on bars, shakes or other portable items.

Following good nutrition principles throughout the day is more important than the meal consumed after a workout. We need to consistently educate our athletes on choosing healthy options that fit with their preferences, goals and tolerances. Establishing those habits is going to go further to help them achieve success than the shake or sandwich they eat after a lift or practice.

The majority of athletes are busy and do not think they have the time to plan out their meals in advance. Grabbing a shake is an easy option for them, but by thinking of quick, easy to make and eat meals, they can definitely make stronger strides in their recovery.

What strategies do you employ with helping your athletes make good food choices?

Written By:
Tim Koba, ATC, CSCS, PES, CES, CMT
tkoba@CAYUGAMED.org

Brain Injuries Do Not Discriminate

Wednesday, March 12th, 2014

Not only is March National Athletic Training Month, but the commemoration also coincides with Brain Injury Awareness Month. A brain injury can happen anytime, anywhere, to anyone – a brain injury does not discriminate. According to The Brain Injury Association of America (BIAA), 2.4 million Americans sustain a brain injury each year. About 75% of TBIs that occur each year are concussions or other forms of mild traumatic brain injury (MTBI), according to the BIAA Fact Sheet.

Among the things which increase the anxiety level of parents of children playing contact or collision sports, or any sport for that matter, is the fact that many high school programs don’t employ Certified Athletic Trainers (ATs) who have education in treating sports injuries, including heat illness, spine and neck injuries, sudden cardiac arrest, and in recognizing the often subtle signs or symptoms of a concussion.

It is often important to document the extent of an individual’s cognitive deficits when he or she has suffered an injury. This can be difficult to establish in children and adolescents since they are continuing to develop. Read more about pre-concussion screening of children and adolescents.

Brain Injury Awareness Day is March 12

Brain Injury Awareness Day is today. The Brain Injury Association of America (BIAA), along with champions on Capitol Hill, Congressional Brain Injury Task Force co-chairs Reps. Bill Pascrell, Jr. (D-N.J.) and Tom Rooney (R-Fla.), will help bring awareness on Brain Injury Awareness Day.

Youth Sports Safety Alliance

The Youth Sports Safety Alliance (YSSA) held its 5th Annual Youth Sports Safety Summit in Washington, D.C. earlier this week. During Monday’s conference, many spoke, including Brian Hainline, M.D. and Steven Broglio, PhD, ATC.  Dr. Hainline is the NCAA Chief Medical Officer and stated that ATs are crucial professionals in the care of student athletes.

Dr. Broglio is the Associate Professor and Director with the NeuroSport Research Laboratory. As a Certified Athletic Trainer, Broglio stated that 1.86-3.8 million sports/recreation concussions happen each year.

The YSSA has worked to raise awareness, advance legislation and improve medical care for young athletes across the country. High school athletes suffer 2 million injuries, 200,000 doctor visits and 30,000 hospitalizations every year. They have many resources on their website to answer questions and provide guidance on how to make sports safer, including information about concussions and brain injuries.

Written By:
Brittney Ryba
BrittneyR@bocatc.org

ETHICS IN ACTION: MIND YOUR OWN BUSINESS?

Tuesday, March 11th, 2014

A famous quote regarding ethics education states: “Although this may sound odd, the purpose of ethics is not to make people ethical, it is to help people make better decisions” (Brown, 1990, xi). Athletic Trainers (ATs) are typically not formally educated on ethical decision-making strategies, which limits our full potential to consider all of the issues associated with the complexities of our personal, professional and organizational values systems.  Our personal values guide our behaviors, our professional code of ethics guides our behaviors, and our organizational policies and procedures guide our behaviors.  Society also has legal and normative influences on our behaviors.  In situations when all of these elements come together in a perfect storm, it is difficult to manage our emotional responses to fully consider all of the factors influencing a case.

Consider the following case:

As an AT in an outpatient facility, you are providing therapeutic modalities to an adult patient who has strange bruises to her upper quarter.  These bruises appear to be in a pattern of hand marks (slaps) about the neck, torso and upper arm regions.  The patient openly denies any abuse and begs you not to report the injuries to the authorities.

1.    Is it our duty to report this observation in light of the denial of any abuse?

2.    What are the possible ramifications for you and the patient if you report this to the authorities?

3.    Who is responsible for reporting this potential abuse if it isn’t you?

4.    Who would protect the patient if you are wrong (or right) and she is returned back to home with the potential abuser?

5.    What factors – personal, professional and organizational - would keep you from reporting?

Kimberly S. Peer, EdD, ATC, FNATA
kpeer@kent.edu

Dr. Peer is an Associate Professor at Kent State University. She holds a Doctorate in Higher Education Administration with a Cognate in Health Care Management. Kimberly was recently appointed as the editor-in-chief for the Athletic Training Education Journal and serves on the Commission on Accreditation of Athletic Training Education Ethics Committee as well as the NATA Committee on Professional Ethics. Her national contributions include service to the BOC, NATA, JAT and REF in multiple capacities. Her statewide service includes the Governor’s appointment to the Ohio licensure board and over 12 years of service to the OATA.

Peer received the NATA Fellow Award and OATA Hall of Fame Award in 2012 and has been lauded with other national, regional and state level awards for her contributions to the profession and athletic training education. Dr. Peer has published and presented extensively on the international and national levels about ethics education and pedagogy and has co-authored with Dr. Gretchen Schlabach the first textbook on ethics in athletic training.

 

 

March is Eye Health and Safety Month

Friday, March 7th, 2014

"It’s all fun and games until someone loses an eye."

How many times have you heard that statement while growing up?  Although not considered a frequent injury in sport, it clearly has long ranging implications.  According to Harrison and Telander (2002), the leading cause of blindness in school-aged children in the United States is sports-related injury.  Of these reported injuries, 90 percent of these sports-related eye injuries could be prevented with protective eyewear.  These authors estimate approximately $175 million in annual costs for the approximate 100,000 visits to doctors.  Understanding the impact of eye injuries is critical to enforcing eye safety strategies in athletics. To get a better understanding, the following link provides "Fast Facts from the Coalition to Prevent Sports Eye Injuries." (http://www.sportseyeinjuries.com/fastfacts.aspx)

Consider the following case in light of the information provided in the fact sheet.

As a DIII collegiate Athletic Trainer (AT), you have an offensive lineman report for pre-season football camp with a history of previous eye injury resulting in the loss of the left eye.  The eye has been replaced with a prosthetic eye, and the right eye is fully functional.  In the pre-participation physical exam, the AT has advised the athlete that participating with the loss of a paired organ is contraindicated.  The AT refers the athlete to the physician for consideration for clearance, as the athlete is committed to playing football in hopes of securing a sport in the NFL.  The team physician refuses to clear the athlete due to the risk of injury to the remaining eye and consequences of that loss.  The family then secures an attorney and launches a lawsuit regarding denying the student the potential likelihood of earning a living in the future.  They are willing to assume the risks associated with the potential loss.

Clearly there are legal and ethical implications in this case.  What is the right thing to do?  Does the assumption of risk from the parents and attorney absolve the AT of responsibility for protecting the athlete?  Are there any other potential ethical issues that could result from this case?

Harrison, A., & Telander, D.G. (2002). Eye Injuries in the youth athlete: a case-based approach. Sports Medicine, 31(1), 33-40.

Written By: Kimberly Peer, EdD, ATC, FNATA
kpeer@kent.edu

Dr. Peer is an Associate Professor at Kent State University. She holds a Doctorate in Higher Education Administration with a Cognate in Health Care Management. Kimberly was recently appointed as the editor-in-chief for the Athletic Training Education Journal and serves on the Commission on Accreditation of Athletic Training Education Ethics Committee as well as the NATA Committee on Professional Ethics. Her national contributions include service to the BOC, NATA, JAT and REF in multiple capacities. Her statewide service includes the Governor’s appointment to the Ohio licensure board and over 12 years of service to the OATA.

Peer received the NATA Fellow Award and OATA Hall of Fame Award in 2012 and has been lauded with other national, regional and state level awards for her contributions to the profession and athletic training education. Dr. Peer has published and presented extensively on the international and national levels about ethics education and pedagogy and has co-authored with Dr. Gretchen Schlabach the first textbook on ethics in athletic training.