Archive for December, 2015

Is ice beneficial post injury?

Thursday, December 31st, 2015

By Tim Koba, ATC

I had a conversation with a coach earlier this year who was asking me about ice.  He had conversations with other coaches who had read the book, Iced by Gary Reinl, and he wanted my opinion.  Since I have not read the book, I felt that in order to give an informed opinion I should do some research.  I looked at an interview with Gary about his take on ice and then searched medical journals to see whether ice had been tested and what the outcomes were.  I was a little surprised at the lack of research specifically studying ice in its many prescribed applications.

In school, we are taught ice has an effect on the inflammation process. The inflammation process is a problem and should be decreased as soon as possible in order to speed recovery.  When tissue is damaged, the body sends microorganisms to the injury site to fight the inflammation and part of that process is tissue swelling.  Ice helps to decrease the blood flow to the area in order to slow this process down.  One of the main arguments against ice in the acute inflammatory process is that this inflammation is actually beneficial to the body.  Inflammation is the body’s way of breaking down tissue and laying the groundwork for recovery.  An interruption to this process can be potentially detrimental.

Acute sprains: Ice has been the mainstay of treatment, along with the remaining letters of the acronym, RICE (also known as rest, ice, compression and elevation), for years.  When I reviewed the effectiveness of RICE on outcomes, there are very few well controlled studies. The main conclusion is more needs to be done to study the effect of RICE on treatment outcomes and return–to-play decisions.

Pain control: Ice has an analgesic effect on injuries.  Applying ice to an acute injury can help to decrease the pain associated with the injury in the first couple of days.  Ice does appear to aid in recovery during the first 48 hours post-surgery.

Tendon injuries: Chronic tendon injuries are characterized by a breakdown and a change in the tendon itself, without the presence of inflammation.  Ice is used for pain associated with the condition but should not be used for inflammation.

Delayed onset muscle soreness (DOMS): Ice may have an effect on the pain associated with DOMS as a result of activity, but it does not shorten the time of discomfort.  The main treatment for DOMS is light exercise.

During the course of the research, I learned rest and immobilization can cause the collagen fibers that repair an injury to align themselves in a haphazard manner.  Moving the joint post injury can get these fibers into better alignment.  I want to stress this is for sprains and strains and not fractures or dislocations, which need different management.  It appears immobilization for a day followed by movement can also help improve healing in the hamstrings for injuries that are more significant than a mild strain.

In light of this research review, I will make some changes in how I recommend athletes manage an injury.

- I will recommend ice as a pain modifying treatment to be used for 10 minutes to decrease pain in the first 48 hours following an injury and to move the joint as they are able.

- I will still recommend compression and elevation for swelling in conjunction with movement.

- I will recommend that athletes lightly exercise if they are sore.

- For chronic conditions, I will recommend soft tissue work and eccentric exercise.

 

I am Thankful to be an Athletic Trainer – Part 3

Wednesday, December 30th, 2015

Editor’s Note: Being thankful and celebrating the good things in life are very much a part of this time of year.  As year-end approaches, it’s important to look back and review your achievements and be proud of your accomplishments.  In this series, our BOC guest writers take a look back to at their career as Athletic Trainers and share their stories on what makes them feel thankful to be in this profession. 

 

Amazing Experiences as an Athletic Trainer

By Brian Bradley, MS, LAT, ATC, CSCS

I am thankful to be an AT because of all of the amazing experiences I have had throughout the years.  I have worked at a professional baseball game in Fenway Park, covered NCAA National Championships and worked at other events while watching Olympic athletes compete.  I have been able to share in a team’s state championship success and console an athlete after a devastating defeat.  I have helped patch an athlete up, so they can play one last time on Senior Night.  I have also helped to rehab a grandmother so she can play with her grandson.  I have had a lot of amazing experiences thanks to the athletic training profession.

 

A Moment of Gratitude

Claudia Curtis, MS, LAT, ATC

Claudia.curtis@phci.org

As a ATs, we take pride in seeing our athletes return from significant time loss injuries to compete and have success, even win state or national championships.  We rejoice with them in their successes, and we share in their sorrow when success isn’t achieved.  We’re used to delivering the news that their season may be over, but what do we do when we fear their career might be over?

In the fall of 2013, I found myself in unfamiliar territory.  The starting quarterback on the team had suffered a concussion ending his previous football season.  This one presented with neurological symptoms that particularly concerned me, leading me to push him toward a specialist.  After further referrals, he was cleared, and his role on the field changed to protect him.  However, the first day of contact in the season, the neurological symptoms came back on a routine tackle.  As quickly as they presented, they resolved, but they sent my mind reeling.  What if the next hit leaves him paralyzed? What if one seemingly routine football play changes his life forever?

So he and I sat down in the athletic training facility and talked one on one.  He had aspirations of being a police officer but thought his only way of getting into college was through football.  We discussed all of the risks and consequences football could have not only on his future goals, but also in his everyday life, his relationships and his independence.  I thought he understood the potential danger that playing football with his diagnosis, cervical spinal stenosis, could have on his life.  I felt I may have eased his mind about ways to achieve his professional goals without football.  However, I didn’t feel that I was really able to empathize with what he was going through in the best way possible, only sympathize.  So I took a giant leap of faith.

This situation came up at the same time ESPN ran the special “The Book of Manning.” Those familiar will remember that Cooper Manning, the one Manning to not play professional football. Manning had the same diagnosis as my patient and has been highly successful in his post-football professional career.  So, I did some internet digging and sent him an email, looking for guidance on how to support my athlete.  I sent the email on a Friday evening: a desperate plea for any advice.  I knew it was a long shot and didn’t anticipate any response.  However, Monday morning when I got to work, I already had a voicemail on the phone in the athletic training facility.  It was Cooper Manning, calling to discuss the situation.  After a short phone call with Cooper, he asked me if I thought the athlete might like to talk to him on the phone, which I knew he would. The call was then scheduled for that evening.

The next day, the athlete came into the athletic training room and immediately gave me a huge hug, saying the words “Thank you so much. That’s the nicest thing anyone has ever done for me.”

That moment, one of gratitude in what may have felt like the worst of situations at the time, was the moment for me when I forgot all of the negatives about my job and remember exactly why I got into athletic training in the first place … and why I continue to have the passion for it every day.

Transition to Practice - Challenges – Role Ambiguity

Tuesday, December 29th, 2015

Stacy Walker, PhD, ATC

Ashley Thrasher, EdD, LAT, ATC, CSCS

“How do I structure my hours?  I didn’t know quite the water situation; who does the water?  I didn’t know how to order supplies, like where they get them from, putting together a supply list. How long I need to give them before I run out of tape?  Do I have to give you 3 months in advance?  A week in advance?  That kind of thing.  So it’s a lot of whatever I ran into.  And of course, like when someone gets hurt, doctor-wise what do I do?”

These thoughts and challenges are common amongst newly certified Athletic Trainers. Despite their academic preparation and orientation, there commonly remains a great deal of ambiguity in their new role.  For the next installment of this series, we are exploring the next challenge newly certified Athletic Trainers experience as they make the transition from a student to a certified, independent clinician.

This role ambiguity stems from their uncertainty in their role as an Athletic Trainer due to a lack of clear responsibilities or expectations from employers and/or mentors.  This ambiguity is not necessarily related to the patient care aspect of their role, but often involves confusion related to administrative procedures when making the transition.

This uncertainty regarding many aspects of their role causes stress among new clinicians.  Examples of these uncertainties and stressors include:

- Lack of formal and informal orientation into role

- Not knowing how to document injuries at their specific institution (e.g., Are the records paper or electronic? Are there standardized forms?)

- Not knowing the specific protocol on referring athletes and to whom to refer athletes

- Not knowing the ordering and/or budgeting process at their setting and when to order medical supplie

- Having limited or no access (i.e., locked in principal’s or nurse’s office) to patient health records (e.g., pre-participation physical exam, health history

- Not understanding procedures or lack of protocols (e.g., concussion, emergency action plan)

- Not knowing if they are allowed to use their cell phones in the clinical setting

- Not having a supervisor or mentor

- Not having clear expectations from their supervisor

“It’s been weird because I’m used to what is expected of you at the college level.  Now with the current situation, at the high school and at the clinic, they really have no idea what to expect of me.  Which is a little weird because I’m used to meeting expectations and surpassing them, but when you don’t really have set expectations that you’re knowledgeable of, it makes it a lot harder to do that.”

This quote speaks to the uncertainty experienced by a new clinician when they are unsure of what others expect of them.

Role ambiguity frequently causes stress.  This unnecessary stress can lead to many negative outcomes, such as burnout, decreased quality of patient care, decreased patient satisfaction, feelings of inadequacy and depression (Chang, 2003; Acker 2004).  Job stress can lead to decreased job satisfaction and increased intent to leave.  One newly certified Athletic Trainer shared that she had considered leaving the profession because of stress involved with the transition.

“The first few weeks of my job were very stressful, trying to adapt to all my new responsibilities.  I wasn't sure if I was cut out for the profession.”

These negative outcomes caused by role ambiguity not only hurt individual Athletic Trainers, but are also detrimental the patients, employers and athletic training as a profession.

Role ambiguity can harm patients because new Athletic Trainers are often so overwhelmed with procedural questions that they focus their energy on adjusting to their roles.  As new Athletic Trainers transitioned, many questions they had were related to role expectations, policies and procedures and administrative items.  When the same Athletic Trainers were interviewed 6 months later, most of their questions were related to patient care.  Once they understood their role, they were able to focus more on their patients.

There are many reasons why young Athletic Trainers decide to leave the profession, including burnout, role strain and role overload (Kahanov, 2013).  For new nurses, role ambiguity is one of the major sources of job stress (Lu, 2005; Chang, 2003), which leads to an increased intent to leave.  Attrition can be costly to employers and reflects poorly on the profession of athletic training.
New Athletic Trainers need support to help manage role ambiguity.  There have been many transition to practice programs that have been implemented in nursing to help with the transition and decrease role ambiguity.  Some features of these programs include orientations, a designated resource person and peer support (Rush et al; Whitehead).  We will be further discussing some ways to provide support and help with role ambiguity later in this series.

References

  1. 1.       Chang E, Hancock K. Role stress and ambiguity in new nursing graduates in Australia. Nurs Health Sci. 2003;5(2):155-163.
  2. 2.       Acker GM. The effect of organizational conditions (role conflict, role ambiguity, opportunities for professional development, and social support) on job satisfaction and intention to leave among social workers in mental health care. Comm Mental Health J. 2004;40(1):65-73.
  3. 3.       Lu H, While AE, Barriball KL. Job satisfaction among nurses: A literature review. Int J Nurs Stud. 42(2):211-227.
  4. 4.       Kahanov L, Eberman LE, Juzesyn L. Factors that contribute to failed retention in former athletic trainers. Internet J of Allied Health Sci Practice. 2013;11(4):1-7.
  5. 5.       Rush KL, Adamack M, Gordon J, Lilly M, Janke R. Best practices of formal new graduate nurse transition programs: An integrative review. Int J Nurs Stud. 2013;50(3):345-356.
  6. 6.       Whitehead B, Owen P, Holmes D, Beddingham E, Simmons M, Henshaw L, Barton M, Walker C. Supporting newly qualified nurses in the UK: A systematic literature review. Nurs Educ Today. 2013;33(4):370-377

Stretching: Is it a safe bet for your athletes?

Tuesday, December 22nd, 2015

By Amy-Lynn Corey

While it’s generally accepted that improving the flexibility of muscles and tendons results in better performances and lowers the chances of injuries, contradictory findings have been reported in much literature that this can be best accomplished using stretching exercises.  Some authors claim that stretching is beneficial for injury prevention, while some clinical evidence suggests that stretching before exercise doesn’t help at all.

Read full article here: https://www.athletictraining.com/stretching-is-it-a-safe-bet-for-your-athletes/

Amy-Lynn Corey is the Online Content Specialist at AthleticTraining.com and HomeCEUConnection.com. AthleticTraining.com is a membership-based service that offers BOC approved online continuing education courses for Athletic Trainers, Physical Therapists and Physical Therapist Assistants.

 

 

 

 

I am Thankful to be an Athletic Trainer – Part 2

Monday, December 21st, 2015

Editor’s Note: Being thankful and celebrating the good things in life are very much a part of this time of year.  As year-end approaches, it’s important to look back and review your achievements and be proud of your accomplishments.  In this series, our BOC guest writers take a look back to at their career as Athletic Trainers and share their stories on what makes them feel thankful to be in this profession. 

NCAA Ice Hockey Tournament in Belfast, Northern Ireland

By Mike McKenney, MS, ATC, NASM-CES

If I could go back in time and ask my newly certified self where I would be the week of Thanksgiving in 2015, the least likely scenario would have my traveling to Belfast, Northern Ireland for The Friendship Four.  The Friendship Four is the first NCAA ice hockey tournament to occur outside of North America. Yet here I am, standing on the bench in SSE Arena, hearing thousands of people cheer us on for the first time as the puck drops to start our first game.

If you were to ask the average sports enthusiast what sporting events would be popular in Northern Ireland, ice hockey would probably not top their list.  However, it's quite the opposite.  Our hosts for this tournament were the Belfast Giants, a professional ice hockey organization founded in 2000 to compete with 10 other teams in the United Kingdom at the professional level, who are supported strongly by their local fan base.

The tournament itself represents a larger effort to bring different communities together.  Belfast has long suffered from political division with a history of civil unrest and violence that often divided sporting contests.  But not ice hockey, as was evident with the Giants organization.  From the moment we stepped foot inside the arena, we were welcomed with open arms by tournament personnel.  This also extended to the fans I was able to meet, who were some of the most enthusiastic supporters of the game I have ever seen.  They were cheering for us like we had been playing alongside the Giants for the past 15 years.  In a moment of utter surprise, I was asked to sign a jersey even though I was clearly not a player, which I can honestly say has never happened before.

We were also welcomed by the local community when the team had the opportunity to visit local primary and secondary schools to answer questions about ice hockey and share their experiences as Division I student athletes.  Since the tournament was over Thanksgiving, a local family with ties to Northeastern even went out of their way to host our entire team for a traditional Thanksgiving dinner, which was extremely gracious since so many of us were away from our families for the holiday.  In addition, our trip included opportunities to visit local historical sites such as the Titanic museum and areas that were significant to the time period known as "The Troubles." These experiences helped put into context why events like the Friendship Four are so important to the Belfast community.

Outside of experiencing all the great things Belfast had to offer, our hockey games were business as usual.  They did not differ much from our normal life on the road for any other away game, with the exception of being much farther away from Boston than normal.  It was extremely rewarding to be a part of a tournament intended to foster community-building and to create more exposure for the game of ice hockey.  This is an experience I am thankful for and will forever remember, and I would not have been a part of it had I not been an Athletic Trainer.

 

Finish 2015 on a High Note and Prepare for 2016

Friday, December 18th, 2015

By Cherie Trimberger

Communications Coordinator

The end of the year is only a few weeks away.  While your mind may be filled with family, holidays and travel, there are some important things for you to remember in order to start your new year on a high note.  Maintaining your certification and planning for your professional development are important steps to starting your year off right.  Below is a list of the top 5 items that should be on your radar as 2015 ends and 2016 begins.

1. The current reporting period ends December 31, 2015 at 11:59pm CT.

Athletic Trainers (ATs) are required to complete the following to maintain their certification.  Log in to BOC Central™ at www.bocatc.org/BOCCentral to check your requirements.

Standards of Professional Practice - ATs are required to comply with the BOC Standards of Professional Practice, which consists of Practice Standards and the Code of Professional Responsibility.

Emergency Cardiac Care - ATs must maintain ongoing Emergency Cardiac Care (ECC) certification at the Basic Life Support/Professional Rescuer level or beyond.

Certification Maintenance Fee - ATs are required to pay an annual certification maintenance fee.

2. Start the new reporting period off right by taking the BOC self-assessment exam.

During the 2014-2015 reporting period, did you feel unsure of what continuing education (CE) programs would be the right fit for you?  The BOC self-assessment exams can help by determining your strengths and weaknesses.

Knowing your strengths and weaknesses will help you plan for the 2016-2017 reporting period so you can select the best CE options for you.   To take a BOC self-assessment exam now, follow this link https://sae.bocatc.org/.

3. Safety is the key for a great new year.  Is your athletic training facility safe?

An easy-to-use online resource can help you gauge your athletic training facility’s compliance with applicable regulations and best practices.  Available at www.bocatc.org/facility, the BOC Facility Principles online tool lets you assess accessibility, privacy and confidentiality, employee safety, safe handling of hazardous materials, emergency preparedness and more. The information is also compiled in the BOC Facility Principles document, downloadable in PDF format from www.bocatc.org/facility.

4. Start planning for National Athletic Training Month in March.

National Athletic Training Month is coming up in March and 2016’s theme is “A safer approach to work, life and sport.”  Now is a great time to think about how you can promote the athletic training profession and your work as an AT.

Start by promoting certification and National Athletic Training Month on your social media including Facebook, Twitter, LinkedIn or any other you might prefer.  Another simple way to get the word out about athletic training is to request our promotional images, which represent a variety of sports and activities.  Requests can be made at www.bocatc.org/awareness.

5. Don’t miss out on the 67th National Athletic Trainers’ Association Clinical Symposia & AT Expo. Come check out the BOC exhibit at the 67th National Athletic Trainers’ Association Clinical Symposia & AT Expo.  The meeting will be held in Baltimore, Maryland, on June 23-25, 2016.  Learn more and resister at http://convention.nata.org/.

I am Thankful to be an Athletic Trainer – Part 1

Thursday, December 17th, 2015

Editor’s Note: Being thankful and celebrating the good things in life are very much a part of this time of year.  As year-end approaches, it’s important to look back and review your achievements and be proud of your accomplishments.  In this series, our BOC guest writers take a look back at their career as Athletic Trainers and share their stories on what makes them feel thankful to be in this profession. 

 

Being Thankful for Being Prepared

By Beth Wolfe, CAGS, ATC

The motto of the Boy Scouts of America is “Prepared. For Life” and I strongly believe Athletic Trainers (ATs) embody this principle both as healthcare professionals and good Samaritans (Boy Scouts of America, 2015).  Ever since I became CPR certified in high school, I have always carried a pocket mask, gloves and whistle on my lanyard or car keys as  you never know when an emergency might occur.  Since 2010, I have had to use my emergency equipment as a first responder 5 times in 5 years and none of those emergencies occurred while providing athletic training services.

Whether walking to class, standing on a street corner or riding the subway, emergencies happen when we least expect it and literally may fall at your feet.  My knowledge, skills and training in emergency care as an AT equipped me to help those in need when seconds matter.  Although I am not a Boy Scout, I feel every AT has a special merit badge in knowing that we have been trained, equipped and prepared to act when life may take an unexpected turn for the worst.  Being a part of a profession that campaigned “We Prepare - You Perform” for National Athletic Training Month (2015) is a symbol/merit badge I am proud to wear.  Life is precious and fragile, and I am thankful that athletic training has prepared me and given me a skillset that can help save a life.

Reference:

Boy Scouts of America. (2015). About the BSA: BSA at a Glance. Retrieved from: http://www.scoutingnewsroom.org/about-the-bsa/at-a-glance/.

 

Trust and Appreciation from Athletes and Their Parents

By Devon Serrano, MS, LAT, ATC

My first solo season has been one of firsts: my first solo game coverage, my first work-related flights, my first season of crazy injuries, the first time I questioned my sanity and the first time a parent gave me my confidence back.

I fell in love with athletic training at the age of 16 and did everything possible to pursue it.  After what seemed to be a lifetime of studying and clinical hours, the moment I received my master’s degree in clinical athletic training seemed like the most important moment of my career.  I took my first contract position filled with hope and ambition; I only had a small idea of what I was getting myself into.

My first season has opened my eyes in ways I didn’t know possible.  I saw injuries I only read about in textbooks, and I worked harder than I ever knew possible.  Somehow I managed to care for a Division I team while working on my doctorate.

Needless to say, there were times I questioned everything. “Am I good enough to be here?” “Am I doing enough for my athletes?” “What is going on?” “What am I thinking?” The list goes on and on.

After the last game of the season and our ceremony to honor the seniors, I was talking to the mother of one of the senior captains.  I thanked her for trusting me to take care of her daughter and the rest of the team this season.  The athlete’s mother looked at me with the most genuine look in her eyes as she grabbed my forearm and smiled.  She then said she felt confident her daughter was receiving the care she needed. Every time she spoke to her daughter, she would say that she and I were working together on the right direction for her care.

“I trust you,” she said as she watched me choke up. “When a mama knows she can trust you, you know you’ve found your calling.”

That one statement means more to me than any win possibly could. It reminded me of why I entered this profession in the first place almost 10 years ago and makes me thankful to be an Athletic Trainer.

Got flu prevention? Vaccination is the best available defense.

Wednesday, December 16th, 2015

By Kelly Berardini, MHA, ATC

klberardini@gmail.com

’Tis the season not only for holiday cheer, but also for the flu.  Nothing puts a damper on winter spirits like a fever, body aches and sore throat, which are frequent features of seasonal influenza infection, also known as the flu.  Don’t let this all-too-common virus ruin the good times for you, your family, your colleagues or your patients.  National Influenza Vaccination Week (NIVW) was December 6 through 12.  It’s a great time to remind everyone about the best available defense against the flu, which sickens 5-20% of Americans, hospitalizes more than 200,000, and kills between 3,000 and 49,000 annually, according to the Centers for Disease Control and Prevention (CDC).

Why promote flu shots when many people who choose to get vaccinated did so closer to Halloween than Christmas?  Tracking conducted by CDC reveals that influenza vaccine activity drops sharply by the end of November.  Along with other leaders in the healthcare arena, CDC wants to remind everyone that, although the holidays are here, it’s still not too late to get vaccinated.

Who Should Get Vaccinated?

With rare exceptions (e.g., severe allergy to one or more vaccine ingredients), everyone ages 6 months and older should be vaccinated every flu season.  Pregnant and breastfeeding women and most patients with chronic illnesses can be safely vaccinated.  It’s especially important for those at high risk of flu-related complications, as well as people with various medical conditions, including asthma, heart disease and endocrine or blood disorders (e.g., diabetes, sickle cell disease).

Types of Vaccines

There are many flu vaccine options available, including standard or high dose, trivalent or quadrivalent, live attenuated or inactive and preservative free (no thimerosal). Different vaccines and routes of administration (i.e., nasal vs. injection) are approved for use in different groups of people.  Factors to determine which is best suited for a particular individual include age, health status and medical conditions and any relevant allergies.

Efficacy and Safety

The extent to which the vaccine prevents flu-related illness varies each season, as well as among different populations and across geographical regions.  Furthermore, the probability of an individual’s post-vaccination protection is impacted by 2 primary factors: 1) his/her characteristics (e.g., age, health status) and 2) the vaccine’s match between its pre-designed target viruses and the viruses spreading within the person’s community.  A March 2015 study showed seasonal influenza vaccination prevented more than 40,000 flu-related deaths in the U.S. between 2005 and 2014.1

Hundreds of millions of Americans have been safely vaccinated against influenza during the past 50 plus years.  Risk of significant side effects is extremely low, and flu vaccine safety is supported by extensive surveillance and research.

What can Athletic Trainers do to help prevent the flu?

▪ Educate yourself regarding influenza, which affects millions worldwide and can result in serious outcomes for some.  It’s not just an uncomfortable inconvenience.

▪ Promote flu vaccination in your work setting.  The prevalent misinformation on vaccines can cause unwarranted fear and avoidance.

▪ Enact communicable illness prevention and management policies and procedures. Get started with CDC’s recommendations for infection control in healthcare facilities.  Make it known that sick staff, patients and athletes should stay home.

▪ Protect yourself by getting a flu shot, as well as by employing other proven prevention techniques, such as proper hand-washing.

Bottom line: Flu vaccination is the best available protection against this potentially serious illness.

Resource

1. Foppa et al. Deaths averted by influenza vaccination in the U.S. during the seasons 2005/06 through 2013/14. Vaccine, Volume 33, Issue 26, Pages 3003-3009.

Thompson et al. Estimating influenza-associated deaths in the United States. Am J Public Health, 99 (Suppl. 2) (2009), pp. S225–S230.

Molinari et al. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine. 2007 Jun 28;25(27):5086-96.

 

 

BOC Athletic Trainers Offer Their Advice on Completing CE Requirements

Wednesday, December 9th, 2015

Completing continuing education (CE) requirements can be a challenge even for the Athletic Trainers who currently work at the Board of Certification (BOC).  Take a look at their process for selecting CE programs, their challenges and advice to other ATs currently working on their CE requirements for the reporting period ending December 31, 2015.

1. What do you normally look for in your CE programs? 

Nathan Burns, MS, ATC - Credentialing Program Coordinator

As I put together my plan to complete my CE requirements, I first look at new technologies and NATA position statements I may need to learn about to be a more efficient AT.  After that, I search out CE opportunities that will allow me to grow as an AT.

Chad Kinart, MS, ATC - Exam Development Manager

I look for the highest quality programs from an evidence and expertise perspective that I can afford within the given reporting period.  I also look at the current state of the profession and determine if there are any new changes I need to have an increased awareness of, including new position and consensus statements.

Shannon Leftwich, MA, ATC - Director of Credentialing and Regulatory Affairs

I look for on-demand programs that work within my time to complete them.  I also look for topics that I find interesting or are necessary to maintain my certification.

Jessica Roberts, MS Ed, ATC - Professional Development Coordinator

In no particular order, the 3 most important components of choosing CE for me are 1) topics of content offered and level of difficulty, 2) reputation of the BOC Approved Provider and 3) quality of CE programming.

Kelli Wilkins, MA, ATC - Compliance Specialist

I normally look for courses that can provide me with a new tool, technique, protocol or a topic I know little about.  These types of programs generally keep me intrigued, and I am learning something new the entire time.

 

2. What was your biggest challenge completing CE requirements?  How did you overcome this challenge?

Nathan Burns, MS, ATC - Credentialing Program Coordinator

The biggest challenge was finding CE opportunities that align with my current job responsibilities at the BOC.  I made the decision to seek out CE opportunities to allow me to grow as an AT in the event I begin to work as an AT in a PRN  or as needed environment.

Chad Kinart, MS, ATC - Exam Development Manager

 Recently, my biggest challenge in completing CE requirements has been time.  In addition to family life and work, I have been completing my MBA.  In order to balance everything, I had a plan developed that would allow me to get the requirements in a timely manner without undue stress.

Shannon Leftwich, MA, ATC - Director of Credentialing and Regulatory Affairs

My biggest challenge is finding the time to sit down and complete them.  I usually have to block out time on my calendar and make myself do it.

Jessica Roberts, MS Ed, ATC - Professional Development Coordinator

I struggle to find programs that align with my daily duties as an AT.  As I spend my days working for the BOC and protecting the public, I prefer to learn about regulatory issues and other organization and administrative types of content.  Options for programs that fall under domain 5 are limited.  I overcome this challenge by attending the Regulatory Conference, leadership workshops and giving presentations on areas of interest that fall within domain 5.  I find this content interesting to learn about and even more fun to present to others.

Outside of the BOC, I practice as an AT in a PRN capacity.  My practice mostly revolves around evaluation and immediate care of acute injuries.  I have been fortunate to identify reputable BOC Approved Providers who offer CE programming in these domains at an advanced level to help me increase my knowledge, skills and abilities and to ensure I am providing the best care possible to patients with acute needs.

Kelli Wilkins, MA, ATC - Compliance Specialist

My biggest challenge is finding a program that fits conveniently into my schedule.  I have had good luck with online or home study courses that allow me to dictate the schedule.

 

3. What advice would you give to other ATs currently working on their CE requirements? 

Nathan Burns, MS, ATC - Credentialing Program Coordinator

It is important to decide what your ultimate goal of your CE plan is.  Are you trying to learn a new skill, perfect an old skill or stay current with the changing environments?

 Chad Kinart, MS, ATC - Exam Development Manager

 Develop a game plan at the end of one reporting period in order to begin executing on Day 1 of the new reporting period.

Shannon Leftwich, MA, ATC - Director of Credentialing and Regulatory Affairs

There are a lot of options out there to explore in order to find the right fit for you.  There are subscription based providers, live events, on-demand or home study programs, journals and so much more!  If you aren’t aware of all the options, don’t hesitate to contact the BOC staff.  We’re here to help you.

Jessica Roberts, MS Ed, ATC - Professional Development Coordinator

Free does not always equal quality programs.  While cost is a concern for many, I feel the content and quality of the program to be highly important.  To me, it doesn’t matter if a program is free if I didn’t learn a substantial amount of information or new skills to better myself or my patients.

Easy does not equal maintenance of minimum competence.  Choose programs that stretch your knowledge, skills and abilities as a healthcare provider.  Build your knowledge bank and your resume; don’t just go through the motions.  Attendance at a conference does not always equal competent practitioners.  You’ll get out of it what you put into it, so make it worth your time and give it your all.

Participate in a variety of activities.  Try programs that offer content in areas where you may be weak in order to maintain minimum competence.  Extend yourself by presenting on a topic where you may be a subject matter expert and share your passion with others. Consider a specialized CE program to learn in-depth information about one topic.

Don’t be afraid to explore new activities and providers, learn about new content and stretch yourself as a student of the profession. If you’re not growing, you’re dying.

Kelli Wilkins, MA, ATC - Compliance Specialist

Don’t look for CE programs just based on price.  Look for a program that you know you will benefit from.  Attend a program because you want to and not because you have to.

 

An Athletic Trainer’s Role: College and School Mass Shootings

Monday, December 7th, 2015

By Desi Rotenberg, MS, LAT, ATC

The topic of mass shootings has recently become a hot button issue due to the increasing number of incidents occurring in the last few years.  While shooters who commit these atrocities must be held responsible, we must take a deeper look at the root cause of why an individual would feel the need to cause such chaos and destruction.  Before I can delve into the basic psychology of an active shooter, I want to expose a truth: Athletic Trainers are not immune to this threat.  Between 2000 and 2013, 160 active shooter incidents occurred in the United States; of those 160 incidents, 39 took place in an educational environment.1

While Athletic Trainers on high school and collegiate campuses may only be exposed to the athletic population, we must not turn a blind eye to the reality that active shooter incidents can occur anytime and any place.  It is paramount as university or high school staff, we take the necessary precautions and training to ensure the safety of our staff, our athletes and ourselves.

Having an emergency action plan in place to ensure the safety and protection of you and your staff can be the difference between life and death.  Being from Colorado, I will never forget April 20, 1999 (Columbine High School), or July 20, 2012 (Aurora Movie Theater), 2 dates when the threat of what human beings are capable of became very real.

In my classroom, I have spoken with my students about the possibilities and potential dangers of what can occur in a crisis situation.  However, rather than focusing on the threat, I focus my efforts on creating a plan.  This plan involves the cultivation of an awareness that, when things begin to go wrong, we must know how and when to act. This principle is very similar to how an Athletic Trainer must respond in the event of a sudden illness or injury.

The first step is ensuring there is a plan in place that can be practiced regularly by all staff on-site.  Collaboration with other departments, teachers and staff will allow for better communication and flow in the event of an emergency.  Most educational institutions will have plans in place. They will make sure you and your staff are familiar with the action steps that are essential to ensuring your safety.  The second step will be to establish a rendezvous point.  In the event your staff becomes separated in an emergency situation, it is critical to look out for one another.

Furthermore, we must attempt to understand the root cause of why individuals feel the need to cause such destruction. As Athletic Trainers, we understand the best protection from injury is preventative medicine; so too, I believe we have a responsibility to do our part in preventing mass shootings from occurring.  Am I suggesting that we can single handedly stop a mass shooting from occurring?  Maybe.

If this topic interests you, please check out the article published by Esquire Magazine in 2014.

http://www.esquire.com/news-politics/a30024/mass-shooters-1014/

So the big question: How do we prevent these mass shootings from occurring at the source?  We may not stop a shooter from entering a school with the intent of carrying out mass murder, but we can do our part in treating everyone we meet in our lives, whether they be friend or stranger, with a nurturing resolve.  Most mass shooters simply want to be noticed, and feel the only way to be recognized is to carry out a temporary, devastating act.  The reality lies within us. Our efforts should be focused on long-term positive interactions with the world around us.  If we commit ourselves to treating every human being with honor, respect, empathy, positivity and love, we may be able to help a lost, troubled individual feel valued.

As Athletic Trainers, we may have a wide range of staff under our supervision.  As leaders, it is our responsibility to ensure our facilities are safe and our staff are well prepared in the event of an active assailant.  While the data shows a small occurrence rate, we should always be aware these incidents usually have a similar cause and can occur any time and any place.

“People will not remember what you did or what you said… but they will always remember how you made them feel”

- Maya Angelou

Resources

1. U.S. Department of Justice. Federal Bureau of Investigation (2013). A Study of Active Shooter Incidents in the United States Between 2000 and 2013. Retrieved from https://www.fbi.gov/news/stories/2014/september/fbi-releases-study-on-active-shooter-incidents/pdfs/a-study-of-active-shooter-incidents-in-the-u.s.-between-2000-and-2013.

2. Esquire Magazinehttp://www.esquire.com/news-politics/a30024/mass-shooters-1014