Organizational Expectations Regarding Documentation Practices in Athletic Training.

CONTEXT: Although guidance is available, no nationally recognized standard exists for medical documentation in athletic training, leaving individual organizations responsible for setting expectations and enforcing policies. Previous research has examined clinician documentation behaviors; however, the supervisor's role in creating policy and procedures, communicating expectations, and ensuring accountability has not been investigated. OBJECTIVE: To investigate supervisor practices regarding support, hindrance, and enforcement of medical documentation standards at an individual organization level. DESIGN: Mixed-methods study. SETTING: Online surveys and follow-up interviews. PATIENTS OR OTHER PARTICIPANTS: We criterion sampled supervising athletic trainers (n = 1107) in National Collegiate Athletic Association member schools. The survey collected responses from 64 participants (age = 43 ± 11 years; years of experience as a supervisor = 12 ± 10; access rate = 9.6%; completion rate = 66.7%), and 12 (age = 35 ± 6 years; years of experience as a supervisor = 8 ± 5) participated in a follow-up interview. DATA COLLECTION AND ANALYSIS: We used measures of central tendency to summarize survey data and the consensual qualitative research approach with a 3-person data analysis team and multiphase process to create a consensus codebook. We established trustworthiness using multiple-analyst triangulation, member checking, and internal and external auditing. RESULTS: Fewer than half of supervisors reported having formal written organization-level documentation policies (n = 45/93, 48%) and procedures (n = 32/93, 34%) and an expected timeline for completing documentation (n = 24/84, 29%). Participants described a framework relative to orienting new and existing employees, communicating policies and procedures, strategies for holding employees accountable, and identifying purpose. Limitations included lack of time, prioritization of other roles and responsibilities, and assumptions of prior training and record quality. CONCLUSION: Despite a lack of clear policies, procedures, expectations, prioritization, and accountability strategies, supervisors still felt confident in their employees' abilities to create complete and accurate records. This highlights a gap between supervisor and employee perceptions, as practicing athletic trainers have reported uncertainty regarding documentation practices in previous studies. Although supervisors perceive high confidence in their employees, clear organization standards, employer prioritization, and mechanisms for accountability surrounding documentation will result in improved patient care delivery, system outcomes, and legal compliance.

The effects of interpersonal development programmes with sport coaches and parents on youth athlete outcomes: A systematic review and meta-analysis.

Interpersonal coach-and parent development programmes (CDP and PDP, respectively), have the goal to foster positive youth sport experiences through high-quality relations between coaches, parents, and youth athletes. In this paper we systematically reviewed the extant literature and estimate the overall magnitude of such programmes and how they can inform future interventions. Specifically, we aimed to: (a) conduct a systematic review on the literature of interpersonal CDPs and PDPs within the youth sport context; (b) examine the effects of such interventions on youth athlete outcomes via a meta-analysis. English written peer-reviewed publications and grey literature was identified through electronic search in databases and manual searches of reference lists. By utilising a priori criteria for inclusion and exclusion, 33 studies describing interpersonal CDPs, and PDPs were identified in the systematic review. Studies that presented required data for estimation of Hedge's g effect sizes were included in the meta-analysis (k = 27). By and large, the included studies used a quasi-experimental design (58%), sampled from team sports (79%), and reported several delivery methods (e.g., workshops, audio feedback, observations, peer group discussions) and outcome measures (e.g., anxiety, autonomous motivation, self-confidence). Some interventions were based on the same delivery protocols (e.g., Coach Effectiveness Training, Mastery Approach to Coaching) or theoretical frameworks (e.g., Achievement Goal Theory, Self-Determination Theory). The meta-analysis showed statistically significant small, and medium, effect sizes on a subsample of youth athlete outcomes (e.g., task-related climate, fun and enjoyment, anxiety), indicating that coach interpersonal skills can contribute to positive youth sport experiences. Theory-based interpersonal CDPs and PDPs are recommended to expand the knowledge in this field of research.

Enseñanza de deportes de colaboración y oposición: análisis comparativo entre metodologías comprensivas y modelo tradicional / Collaborative and opposition sports teaching: comparative analysis between comprehensive methodologies and the traditional model / Ensino colaborativo e de oposição do esporte: análise comparativa entre metodologias integrais e o modelo tradicional

El propósito del estudio fue determinar el efecto que produce la aplicación de una unidad de enseñanza de los deportes de colaboración y oposición diseñada en base a dos propuestas del modelo pedagógico comprensivo: el Teaching Games for Understanding y la Didáctica Cognitiva, en comparación a un modelo tradicional de enseñanza. La muestra estuvo conformada por alumnos(as) de 5° a 8° básicos (12 a 14 años). Mediante metodología observacional, fueron evaluadas las principales acciones de juego eficientes en las dimensiones de ataque y defensa, en momentos de test y retest, a un grupo control (GC) y otro experimental (GE). El análisis de varianza (MANOVA) y las comparaciones por pares con corrección de Bonferroni aplicadas con un alfa de 0.05, evidenciaron diferencias significativas entre ambos grupos, de las acciones motoras de lanzamiento en zona eficaz (GE: 74,3% GC: -16,7%) y Pase simple (GE: -27,1% - GC: -3,1%). Mientras que, mediante el análisis descriptivo de las tasas de ocurrencia, se encontraron diferencias de las acciones motoras de Anticipación (GE:211,1% - GC:20%), marcación eficiente (GE: 330,8% - GC: -7,1%) y desmarcación (GE: 400% - GC: 0%). Los hallazgos de ambos análisis muestran que la aplicación de metodologías comprensivas en la enseñanza de los deportes de colaboración y oposición en el contexto de educación física escolar, mejoran la calidad de las acciones de juego, en comparación a un modelo tradicional de enseñanza.

The purpose of the study was to determine the effect produced by the application of a teaching unit for collaborative and oppositional sports designed on the basis of two proposals of the comprehensive pedagogical model: Teaching Games for Understanding and Cognitive Didactics, compared to a traditional teaching model. The sample consisted of students from 5th to 8th grade (12 to 14 years old). By means of observational methodology, the main efficient game actions in the dimensions of attack and defense were evaluated, in test and retest moments, to a control group (CG) and an experimental group (EG). The analysis of variance (MANOVA) and pairwise comparisons with Bonferroni correction applied with an alpha of 0. 05, showed significant differences between both groups in the motor actions of throwing in the effective zone (EG: 74.3% - CG: -16.7%) and simple passing (EG: -27.1% - CG: -3.1%), while descriptive analysis of the occurrence rates showed differences in the anticipation motor actions (EG: 211.1% - CG: 20%), efficient tackling (EG: 330.8% - CG: -7.1%) and untacking (EG: 400% - CG: 0%). The findings of both analyses show that the application of comprehensive methodologies in the teaching of collaborative and oppositional sports in the context of school physical education improves the quality of the game actions, compared to a traditional teaching model.

O objetivo do estudo foi determinar o efeito produzido pela aplicação de uma unidade de ensino de esportes colaborativos e opostos projetada com base em 2 propostas do modelo pedagógico integral: Jogos de ensino para a compreensão e didática cognitiva, em comparação com um modelo de ensino tradicional. A amostra foi composta por alunos da 5ª à 8ª série (12 a 14 anos). Por meio de metodologia observacional, foram avaliadas as principais ações de jogo eficientes nas dimensões de ataque e defesa, nos momentos de teste e reteste, em um grupo controle (GC) e um grupo experimental (GE). A análise de variância (MANOVA) e as comparações por pares com correção de Bonferroni aplicada com alfa de 0,05, mostraram diferenças significativas entre ambos os grupos, das ações motoras de lançamento na zona efetiva (GE: 74,3% GC: -16,7% ) e passe simples (GE: -27,1% - GC: -3,1%). Já pela análise descritiva das taxas de ocorrência, foram encontradas diferenças nas ações motoras de Antecipação (GE: 211,1% - GC: 20%), marcação eficiente (GE: 330,8% - GC: -7,1%) e desmarcação (GE: 400% - GC: 0%). Os resultados de ambas as análises mostram que a aplicação de metodologias abrangentes no ensino de esportes colaborativos e de oposição no contexto da educação física escolar melhora a qualidade das ações de jogo, em comparação com um modelo de ensino tradicional.

Work-Family Conflict and Family Role Performance Among Collegiate Athletic Trainers.

CONTEXT: Work-life balance continues to be a focal point of athletic training research, particularly due to the job challenges and demands of health care providers. Despite a large body of literature, much is still unexplored, especially in the area of family role performance (FRP). OBJECTIVE: To examine the relationships between work-family conflict (WFC), FRP, and various demographic variables among athletic trainers employed in the collegiate setting. DESIGN: Cross-sectional online survey. SETTING: Collegiate setting. PATIENTS OR OTHER PARTICIPANTS: A total of 586 collegiate athletic trainers (females = 374, males = 210, sex variant or nonconforming = 1, preferred not to answer = 1). MAIN OUTCOME MEASURE(S): Data were collected through an online survey (Qualtrics) in which participants responded to demographic questions and previously validated WFC and FRP scales. Demographic data were reported and analyzed for descriptive information and frequencies. Mann-Whitney U tests were performed to identify differences among groups. RESULTS: Participants' mean scores were 28.19 ± 6.01 and 45.86 ± 11.55 for the FRP and WFC scales, respectively. Mann-Whitney U tests revealed differences between men and women for WFC scores (U = 344 667, P = .021). The FRP score was moderately negatively correlated with the WFC total score (rs[584] = -0.497, P < .001) and predicted the WFC score (b = 72.02, t582 = -13.30, P = .001). The Mann-Whitney U test demonstrated that married athletic trainers (47.20 ± 11.92) had higher WFC scores than those who were not married (43.48 ± 11.78; U = 19847.00, P = .003). Mann-Whitney U analysis (U = 32 096.00, P = .001) also revealed a difference between collegiate athletic trainers with children (48.16 ± 12.44) and those without children (44.68 ± 10.90). CONCLUSIONS: Collegiate athletic trainers experienced more WFC with marriage and having children. We propose that the time required to raise a family and build relationships may cause WFC due to time incongruencies. Athletic trainers want to be able to spend time with their families; however, when such time is highly limited, then WFC increases.

Adverse Childhood Experiences and Burnout in Athletic Trainers: An Exploratory Study.

CONTEXT: Burnout, a state of physical or emotional exhaustion, is a concern within athletic training, as between 17% and 40% of athletic trainers (ATs) report high levels of burnout. Adverse childhood experiences (ACEs) are linked with higher levels of burnout in other health professions. OBJECTIVE: To compare burnout with ACEs in ATs. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: One thousand ATs were selected at random to participate in the study. Of these, 78 ATs started the survey, and 75 ATs completed it. MAIN OUTCOME MEASURE(S): Burnout, as measured by the Copenhagen Burnout Inventory (CBI) overall and subscale scores, was compared across groups based on the number of adverse experiences as measured by the ACEs survey. Multiple analysis of variance tests were used to determine the association between ACEs score and overall, personal, work-related, and patient-related burnout. RESULTS: At least 1 adverse experience was reported by 37 (49.33%) participants. Those with ≥4 ACEs had higher odds of describing overall, personal, and work-related burnout than those with 0 to 3 ACEs. Moderate burnout (CBI score ≥ 50.00) was noted in 27 (36.00%, overall), 44 (58.67%, personal), 34 (45.3%, work related), and 15 (20.00%, patient related) ATs. Participants with 4 ACEs had higher overall burnout (67.11 ± 19.89; F6,68 = 2.59, P = .03) than those with 0 (40.53 ± 17.12, P = .04), 1 (38.42 ± 20.99, P = .04), or 7 (19.08 ± 12.09, P = .03) ACEs. The same pattern existed with personal burnout, as participants with 4 ACEs (76.67 ± 17.33) had higher scores (F6,68 = 3.40, P = .00) than those with 0 (46.60 ± 17.49, P = .02), 1 (42.78 ± 21.48, P = .01), or 7 (27.08 ± 20.62, P = .03) ACEs. No other differences were observed. CONCLUSIONS: Between 20.00% and 58.67% of ATs surveyed reported some form of burnout. Higher levels of overall and personal burnout were found in those with 4 ACEs. Although we expected to see lower levels of burnout in those with fewer ACEs, it was surprising that those with 7 ACEs had some of the lowest CBI scores. Athletic trainers with childhood trauma may find it beneficial to engage in self-regulation exercises to reduce or limit triggers and burnout. Additionally, employers should explore developing trauma-informed workplaces to better support employees.

Implementation of Patient-Centered Care by Athletic Training Students during Clinical Experiences: A Report from the Association of Athletic Training Education Research Network.

Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. A multisite panel design was used to recruit 363 students from twelve professional athletic training programs (five undergraduate, seven graduate). Over 1.5 years, clinical experience patient encounter data were logged in E*Value Case Logs, including student role during the encounter, length of encounter, and clinical site. Generalized estimating equations models characterized the likelihood students included PCC behaviors in 30,522 encounters. Discussing patient goals was associated with student role (χ2(2) = 40.6, p < 0.001) and length of encounter (χ2(4) = 67.6, p < 0.001). Using patient-reported outcome measures was associated with student role (χ2(2) = 21.6, p < 0.001), length of encounter (χ2(4) = 34.5, p < 0.001), and clinical site (χ2(3) = 17.3, p = 0.001). Implementing clinician-rated outcome measures was affected by length of encounter (χ2(4) = 27.9, p < 0.001) and clinical site (χ2(3) = 8.6, p = 0.04). PCC behaviors were largely associated with student role and length of encounters; clinical site had less impact. Athletic training educators should emphasize progressive autonomous supervision with preceptors and encourage students to facilitate slightly longer patient visits, when possible, to incorporate more PCC behaviors.

Examining pharmacists' anti-doping knowledge and skills in assisting athletes to avoid unintentional use of prohibited substances.

OBJECTIVES: To explore the knowledge and skills of pharmacists practicing in Sydney, Australia, in preventing the use of prohibited medications by athletes. METHODS: Using a simulated-patient study design, the researcher (an athlete and pharmacy student herself) contacted 100 Sydney pharmacies by telephone requesting advice about taking a salbutamol inhaler (a WADA-prohibited substance with conditional requirements), for exercise-induced asthma, following a set interview protocol. Data were assessed for both clinical and anti-doping advice appropriateness. KEY FINDINGS: Appropriate clinical advice was provided by 66% of pharmacists in the study, appropriate anti-doping advice was provided by 68%, and 52% provided appropriate advice across both aspects. Of the respondents, only 11% provided both clinical and anti-doping advice at a comprehensive level. Identification of accurate resources was made by 47% of pharmacists. CONCLUSIONS: Whilst most participating pharmacists had the skills to deliver assistance regarding the use of prohibited substances in sports, many lacked core knowledge and resources to enable them to deliver comprehensive care to prevent harm and protect athlete-patients from anti-doping violations. A gap was identified regarding advising/counselling athletes, indicating the need for additional education in sport-related pharmacy. This education would need to be coupled with the incorporation of sport-related pharmacy into current practice guidelines to enable pharmacists to uphold their duty of care and for athletes to benefit from their medicines-related advice.

Practices and Perceptions of Family-Centered Care: A Cross-Sectional Survey of Secondary School Athletic Trainers.

Family-centered care (FCC) includes collaboration between families and healthcare providers, the creation of flexible policies, and the family taking an active role in the delivery of care. Secondary school athletic trainers provide care for underage patients in school-based health systems, making them responsible for maintaining communication with parents, guardians, and/or caregivers. This cross-sectional survey investigated the extent to which athletic trainers (n = 205) include aspects of FCC in their daily secondary school clinical practice (current practices = CP) and whether they believe that aspect of care is necessary for FCC to be provided in athletic training (perceived necessary = PN) in their everyday practice using the Family-Centered Care Questionnaire-Revised tool. The total mean score for the CP scale (mean = 26.83 ± 4.36) was significantly lower (p ≤ 0.01) than the PN scale (mean = 35.33 ± 4.17). All FCC subscales compared between CP and PN were significantly different (p ≤ 0.01), with each being of higher importance than CP in athletic training. Data analysis revealed four themes related to enhancing FCC in secondary schools: limited education and resources, staffing and space concerns, non-technical skills, and social determinants of health. Attention should be placed on developing resources and interventions for secondary school athletic trainers to collaboratively work with children and their support systems.

Challenges and understandings of creative practice in professional sport training.

We conducted a qualitative study involving twelve expert sports coaches to explore and compare the range of creative practices they adopted during their professional activities. Their written responses to open-ended questions highlighted different interrelated dimensions of creative engagement in coaching sport, suggesting that efforts to instil creativity may initially focus on an individual athlete; they may often span a range of behaviours dedicated to efficiency; they may involve significant degrees of freedom and trust; and they cannot be captured by a single defining feature. We contextualise these findings in the light of recent literature in sports studies, performance science and creativity research, providing concrete examples based on the written statements provided by our participants. We conclude by offering insights for future research and coaching practice that may be relevant in broader domains.

A experiência esportiva no programa Curumim do Sesc Ribeirão Preto: descobertas, aprendizados e influências / The sports experience in the Curumim program of Sesc Ribeirão Preto: discoveries, learnings and inlfuences / La experiencia deportiva en el programa Curumim del Sesc Ribeirão Preto: descubrimientos, aprendizajes y influencias

Este artigo buscou compreender como a prática esportiva vivenciada no programa Curumim influenciou a relação dos antigos participantes do programa no Sesc Ribeirão Preto com o esporte. Como metodologia, utilizamos a Teoria Fundamentada; seis adultos que participaram do Curumim foram entrevistados. Durante a análise, cinco categorias foram estabelecidas, sendo a principal "Curumim como 'uma janela que se abre': descobertas, aprendizados e influências". Por fim, foi possível evidenciar a influência do Curumim no envolvimento com a prática esportiva. Contudo, este não foi um fator decisivo. Ainda, experiências marcantes demonstraram potencial para alterar o modo de ação de seus frequentadores e definir a escolha profissional dos participantes (AU).

This article sought to understand how the sports practice experienced in the Curumim Program influenced the relationship of the former participants with sport. As methodology, the Grounded Theory was used; six adults who participated in the Curumim in Sesc Ribeirão Preto were interviwed. Analyzing the data, five categories were established and the main one was "Curumim as 'an open window': discoveries, learning and influences". Finally, it was possible to perceive the influence of Curumim in sports practice, however, this was not a decisive factor. Still, remarkable experiences showed the potential to change the way of action of its participants and to define the professional choice (AU).

Este artículo buscó comprender cómo la práctica deportiva vivida en el Programa Curumim influyó en la relación de los ex participantes del Sesc Ribeirão Preto con el deporte. Como metodología, se utilizó la Teoría Fundamentada; se entrevistaron seis adultos que participaron en el Curumim. En el análisis, se establecieron cinco categorías, siendo la principal "Curumim como una 'ventana que se abre': descubrimientos, aprendizajes e influencias". Finalmente, se pudo evidenciar la influencia de Curumim en la práctica deportiva, pero, este no fue un factor determinante. Todavía, experiencias notables demostraron el potencial para cambiar las acciones de sus habituales y definir su elección profesional (AU).

Differences in Access to Athletic Trainers in Public Secondary Schools Based on Socioeconomic Status.

CONTEXT: Significant health care disparities exist in the United States based on socioeconomic status (SES), but the role SES has in secondary school athletes' access to athletic training services has not been examined on a national scale. OBJECTIVE: To identify differences in access to athletic training services in public secondary schools based on school SES. DESIGN: Cross-sectional study. SETTING: Database secondary analysis. PATIENTS OR OTHER PARTICIPANTS: Data for 3482 public high schools. MAIN OUTCOME MEASURE(S): Data were gathered from the Athletic Training Locations and Services (ATLAS) database, US Census Bureau, and National Center for Education Statistics. We included schools from 5 states with the highest, middle, and lowest poverty percentages (15 states total) and collected county median household income, percentage of students eligible for free or reduced-price lunch, race and ethnicity demographics, and access to athletic training services (full-time athletic trainer [AT], part-time AT only, no AT) for each school. Data were summarized in means, SDs, medians, interquartile ranges (IQRs), frequencies and proportions, 1-way analyses of variance, and Kruskal-Wallis tests. RESULTS: Differences were present in school SES between schools with full-time, part-time-only, and no athletic training services. Schools with greater access to athletic training services had fewer students eligible for free or reduced-price lunch (full time: 41.1% ± 22.3%, part time only: 45.8% ± 24.3%, no AT: 52.9% ± 24.9; P < .001). Similarly, county median household income was higher in schools with increased access to athletic training services (full time median [IQR]: $56 026 [$49 085-$64 557], part time only: $52 719 [$45 355-$62 105], and no AT: $49 584 [$41 094-$57 688]; P < .001). CONCLUSIONS: Disparities in SES were seen in access to athletic training services among a national sample of public secondary schools. Access to ATs positively influences student-athletes' health care across several measures. Pilot programs or government funds have been used previously to fund athletic training services and should be considered to ensure equitable access, regardless of school SES.

Secondary School Athletic Coaches' Perceptions and Knowledge of the Athletic Training Profession.

CONTEXT: Coaches play a role in streamlining care, especially by directing student-athletes in need of further medical attention to the athletic trainer (AT). The AT-coach relationship holds great potential for incorporating collaborative care, and yet, little is known about coaches' perceptions and knowledge of ATs. OBJECTIVE: To investigate coaches' perceptions of athletic training and their knowledge regarding the roles and responsibilities of ATs in secondary schools. DESIGN: Concurrent mixed-methods study. SETTING: Cross-sectional online questionnaire. PATIENTS OR OTHER PARTICIPANTS: Secondary school athletic coaches from 10 sports with the highest participation rates during the 2017-2018 season (n = 1097). Most respondents were male (n = 795, 72.4%), and their average age was 44.7 ± 11.4 years. MAIN OUTCOME MEASURE(S): Participants completed a web-based questionnaire containing demographics and quantitative measures assessing their perceived value and knowledge of ATs, as well as open-ended questions. Descriptive statistics summarized the demographic data. Counts and percentage responses for quantitative measures were reported. Open-ended responses were analyzed using the general inductive approach. RESULTS: Approximately 93% of respondents considered an AT a trusted source of medical information and a key member of the sports medicine team. Most respondents selected injury prevention (98.9%), first aid and wound care (97%), therapeutic interventions (89.9%), and emergency care (85.8%) as skills ATs are qualified to perform. Forty-six percent of respondents were willing to coach without an AT employed. Coaches trusted ATs as part of the "athletic team" and as gatekeepers, referring student-athletes for advanced care when warranted. Regarding the AT role, coaches emphasized the treatment of minor injuries and the idea of "coverage versus care." CONCLUSIONS: Secondary school coaches valued the athletic training profession and were knowledgeable regarding various roles and responsibilities ATs frequently perform. However, they may view ATs as luxuries instead of necessities, as evidenced by the fact that just under half of responding coaches were willing to coach without an AT employed at the school.

Board of Certification Examination Achievement Gaps as a Barrier to Diversifying the Athletic Training Profession.

CONTEXT: Achievement gaps have been well documented in the medical and health professions. Previous researchers have indicated that individuals from underrepresented minority groups consistently fall short of White candidates in performance on standardized credentialing examinations. OBJECTIVE: To determine the relative risk of failure by ethnicity and first-time and retake pass rates on the Board of Certification (BOC) examination. DESIGN: Descriptive study. SETTING: Professional master's degree athletic training programs. PATIENTS OR OTHER PARTICIPANTS: A total of 3742 unique candidates with 4425 attempts between examination windows 1 of 2011-2012 (April) and 5 of the 2019-2020 (February) cycle of the BOC examination. MAIN OUTCOME MEASURE(S): Ethnicity as self-selected by the candidates, attempt number, result of each attempt, year, and testing window. RESULTS: Examination candidates self-identified as White (60.4%, n = 2261/3742), unknown (ie, withheld an ethnicity selection; 10.6%, n = 395/3742), Hispanic (8.6%, n = 320/3742), or African American (8.4%, n = 313/3742). On the first attempt, White candidates passed at a rate of 93.2% (2107/2261), African American candidates at 74.8% (234/313), and Hispanic candidates at 86.9% (278/320; overall first-time pass rate for this subsample = 90.5%, 2619/2894). The relative risk of first-attempt failure was higher for African Americans than for both White (relative risk = 3.706, 95% CI = 2.903, 4.730; P < .001) and Hispanic (relative risk = 1.923, 95% CI = 1.368, 2.703; P > .001) candidates. For Hispanic candidates, the relative risk of first-attempt failure was about 50% lower than for White candidates (relative risk = 0.519, 95% CI = 0.377, 0.715; P < .001). CONCLUSIONS: Achievement gaps existed between White candidates and those from ethnic minority groups in athletic training. Diversification of the athletic training workforce will require ensuring equity in preparation for and success on the BOC examination.

Content Validation of the Athletic Training Milestones: A Report from the Association for Athletic Training Education Research Network.

The Athletic Training Milestones were developed as a comprehensive framework to assess athletic trainers' knowledge, skill, and behavior acquisition across the continuum of athletic training practice. However, without established content validity, it is unclear whether the Athletic Training Milestones can be used effectively as a clinical evaluation and research tool to evaluate competence and performance across multiple users and sites. We conducted a highly conservative content validity index (CVI) with data from 12 content experts. Our findings revealed an extremely high overall scale CVI of 0.99, and CVI scores of the 28 individual subcompetency items assessed ranged from 0.83 to 1.00. For the athletic training profession to truly embrace competency-based evaluation and performance assessments, we need a highly valid and comprehensive instrument, such as the Athletic Training Milestones.

Surgical Coaching: Patient Perspectives Regarding Surgeon Coaches in the Operating Room.

BACKGROUND: Surgical coaching programs have been introduced as platforms for ongoing professional development amongst independently practicing surgeons. While there is a plethora of evidence regarding the effectiveness of surgical coaching for practicing staff surgeons, patients' opinions regarding surgical coaching are largely unknown. OBJECTIVES: To determine patients' baseline attitudes and opinions about the hypothetical situation of their treating surgeon having a surgical coach present during their upcoming operation, and to determine patients' baseline knowledge and prior exposure to surgical coaching. DESIGN AND SETTING: This study was conducted at a tertiary hospital in Vancouver, Canada. Patients on the surgical waitlist of 2 independently practicing Otolaryngologists within the subspeciality of Neurotology were invited to participate in the study. Participants engaged in a semi-structured interview to discuss their opinions and knowledge of physician coaches and to learn about surgical coaching. The interview was conducted based on a pre-set script. RESULTS: Of the 100 patients approached, 70 consented to participate. Forty-three (61%) participants identified as female, and the mean age was 56±15 years. Initially, 84% of participants (n = 59) consented to the hypothetical presence of a surgical coach. Post-discussion, this number increased to 95.7% (n = 67, p = 0.04). Prior participant exposure to coaching related to employment, education, athletics, or music was high (90%, n = 63). Younger participants between 25 and 45 years of age were more amenable to the presence of a surgical coach compared to participants >66 years of age (p = 0.01). After the interview, 55 (79%) participants were interested in learning more about surgical coaching. CONCLUSION: Many patients were unaware of the rationale and importance of surgical coaching programs for practicing staff surgeons. Most patients, especially younger patients, were amenable to the presence of a surgical coach during their surgery, and this number increased in all age categories with patient education about surgical coaching.

Influence of the size of the cities of birth and residence in the sports career: an analysis through the bolsa-atleta program / Influência do tamanho das cidades de nascimento e residência na carreira desportiva: uma análise por meio do programa bolsa-atleta

ABSTRACT This study aimed to verify whether the size of municipalities in which Brazilian high-performance athletes are born or live influences the federal government subsidy, in addition to pointing out whether factors such as human development index, demographic density and municipal investment in sports also exert influence. The sample consisted of 2,033 Brazilian municipalities that had athletes, born or resident, receiving the Brazilian incentive Bolsa-Atleta program. The size of municipalities influences the amount and level of grant obtained, demonstrating that the smaller the population size, the lower the chance of obtaining a higher grant level. In addition, factors such as human development index, demographic density and investment in sport influence the acquisition of grants by athletes, mainly by resident athletes, which shows an internal sports migration in the country as a result.

RESUMO O presente estudo teve por objetivo verificar se o tamanho dos municípios em que os atletas brasileiros de rendimento nascem ou residem gera influência na obtenção de subsídio pelo governo federal, além de apontar se fatores como índices de desenvolvimento humano, densidade demográfica e investimento municipal no esporte também exercem influência. A amostra consistiu em 2033 municípios brasileiros que apresentaram atletas nascidos ou residentes contemplados pelo programa de incentivo brasileiro Bolsa-Atleta. Por meio da análise, pode-se verificar que o tamanho dos municípios influência na quantidade e no nível de bolsa obtido, demonstrando que quanto menor o tamanho da população, menor a chance de se obter um nível mais alto de bolsa. Além disto, pode-se notar que fatores como índices de desenvolvimento humano, densidade demográfica e investimento no esporte exercem influência na aquisição de bolsas pelos atletas, principalmente, por parte de atletas residentes, o que evidencia uma migração esportiva interna no país.

Contradiction between Supply and Demand of Public Sports Services and Coping Strategies Based on the Genetic Algorithm.

The current situation of China's sports public service is not very satisfactory. This research analyzes not only the operation characteristics of the public sports service supply mode but also the connotation mechanism of the public sports service collaborative supply. The article also constructs the mechanism elements and the index system of the public sports service collaborative supply from the perspective of the genetic algorithm. Taking the eastern and central regions as research cases, this paper analyzes the actual situation of the collaborative supply of public sports services, and further explores the gap between urban and rural public sports. It puts forward the ideas and strategic paths for the innovative development of the collaborative supply model of public sports services. This research uses descriptive statistical analysis on the evaluation results of public sports service quality to examine the actual performance value of public sports service quality in various regions and uses the characteristics of different fitness of genetic algorithms to select the optimal supply and demand of public sports services in different regions. By analyzing the characteristics of insufficient supply and demand of public sports services in various regions, an optimal genetic algorithm model is constructed, and then combined with the scope of the study area and the number of people in the area, the genetic algorithm is used to continuously optimize until a set of optimal solutions appears, thus completing the optimal configuration of public sports services. The optimal path for the development of public sports in different regions is obtained, so as to promote the development of regional public sports. The study found that the satisfaction of sports funds in primary and middle schools in the east and middle is not very high, and the satisfaction with sports funds in middle schools is higher than that in primary schools, but only 50% of schools choose that sports funds are basically sufficient. The difference in satisfaction with sports funding in middle schools in the eastern and central regions is not obvious, and the satisfaction with sports funding in primary schools in the eastern region is higher than that in the central region. Judging from the amount of sports expenditures filled in by schools, 2000-3000 yuan per school year for primary schools and 4000-5000 yuan for middle schools are more common. Based on the calculation of 1,000 students in a school, the per capita sports expenditure is less than 10 yuan, which is very limited for sports training. This research will help to change the service concept and scientific decision-making and change the supply mode of sports public services. It will establish not only a vertical, complete, and horizontally smooth organizational structure and coordination mechanism but also a clear strategy for equalization of urban and rural sports public services.

Athletic trainers' viewpoints of patient-centered care: Preliminary findings.

The core competency of patient-centered care (PCC) states that for positive patient outcomes, the provider must respect the patient's views and recognize their experiences. The Athletic Training Strategic Alliance Research Agenda Task Force identified a profession-wide belief that examining the extent to which athletic trainers (ATs) provide PCC in their clinical practice would benefit the profession. To first address this line of inquiry, we must study the subjectivity of how ATs view PCC. This study used Q methodology which is a research design that collects data from participants from a quantitative and qualitative perspective. A total of 115 (males = 62, females = 53, age = 37±10 y, experience = 13±10 y) ATs dispersed between 11 job settings volunteered for this study. Participants were asked to pre-sort (agree, disagree, neutral) 36 validated statements representing the 8 dimensions of PCC, then completed a Q-sort where they dragged-and-dropped the pre-sorted statements based on perceived importance in providing PCC. The Q-sorts were analyzed using QMethod software. A principal component analysis was used to identify statement rankings and factors. Factors were determined by an Eigenvalue > 1 and analyzed using a scree plot. The 6 highest selected statements per factor were assessed to create the distinguishing viewpoints. Two distinguishing viewpoints emerged from the factor analysis of the Q-sorts: 1) the interpersonal connection that valued teamwork, open communication, and respectful care with varied populations; 2) the holistic gatekeeper that valued personal promotion for activities of daily living, self-care, and quality of life. Overall, ATs value patient's preferences and respect. However, a lack of importance was identified for incorporating the disablement model which is a core competency and adopted framework by the athletic training profession.

Supportive Communities: Conceptualizing Supportive Structures for Coaches' Learning and Well-Being in Community Youth Soccer.

Sweden has an extensive culture of community club sports for children and youths, based on voluntary leadership. Being a voluntary coach can be stressful and can affect coaches' well-being. Since voluntary coaching is closely connected to and conditioned by family life and civil occupation, coaches need support for practical issues as well as for developing their coaching assignment in relation to the constantly changing conditions within sports for children and youths. The aim of this paper was to conceptualize and problematize the supportive structures in everyday activities, in order to promote learning and well-being and to prevent mental health issues. This paper is conceptual and based on a paradigm case. The starting point is communities of practice (CoP) and how CoPs can contribute to the development of supportive structures for coaches in youth sports. In conclusion, a CoP is dependent on negotiation within the coaching team as well as on facilitating factors that can add knowledge, perspectives, and experiences to the CoP. The facilitating factors mean that a CoP has the potential to be health-promoting for both coaches and players. Hence, it is important to create conditions, structures, and support-such as policies, practice-based education, mentorship, and facilitators.

Life satisfaction and athletic identity among Olympic para-alpine skiers: a survey.

The objective of this study was to examine life satisfaction and athletic identity among para-alpine skiers and explore their associations with sociodemographic, sports practice, and disability-related characteristics of the participants. The respondents to the on-site survey were 129 para-alpine ski racers with acquired disability from 33 countries on all five continents who competed in the Paralympic games in Sochi (aged 16-53 years, mean and median 30 years, 100 men). Two self-developed assessment instruments were used - a 7-point Likert-type life-satisfaction questionnaire probing seven domains (health, family, education, freedom, friends, travelling, and self) and the Athletic Identity Scale (AIS; possible score range 17-85). The independence between life-satisfaction items was confirmed by low interitem correlations (largest absolute value <0.25, 15 of 21, and <0.15). The estimated internal-consistency reliability (Guttman lambda-2) of AIS was 0.65. The reported life satisfaction was very high (median of 6 for all domains except education, where it was 5). Like life-satisfaction ratings, the AIS scores were also very high on average (mean and median score 81). In general, the level of life satisfaction and athletic identity were not notably associated with sociodemographic, sports practice, and disability characteristics of the participants. The likely reason is high average and, hence, low variability of life-satisfaction ratings, as well as imperfect metric characteristics of the AIS. Nonetheless, the overall findings encourage further research into factors that drive the participation of disabled athletes in (winter) Paralympic games and the possible role of the rehabilitation process in this regard.