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1.
J Athl Train ; 54(12): 1229-1236, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31714144

RESUMO

CONTEXT: California is currently the only state that does not regulate who can and cannot call themselves athletic trainers (ATs). Therefore, previous national or state-specific investigations may not have provided an accurate representation of AT availability at the secondary school level in California. Similarly, it is unknown whether the factors that influence AT availability in California, such as socioeconomic status, are similar to or different from those identified in previous studies. OBJECTIVE: To describe the availability of ATs certified by the Board of Certification in California secondary schools and to examine potential factors influencing access to AT services in California secondary schools. DESIGN: Cross-sectional study. SETTING: Online survey. PATIENTS OR OTHER PARTICIPANTS: Representatives of 1270 California high schools. MAIN OUTCOME MEASURE(S): Officials from member schools completed the 2017-2018 California Interscholastic Federation Participation Census. Respondents provided information regarding school type, student and student-athlete enrollment, whether the school had ATs on staff, and whether the ATs were certified by the Board of Certification. The socioeconomic status of public and charter schools was determined using the percentage of students eligible for free or reduced-price lunch. RESULTS: More than half (54.6%) of schools reported that they either did not employ ATs (47.6%) or employed unqualified health personnel (UHP) in the role of AT (7.0%). Nearly 30% of student-athletes in California participated in athletics at a school that did not employ ATs (n = 191 626, 28.9%) and 8% of student-athletes participated at a school that employed UHP in the role of AT (n = 54 361, 8.2%). Schools that reported employing ATs had a lower proportion of students eligible for free or reduced-price lunch than schools that did not employ ATs and schools that employed UHP (both P values < .001). CONCLUSIONS: With ongoing legislative efforts to obtain regulation of ATs in California, secondary school administrators are encouraged to hire ATs with the proper certification to enhance the patient care provided to student-athletes and improve health outcomes.

2.
J Athl Train ; 54(7): 822-830, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31386576

RESUMO

CONTEXT: Medical documentation is a required component of patient care in all health care professions. OBJECTIVE: To evaluate athletic trainers' perceived behaviors toward, barriers to, and confidence in their medical documentation. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: We purchased a list of randomly selected e-mails from the National Athletic Trainers' Association. Of the 9578 participants, 1150 accessed our questionnaire (12.0% access rate), 1053 completed at least 1 portion, and 904 completed the questionnaire in its entirety (85.8% completion rate). Of the participants, 60.1% (n = 569/947) were female, 66.6% (n = 632/949) held a master's degree, 39.3% (n = 414/1053) worked in a collegiate or university setting, and 36.1% (n = 381/1053) worked in a secondary school setting. MAIN OUTCOME MEASURE(S): We used a 31-item questionnaire with demographics (12 items), medical documentation behaviors (16 items), barriers (2 items), and perceptions (1 multipart item) sections. The questionnaire explored athletic trainers' behaviors as well as confidence in, comfort with, and concerns about their documentation practices (Cronbach α = 0.887). We used descriptive statistics to identify characteristics of central tendency (mean, standard deviation, mode, frequency). RESULTS: Participants always (45.7%, n = 478/1046) or very frequently (39.0%, n = 408/1046) used a double documentation system consisting of electronic and paper records (50.4%, n = 523/1038). They most often documented to provide legal protection (86.8%, n = 914/1053), because it is a legal obligation (79.1%, n = 833/1053), or to track patient progress (83.9%, n = 883/1053). The most frequently cited barriers to medical documentation were time (76.5%, n = 806/1053), managing too many patients (51.9%, n = 547/1053), technological concerns (17.2%, n = 181/1053), and software limitations (17.2%, n = 181/1053). Respondents believed they were competent, comfortable, and confident in their documentation practices. CONCLUSIONS: We were able to evaluate the generalizability of previous research while adding to the understanding of the behaviors toward, barriers to, and perceptions about medical documentation. We confirmed that time and patient load affected the ability to perform high-quality medical documentation.


Assuntos
Documentação , Assistência ao Paciente , Prática Profissional , Esportes , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Competência Profissional , Instituições Acadêmicas , Inquéritos e Questionários , Universidades
3.
J Athl Train ; 53(6): 619-626, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29893602

RESUMO

CONTEXT: High-quality patient care documentation is an essential component of any health care professional's daily practice. Whereas athletic trainers (ATs) recognize the importance of patient care documentation, several barriers may prevent them from producing high-quality patient care documentation. OBJECTIVE: To explore beneficial strategies and techniques that ATs perceived would enhance the quality of patient care documentation in the secondary school setting. DESIGN: Qualitative study. SETTING: Individual telephone interviews. PATIENTS OR OTHER PARTICIPANTS: Ten ATs who were members of the Athletic Training Practice-Based Research Network and employed in the secondary school setting were interviewed (4 men, 6 women with 7.1 ± 7.8 years of athletic training experience). DATA COLLECTION AND ANALYSIS: An individual telephone interview was conducted with each participant. Once transcribed, data were analyzed into common themes and categories per the consensual qualitative research tradition. Trustworthiness of the data was achieved through triangulation strategies: (1) the inclusion of multiple researchers to ensure accuracy and representativeness of the data and (2) participant member checking. RESULTS: Participants identified several documentation strategies they perceived would be helpful to improve the quality of patient care documentation, including mode and consistency of documentation and the need for a standardized process as well as the need for system standardization. In addition, participants discussed the need for more education on patient care documentation. Specifically, they identified ways of learning and strategies for future education to enhance patient care documentation across the profession. CONCLUSIONS: As athletic training continues to evolve, it is crucial that ATs are well educated on how to produce high-quality patient care documentation as a part of routine practice. Continuing professional development opportunities are needed to promote lifelong learning in the area of patient care documentation.


Assuntos
Registros Médicos/normas , Administração dos Cuidados ao Paciente , Adulto , Educação Continuada/métodos , Feminino , Humanos , Masculino , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/estatística & dados numéricos , Educação Física e Treinamento , Competência Profissional , Pesquisa Qualitativa , Melhoria de Qualidade , Instituições Acadêmicas/estatística & dados numéricos , Esportes/educação
4.
J Allied Health ; 47(1): e1-e7, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29504024

RESUMO

BACKGROUND: Preceptors are important contributors to the professional development of students in allied healthcare programs. Considering their role in supervising and teaching students during clinical education, it is important that preceptors understand and embody effective characteristics and behaviors. Most existing research on preceptor effectiveness in nursing, medicine, and dietetics professions has examined preceptor and student perceptions of effective behaviors independently. OBJECTIVE: The purpose of our study was to investigate effective preceptor behaviors from perspectives of paired preceptors and students affiliated with athletic training programs. PROCEDURES: This qualitative study included interviews of eight paired groups of preceptors (n=8) and athletic training students (n=13) within collegiate, rehabilitation clinic, and high school settings. Data were analyzed using a general inductive approach using open, axial, and selective coding. RESULTS: Our participants concurred that effective preceptors: 1) communicate expectations early and often, 2) demonstrate approachability and openness towards students, 3) provide hands-on patient care responsibilities, and 4) take the time to actively instruct students. CONCLUSIONS: Preceptors are encouraged to exhibit these effective instructional and interpersonal behaviors. Based on these themes, allied health program administrators should provide preceptor trainings that encourage these behaviors to enhance student learning and professional preparation.


Assuntos
Percepção , Condicionamento Físico Humano , Preceptoria/organização & administração , Estudantes de Ciências da Saúde/psicologia , Adulto , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
5.
J Athl Train ; 52(7): 656-666, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28574751

RESUMO

CONTEXT: Documenting patient care is an important responsibility of athletic trainers (ATs). However, little is known about ATs' reasons for documenting patient care and the mechanics of completing documentation tasks. OBJECTIVE: To understand ATs' perceptions about reasons for and the mechanics of patient care documentation. DESIGN: Qualitative study. SETTING: Individual telephone interviews with Athletic Training Practice-Based Research Network members. PATIENTS OR OTHER PARTICIPANTS: Ten ATs employed in the secondary school setting (age = 32.6 ± 11.4 years, athletic training experience = 7.1 ± 7.8 years) were recruited using a criterion-based sampling technique. Participants were Athletic Training Practice-Based Research Network members who used the Clinical Outcomes Research Education for Athletic Trainers electronic medical record system and practiced in 6 states. DATA COLLECTION AND ANALYSIS: We used the consensual qualitative research tradition. One investigator conducted individual telephone interviews with each participant. Data collection was considered complete after the research team determined that data saturation was reached. Interviews were transcribed verbatim and independently analyzed by 4 research team members following the process of open, axial, and selective coding. After independently categorizing interview responses into categories and themes, the members of the research team developed a consensus codebook, reanalyzed all interviews, and came to a final agreement on the findings. Trustworthiness was established through multiple-analyst triangulation and member checking. RESULTS: Participants identified 3 reasons for documenting patient care: communication, monitoring patient care, and legal implications. Four subcategories emerged from the mechanics-of-documentation theme: location, time of day, length of time, and criteria for documenting. The ATs described different criteria for documenting patient care, ranging from documenting every injury in the same manner to documenting time-loss and follow-up injuries differently. CONCLUSIONS: Whereas ATs recognized individual mechanisms that enabled them to document patient care, they may need more guidance on the appropriate criteria for documenting various patient care encounters and strategies to help them document more effectively.


Assuntos
Documentação/métodos , Registros Médicos , Assistência ao Paciente , Educação Física e Treinamento , Adulto , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Instituições Acadêmicas , Inquéritos e Questionários , Adulto Jovem
6.
J Athl Train ; 52(7): 667-675, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28574752

RESUMO

CONTEXT: For the practice characteristics of the services athletic trainers (ATs) provide to be identified, all ATs must complete high-quality patient care documentation. However, little is known about ATs' perceptions of patient care documentation or the potential barriers they may encounter while trying to ensure high-quality documentation. OBJECTIVE: To explore ATs' perceptions of and barriers to patient care documentation via the Clinical Outcomes Research Education for Athletic Trainers (CORE-AT) electronic medical record system in the secondary school setting. DESIGN: Qualitative study. SETTING: Individual telephone interviews. PATIENTS OR OTHER PARTICIPANTS: We interviewed 10 ATs (4 men, 6 women; age = 32.6 ± 11.4 years, athletic training experience = 7.1 ± 7.8 years) who were members of the Athletic Training Practice-Based Research Network (AT-PBRN) and employed in the secondary school setting. DATA COLLECTION AND ANALYSIS: We conducted an individual interview with each participant. After transcription of the interviews, the data were analyzed into common themes and categories following the consensual qualitative research tradition. Data triangulation occurred through member checking and multiple researchers to ensure accuracy during data analysis. RESULTS: Participants revealed several perceptions of patient care documentation, consisting of quality, expectations and accountability, priority, incentive, and culture of the secondary school setting. In addition, we identified barriers to quality patient care documentation: lack of time, lack of accountability for documenting patient care, inadequate facility resources, and lack of personnel. Participants discussed the volume of patients as a unique challenge in the secondary school setting. CONCLUSIONS: Whereas ATs perceived patient care documentation as important, several practical barriers may inhibit their ability to complete high-quality documentation of the services they provide. Effective strategies to improve the quality of patient care documentation among ATs are needed to ensure that their value, particularly in the secondary school setting, is accurately characterized.


Assuntos
Documentação , Registros Médicos , Assistência ao Paciente , Educação Física e Treinamento , Adulto , Atitude do Pessoal de Saúde , Emprego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assistência ao Paciente/normas , Pesquisa Qualitativa , Instituições Acadêmicas , Inquéritos e Questionários
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