1. Chapter 1: The Athletic Trainer and the Sports Medicine Team
Jennifer L. Doherty, MS, LAT, ATC
Academic Program Director, Entry-Level ATEP
Florida International University
Acute Care and Injury Prevention

2. Sports Medicine
Broad field of medical practices related to physical activity and sport
Involves a number of specialties involving active populations
Typically classified as relating to performance enhancement or injury care and management

3. Sports Medicine Human Performance Management Injury
Exercise Physiology
Practice of Medicine
Biomechanics
Sports Physical Therapy
Sport Psychology
Athletic Training
Sports Nutrition
Sports Massage

4. The Players on the Sports Medicine Team
Physicians
Dentist
Podiatrist
Nurse
Physicians Assistant
Physical Therapist
Athletic Trainer
Massage Therapist
Ophthalmologist
Dermatologist
Gynecologist
Exercise Physiologist
Biomechanist
Nutritionist
Sport Psychologist
Coaches
Strength & Conditioning Specialist
Social Worker
Neurologist
Osteopath
Psychiatrist

5. Growth of Professional Sports Medicine Organizations
International Federation of Sports Medicine (1928)
American Academy of Family Physicians (1947)
National Athletic Trainers Association (1950)
American College of Sports Medicine (1954)
American Orthopaedic Society for Sports Medicine (1972)
National Strength and Conditioning Association (1978)
American Academy of Pediatrics, Sports Committee (1979)
Sports Physical Therapy Section of APTA (1981)
NCAA Committee on Competitive Safeguards and Medical Aspects of Sports (1985)

6. National Athletic Trainers’ Association (NATA)
Purpose:
To enhance the quality of health care for athletes and those engaged in physical activity, and to advance the profession of athletic training through education and research in the prevention, evaluation, management and rehabilitation of injuries
30,000 members

7. Purpose of Professional Sports Medicine Organizations
Promote involvement of various health related professions
Dentistry, podiatry, chiropractic medicine
Focus on athletic health and safety
All bodies have worked towards the reduction of injury and illness in sport

8. Sports Medicine Journals
A variety of publications exist, providing excellent resources to the sports medicine community
Journal of Athletic Training
Journal of Sports Rehabilitation
International Journal of Sports Medicine
Physician and Sports Medicine
Clinics in Sports Medicine
American Journal of Sports Medicine

9. The Athletic Trainer
Charged with injury prevention and health care provision for the athlete and physically active population
Consists of athletic, recreational or competitive activities
Requires physical skills and utilizes strength, power, endurance, speed, flexibility, range of motion and agility
Athletic trainer deals with the athlete and injury from its inception until the athlete returns to full competition

10. Roles and Responsibilities: Performance Domains
Prevention of athletic injuries
Clinical evaluation and diagnosis
Immediate care of injuries
Treatment, rehabilitation and reconditioning of athletic injuries
Health care administration
Professional responsibilities

11. Personal Qualities of ATCs
Stamina and Adaptability
Prevents burnout
Empathy
Ability to detect stress with a desire to minimize that stress
Sense of Humor
Helps relieve tension and promote relaxation

12. Personal Qualities of ATCs
Ability to Communicate
Oral and written communication is necessary
Intellectual Curiosity
Lifelong commitment to learning
Ethics
High standard of conduct and integrity

13. The ATC and the Athlete Major concern for the ATC = athlete
All decisions impact the athlete
The injured athlete must always be informed
Be made aware of the how, when and why that dictates the course of injury rehabilitation

14. The ATC and the Athlete
The athlete must be educated about injury prevention and management
Instructions should be provided regarding training and conditioning
Inform the athlete to listen to his/her body in order to prevent injuries

15. The ATC and Parents ATC must keep parents informed,
Particularly in the secondary school setting
The parents decision regarding healthcare must be a primary consideration
Insurance plans may dictate care
Selection of physician

16. The ATC and Parents
ATC, physician and coaches must be aware and inform parents of Health Insurance Portability and Accountability Act (HIPAA)
Regulates dissemination of health information
Protects patient’s privacy and limits the people who could gain access to medical records

17. The ATC and the Team Physician
ATC works under the direct supervision of a physician
Physician and ATC must be able to work together
Have similar philosophical opinions regarding injury management
Helps to minimize discrepancies and inconsistencies

18. Roles and Responsibilities of the Team Physician
Compiling medical histories and conducting physical exams
Pre-participation screening
Diagnosing injury
Deciding on disqualifications
Based on medical knowledge and psychophysiological demands of the sport

19. Roles and Responsibilities of the Team Physician
Attending practice and games
Commitment to sports and athletes
Potentially serve as the ATEP Medical Director
Provides input into educational content
Provides programmatic instruction

20. The ATC and the Coach Must understand the role of the ATC
Coach must clearly understand the limits of their ability to function as a healthcare provider
Directly responsible for injury prevention
Appropriate conditioning programs

21. Roles and Responsibilities of the Team Physician
Coach must be aware of risks associated with the sport
Provide appropriate training and equipment
Must have knowledge of CPR and first aid
Must have thorough knowledge of skills, techniques, and environmental factors associated with sport
Develop good working relationships with staff, including athletic trainers

22. Athletic Training Where have we been? Where are we now?
Where are we going?

23. Athletic Training: Where have we been clinically?
Traditional employment settings deal exclusively with an athletic population:
Colleges
Secondary schools

24. Athletic Training: Where are we now clinically?
Today, ATCs work in a variety of settings
Professional sports
Hospitals
Clinics
Industrial settings
The military
Equipment sales
Physician extenders

25. Athletic Training: Where are going clinically?
Employment opportunities are becoming increasingly diverse
Dramatic transformation since 1950
Due largely in part to the efforts of the NATA
More employment settings will include:
Research
Administration

26. Athletic Training: Where are we going clinically?
Evolution of the profession has led to:
Recognition of ATC’s as healthcare providers
Increased diversity of practice settings
Passage of practice acts
Third party reimbursement for athletic trainers
Constant revision and reform of athletic training education

27. Athletic Training: Where have we been educationally?
Formerly there were two types of athletic training education programs
Accredited education programs
Competency-based education
Internship education programs
Quantity-based education

28. Athletic Training: Where are we now educationally?
In 1998, the NATA - Education Council was established to dictate the educational preparation for the athletic training student
Focus has shifted to competency based education at the entry level
Education Council has significantly expanded and reorganized the clinical competencies and proficiencies

29. Athletic Training Education Competencies Twelve Content Areas
Risk management
Pathology of injuries and illnesses
Assessment and evaluation
Acute care
Pharmacological aspects of injury and illness
Therapeutic modalities
Therapeutic exercise
General medical conditions and disabilities
Nutritional aspects of injury and illnesses
Psychosocial intervention and referral
Organization and administration
Professional responsibilities

30. Athletic Training: Where are we now educationally?
June 1990 – the AMA officially recognized athletic training as an allied health profession
Committee on Allied Health Education and Accreditation (CAHEA) was charged with developing the guidelines for academic programs to use in preparation of individuals for entry into profession through the Joint Review Committee on Athletic Training (JRC-AT)

31. Athletic Training: Where are we now educationally?
June CAHEA dissolved
Replaced immediately by the Commission on Accreditation of Allied Health Education Programs (CAAHEP)
Recognized as an accreditation agency for allied health education programs by the U.S. Department of Education
Entry level college and university athletic training education programs at both undergraduate and graduate levels are currently accredited by CAAHEP

32. Athletic Training: Where are we going educationally?
In 2003, JRC-AT became an independent accrediting agency
New name: Commission on the Accreditation of Athletic Training Education (CAATE)
CAATE will accredit athletic training education programs without
No involvement from CAAHEP

33. Athletic Training: Where are we going educationally?
CAATE will seek affiliation with CHEA once it is fully independent
CHEA is a private nonprofit national organization that coordinates accreditation activity in the United States
Recognition by CHEA will put CAATE on the same level as other national accreditors, such as CAAHEP
CAAHEP accreditation will be discontinued in 2006; CAATE will begin in 2007

34. Athletic Training: Where are we going educationally?
Specialty Certifications
Build on entry level knowledge
NATA is in the process of developing specialty certifications
Further enhance professional development
Aid in expanding scope of practice

35. Athletic Training: Where are we going educationally?
Seven proposed specialty certifications
Business practice, medical care management, occupational health, wellness, pediatric/adolescent health, adult/geriatric health, special health populations
Candidates will have to complete experiential requirements and pass a standardized examination

36. Requirements for Certification as an Athletic Trainer
Must have extensive background in formal academic preparation and supervised clinical experience
Upon meeting the educational guidelines applicants are eligible to sit for the Board of Certification (BOC) examination

37. BOC Examination Examination consist of the following: Written portion
Practical portion
Written simulation
Exam assesses the 6 domains
Prevention of injuries
Evaluation and diagnosis
Immediate care of injuries
Treatment, rehabilitation & reconditioning
Organization and administration
Professional responsibility

38. BOC Examination
Upon passing BOC examination, you are a BOC certified athletic trainer
Credential of ATC
BOC certification is a prerequisite for licensure in most states

39. Continuing Education Requirements
Continuing education is a requirement to maintain the ATC credential
Ensure ongoing professional growth and involvement
Requirements that must be met to remain certified
80 CEU’s over the course of three years

40. Purpose:
To encourage ATC to obtain current professional development information
To explore new knowledge in specific areas
To master new athletic training related skill and techniques
To expand approaches to effective athletic training
To further develop professional judgement
To conduct professional practice in an ethical and appropriate manner

41. CEU’s are awarded for: Attending symposiums, workshops, seminars
Serving as a speaker or panelist
Certification exam model
Participating in the USOC program
Authoring a research article; authoring/editing a textbook
Completing post-graduate work
Obtaining CPR and first aid certification

42. State Regulation of the Athletic Trainer
During the early-1970s NATA realized the necessity of obtaining some type of official recognition by other medical allied health organizations of the athletic trainer as a health care professional
Laws and statutes specifically governing the practice of athletic training were nonexistent in virtually every state

43. Athletic trainers in many individual states organized efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies
To date 40 of the 50 states have enacted some type of regulatory statute governing the practice of athletic training
Rules and regulations governing the practice of athletic training vary tremendously from state to state

44. Licensure Regulation may be in the form of Licensure
Limits practice of athletic training to those who have met minimal requirements established by a state licensing board
Limits the number of individuals who can perform functions related to athletic training as dictated by the practice act
Most restrictive of all forms of regulation

45. Certification Regulation may be in the form of Certification
Does not restrict using the title of athletic trainer to those certified by the state
Can restrict performance of athletic training functions to only those individuals who are certified

46. Registration Regulation may be in the form of Registration
Before an individual can practice athletic training he/she must register in that state
Individual has paid a fee for being placed on an existing list of practitioners but says nothing about competency

47. Exemption Regulation may be in the form of Exemption
State recognizes that an athletic trainer performs similar functions to other licensed professions (e.g. physical therapy), yet still allows them to practice athletic training despite the fact that they do not comply with the practice acts of other regulated professions

48. Future Directions for the ATC
Determined by the efforts of the NATA and its membership…
Ongoing re-evaluation, revision and reform of athletic training education
CAATE will become an accrediting agency
Third party billing will gradually become the rule, not the exception for ATC’s
Standardization of state practice acts
ATC’s will seek specialty certifications
Expanding breadth and scope of practice

49. Future Directions for ATC
Increase in secondary school employment
Increase in recognition of ATC as a physician extender
Potential for expansion in the military, industry, and fitness/wellness settings
With general population aging, there may be increased opportunity to work with aging physically active individuals
Continue to enhance visibility through research and scholarly publication

50. Future Directions for ATC
Continue to be available for local and community meetings to discuss healthcare of the athlete
Increase recognition and presence internationally
Most importantly, continue to focus efforts on injury prevention and to provided high quality healthcare to physically active individuals who are injured while participating in sport