Athletic training clinical proficiencies
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Athletic Training Clinical Proficiencies. By Sue Shapiro, Ed.D.,L/ATC Clinical Coordinator/Assistant Professor Barry University Miami Shores, Florida. Objectives. Implementation of clinical proficiencies Linking the didactic and clinical components Clinical proficiency delineation

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Athletic Training Clinical Proficiencies

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Athletic training clinical proficiencies

Athletic Training Clinical Proficiencies

By

Sue Shapiro, Ed.D.,L/ATC

Clinical Coordinator/Assistant Professor

Barry University

Miami Shores, Florida


Objectives

Objectives

  • Implementation of clinical proficiencies

  • Linking the didactic and clinical components

  • Clinical proficiency delineation

  • Integrative evaluation strategies/tools


Athletic training clinical proficiencies

Competency-Based Objectives


Athletic training clinical proficiencies

Nothing becomes real for the student

until it is EXPERIENCED


Athletic training clinical proficiencies

CROSSING THE BRIDGE

COMPENTENCY BASED

HOURLY

BASED


Athletic training clinical proficiencies

Competency-Based Instruction

  • Identifies the professional roles students will assume upon completion

  • Determines what constitutes effective performances within these roles


Athletic training clinical proficiencies

Learning Cognitive

Information in Isolation


Athletic training clinical proficiencies

Merging of Didactic and

Clinical Components

DIDACTIC

CLINICAL


Athletic training clinical proficiencies

Flexible Clinical Scheduling

is a Prerequisite toCompetency-BasedProgression


Athletic training clinical proficiencies

Flexible Clinical

Scheduling Should:

  • Provide open laboratory practice

  • Encourage advanced students to practice and teach fellow students in a controlled environment other than the clinical setting


Clinical proficiency preparation

Clinical Proficiency Preparation

First Phase

  • Formulate a student portfolio


Student portfolio matrix

Student Portfolio Matrix


Clinical proficiency preparation1

Clinical Proficiency Preparation

Second Phase

  • Formulate a matrix of the didactic courses in the athletic training program


Didactic course matrix

Didactic Course Matrix


Didactic course matrix1

Didactic Course Matrix


Clinical proficiency preparation2

Clinical Proficiency Preparation

Third Phase

  • Formulation of Clinical Hours Matrix


Clinical hours matrix

Clinical Hours Matrix


Clinical proficiency preparation3

Clinical Proficiency Preparation

Fourth Phase

  • Clinical Proficiency Matrix


Clinical proficiency matrix

Clinical Proficiency Matrix


Clinical proficiency matrix1

Clinical Proficiency Matrix


Clinical proficiency matrix2

Clinical Proficiency Matrix


Clinical proficiencies

Clinical Proficiencies

  • Individual skills

  • Subset skills taught together


Lower extremity clinical proficiency

Individual Subset Skills:

Pelvic obliquity

Tibial torsion

Hip anteversion and retroversion

Genu valgum,varum, and recurvatum

Rearfoot valgus and varus

Forefoot valgus and varus

Pes cavus and planus

Foot and toe posture

Grouped Subset Skills:

Lower Extremity Postural Deviations and Predisposing Conditions

Lower Extremity Clinical Proficiency


Athletic training clinical proficiencies

Good Posture Part Faulty Posture I NI

l. Legs are straight up and down.

Knees and legs

1. Knees touch when feet are apart (genu valgum)

2. Patellae face straight ahead when feet are in good position

2. Knees are apart when feet touch (genu varum)

3. Looking from the side the knees are straight (i.e. neither bent forward nor “locked” backward)

3. Knee curves slightly backward (hyperextension knee or genu recurvatum)

4. Knee bends slightly forward or not as straight as it should be

(flexed knee)

5. Patellae facing slightly toward each other (medial rotated femurs and/or snake eyes)

6. Patellae facing slightly outward (lateral rotated femurs and/or frog eyes)

l. In standing, the longitudinal arch has the shape of a half dome

Feet

l. Low medial longitudinal arch or flatfoot (pes planus)

2. Barefoot or in shoes without heels, the feet toe-out slightly

2. High medial longitudinal arch (pes cavus)

3. In shoes with heels, the feet are parallel

3. Weight borne on the inner side of the foot making ankle roll in (pronation)


Athletic training clinical proficiencies

4. In walking the feet are parallel and the weight is transferred from the heel along the outer border to the ball of the foot

4. Weight borne on the outer border of the foot or the ankle rolls out (supination)

5. In running, the feet are parallel or toe-in slightly. The weight is on the balls of the feet and toes because the heels do not come in contact with the ground

5. Toeing-out while walking or standing (forefoot valgus, outflared or slue-footed)

6. Toeing-in while walking or standing ( forefoot varus or pigeon-toed)

7. Posterior calcaneus rolls inward ( rearfoot valgus)

8. Posterior calcaneus rolls outward (rearfoot varus)

1. Toes should be straight, neither curled downward nor bent upward

Toes

l. Toes bend up at the first joint and down at middle and end joints so that the weight rest on the tips of the toes (hammer toes)

2. Toes should extend forward in line with the foot and not be squeezed together or overlap

2. Big toe slants inward toward the midline of the foot (hallus valgus)

3. Second toe longer than 1st toe (morton foot)


Athletic training clinical proficiencies

  • Pelvic Obliquity

  • Purpose: To identify abnormal pelvic alignment that can lead to leg length discrepancies.

  • Proper Identification Procedures for Pelvic Obliquity:

  • The ACI will observe the student athletic trainer performing a pelvic obliquity check.

  • Patient should be bare foot with the knees fully extended and the feet together.

    The ASIS and iliac crest should be exposed for viewing

    Ask the athlete to stand facing away from the examiner

    Examiner places a finger or two of each hand on each of the athlete’s iliac crests and imagines a line drawnbetween the two crest

    Pelvic obliquity is present when this imaginary line is not parallel to the floor

    Leg length discrepancies should be investigated at this point

    Completed Pelvic Obliquity Observation Pass Fail


    Athletic training clinical proficiencies

    • Hip Anteversion and Retroversion

    • Purpose: To identify abnormal rotational malalignments of the femur in relation to the femoral neck.

    • Proper Testing for Femoral Rotation The ACI will observe the student athletic trainer performing observational and orthopedic testing of the hip for anteversion and retroversion.

    • P NP

    The athlete should be viewed from the front with the knees facing forward. The examiner should observe abnormal toeing in or toeing out of the feet. An athlete with increased femoral anteversion tends to stand with the limb in an internally rotated position, producing in- toeing. While the athlete with decreased femoral anteversion or femoral retroversion tend to stand with the limb in an externally rotated position, producing out-toeing.

    Next, perform a Craig’s Test to estimate the amount of femoral anteversion present. The athlete is placed prone with the ipsilateral knee flexed to 90 degrees.

    The examiner palpates the lateral prominence of the greater trochanter with one hand while controlling the rotation of the limb with the other.

    An imaginary vertical line serves ad the reference for this test. The limb is then rotated until the lateral prominence of the greater trochanter is felt to be maximal.

    The angle made between the axis of the tibia an the vertical is considered an approximation of the femoral anteversion. Normal anteversion is between 8 degrees and 15 degrees.

    Completed Testing for Anteversion and Retroverson Pass Fail


    Important aspects of proficiency delineation

    Important Aspects of Proficiency Delineation

    l. The process is descriptive and not prescriptive

    2. Assignment of importance of each subset in the delineation


    Important aspects of proficiency delineation1

    Important Aspects of Proficiency Delineation

    3. Assignment of Successful Mastery of Clinical Skill

    • % of Mastery needed to pass

    • Particular subsets that must be completed

    • # of times a student can attempt test

    • Should students be allowed to progress to next level if he/she doesn’t successfully complete proficiencies at one level


    Athletic training clinical proficiencies

    Integrating Components

    INTEGRATED COMPONENTS


    Integrating competency based clinical education

    INTEGRATING COMPETENCY BASED CLINICAL EDUCATION

    • Competency based clinical education is a group effort

    • Don’t want student to become check off artist


    Athletic training clinical proficiencies

    Team Teaching

    The coordinated and cooperative planning, teaching, supervision, and evaluation of a group of learners by 2 or more instructors, each having special competencies and knowledge in a specialized area.


    Athletic training clinical proficiencies

    Success of Team

    Teaching Depends on

    • Instructors working in cooperation and communicate as allies

    • Everyone involved is responsible for developing the objectives, instructional methodologies and evaluation

    • Multiple instructors can evaluate clinical competencies with high degree of consistency


    Integrating competency based clinical education1

    INTEGRATING COMPETENCY BASED CLINICAL EDUCATION

    • Competency based clinical education is a group effort

    • Don’t want student to become check off artist

    • Student’s need to be able to THINK-IN-ACTION


    Athletic training clinical proficiencies

    Students need to learn to

    THINK -IN-ACTION

    &

    REASON-IN TRANSITION


    Athletic training clinical proficiencies

    LINKAGE OF EVALUATING SKILLS

    Real World

    Setting

    CLINICAL

    Setting


    Athletic training clinical proficiencies

    Experiential learning does not occur without active participation

    It requires:

    Engagement in the situation


    Athletic training clinical proficiencies

    Problem Solving

    Integrative Evaluation Tools

    • NARRATIVES

    • ALGORITHM


    Athletic training clinical proficiencies

    Algorithm Evaluation

    Blueprint or diagrams that lead a student through a step by step process of how to perform a certain set of tasks in an organized fashion taking into account that the procedure will change or take a different path based on the finding at any giving point


    Integrating competency based clinical education2

    INTEGRATING COMPETENCY BASED CLINICAL EDUCATION

    • Don’t want student to become check off artist

    • Student’s need to be able to THINK-IN-ACTION

    • Emphasizing linking process and content


    Athletic training clinical proficiencies

    LINKING PROCESS AND CONTENT

    CONTENT

    PROCESS


    Integrating competency based clinical education3

    INTEGRATING COMPETENCY BASED CLINICAL EDUCATION

    • Don’t want student to become check off artist

    • Student’s need to be able to THINK-IN-ACTION

    • Emphasizing linking process and content

    • Individualization is very important in competency based programs


    Individualization

    INDIVIDUALIZATION

    Individual

    Abilities

    +

    =

    CLINICAL

    COMPONENT

    Learning Styles


    Athletic training clinical proficiencies

    Individualization

    Allows each student to go through the integrative process:

    • At his/her own content level

    • Pace the learning at their own rate of speed.


    Athletic training clinical proficiencies

    The Sculpturing of a Professional


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