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Keywords

Clinical Practice in Athletic Training

Abstract

Context: Transitioning from didactic to clinical education is overwhelming for novice athletic training students. The change in the learning environment often causes anxiousness as students get acquainted with the clinical site, preceptor expectations, and demonstrating clinical skills during patient care. Learning to communicate provides additional challenges as students must convey information to their patients, practice active listening, relay patient information to their preceptor, and possibly navigate conflict management. Simulation-based orientations have been effective in other healthcare professions to ease this transition; however, it has not been examined in professional athletic training students. Methods: The study used a convenience sample of 17 first-year athletic training students (3 men, 14 women, age=22.59±0.99) enrolled in a CAATE-accredited professional master’s program. Students had completed one didactic semester in the program and were preparing to transition to clinical education. A two-day simulated-based orientation was completed prior to beginning their first clinical education experience. Orientation was designed to introduce the role of clinical education, define student roles and responsibilities, examine how to navigate clinical learning, review policies and procedures, review clinical skills, and practice effective communication. The orientation delivery framework included lectures, facilitated discussion, clinical skill practice, 3 standardized patient (SP) encounters, and two facilitated debrief sessions (one debrief immediately following the orientation and a second debrief two weeks after orientation). A 15 item pre- and post-orientation communication confidence survey was completed. Eight questions evaluated confidence communicating with a preceptor, seven questions evaluated confidence communicating with patients. Descriptive statistics were calculated for all survey items. Paired samples t-tests were used to compare pre- and post-orientation communication confidence ratings. Alpha levels were set at 0.05. A semi-structured debrief guide was stimulated self-reflection during the two debriefs. Qualitative analysis of respondents’ comments was completed using interpretive coding. Results: A paired sample t-test revealed that students’ confidence significantly improved in communicating with preceptors (t=3. 697, df=14, P < 0. 001) and communicating with patients (t= 2. 344, df=14, P<0. 017) after participating in simulation-based orientation. Three themes were established from debrief data, including (1) Improved Communication, (2) Improved Clinical Skills, and (3) Role Clarity. Participants expressed improved confidence to present patients to their preceptors and to perform evaluations. Orientation improved confidence in clinical skill application through skill review yet students described apprehension when new skills were presented. Students grew in their role clarity and felt more confident to ask questions and to express day-to-day concerns and preferences with their preceptors. Conclusions: A simulation-based orientation was effective at improving professional AT students’ communication skills. AT educators should focus on orientation strategies designed to prepare students for their transition from didactic to clinical education. Orientations that include simulations or standardized patients and facilitated debrief help ease the transition to clinical education.

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