Keywords
Association for Athletic Training Education 2025 Symposium
Abstract
Introduction: Dislocations are common injuries managed by athletic trainers, yet athletic training students are unlikely to practice reduction techniques during clinical experiences. Current standards set by the Commission on Accreditation of Athletic Training Education require accredited programs to prepare students to manage patients with dislocations, including joint reductions. Research indicates the use of simulation techniques, such as joint reduction simulators, in education can fill clinical experience gaps and improve student confidence and skills. Shoulder dislocations make up nearly 50% of dislocations with several reduction techniques identified in the current literature. The use of a joint reduction simulator may provide athletic training students a safe opportunity to become familiar with and practice common shoulder reduction techniques. The purpose of this study was to determine whether practicing shoulder reduction techniques on a joint reduction simulator increased athletic training students’ confidence in recognition, knowledge of, and skills to manage shoulder dislocations. Methods: In this cross-sectional design, 23 participants (age = 23.91 ± 4.68 years) enrolled in three accredited professional athletic training programs participated in an in-person lecture and simulation lab and completed pre-test and post-test online surveys. The pre-test survey consisted of demographic questions and Likert-style questions from a previously validated instrument modified for this study. The instrument included 16 questions (4-point scale) to assess participant confidence using three subscales: 1) confidence to recognize, 2) confidence in knowledge and 3) confidence in skills to manage shoulder dislocations. The lecture and simulation lab included a review of anatomy and emergency management for shoulder dislocations, and demonstration of three reduction techniques using the Dislotech™ (Charlottesville, VA) shoulder joint reduction trainer. Participants practiced each technique using the joint reduction trainer . All participants completed a post-test survey with the same 16 Likert-style questions and answered three additional questions about effectiveness and preferred technique. Cronbach’s alpha was used to assess the reliability of the online survey. Descriptive statistics were used to summarize demographic data. Wilcoxon Signed-Rank Tests were used to compare pre-test and post-test survey scores to identify changes in student confidence levels. Data were analyzed using R software (version 4.0.2, R Foundation for Statistical Computing). A-priori significance level was set at p < 0.05. Results: The online survey was found to be internally consistent (16 items; α= 0.76). Most participants had never observed a shoulder reduction (70%, n = 16) or performed a shoulder reduction technique (78%, n = 18) prior to this study. Results demonstrated a significant increase in all individual survey items (Table 1). There was a significant increase in the subscale scores in confidence to recognize a shoulder dislocation (z = -2.15; p < 0.05; r = 0.90). No significant findings were identified on confidence in knowledge (z = -1.90; p = 0.06) and confidence in skills (z = -1.86; p = 0.06) subscales. Translation to Practice: Our results indicate students may have limited exposure to observe or perform shoulder reduction techniques during their training, yet students need to be adequately prepared to recognize and manage dislocations. Simulation can bridge clinical education gaps by offering a safe and effective way for students to practice these important and clinically relevant skills as future athletic trainers. While students gained confidence in recognizing shoulder dislocations in this study, more research is necessary to determine overall effectiveness of joint reduction simulators on students’ confidence in knowledge and skill in managing shoulder dislocations. While the survey instrument demonstrated acceptable reliability, future studies may consider using more distinct questions within each subscale to enhance construct validity. This study is useful for educators, as it highlights positive trends for improving students’ confidence in reducing a dislocated shoulder via simulation. Future research could involve a larger sample size and a more robust assessment instrument to determine confidence improvements.
Recommended Citation
Franklin, T and Hacherl, S
(2025)
"The Effects of a Joint Reduction Trainer on Confidence Levels in Professional Athletic Training Students,"
Clinical Practice in Athletic Training: Vol. 8:
Iss.
1, Article 3.
Available at:
https://scholars.indianastate.edu/clinat/vol8/iss1/3
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