Trust is important in a relationship between patient and healthcare provider. This is especially true with athletic training because it is very possible that the only time you are officially meeting someone is at the lowest point of a patient’s career. Gaining the trust between your population is important because if they trust you they are more likely to be corporative and attentive which can lead to better outcomes for the patient. Trust important in patient outcomes because it make the patient engaged. If there is no trust, then the patient may decide to not come for therapy appointments. This could lead to some serious deficits in the patient and they will never fully recover. Creating trust and keeping rehabs interesting, fresh, and new are essential to keeping patients engaged and aware so they can make a full recovery from their injury. Some of the easiest ways I believe you can gain trust with you patient is having knowledge on things that the age group of the population is into. Taking interest in them as a person and the hobbies they like will open them up to conversations which will gain their trust. If possible, having a meeting where you can introduce yourself and describe your role in the facility or for the population could help the patient population understand you more and make them more likely to report their own injury to you rather than having a coach or employer mandate them to come see you. Another way I think an athletic trainer can build trust in their patients is by giving a through explanation of what happened to them, how what you are doing works, and how you will help their injury. I believe this can calm a lot of their fear and answer a lot of questions which will help the patient trust you and know they are in good care. Overall, a good patient relationship is stemmed from trust and there are ways to improve the trust to have successful outcomes.
I will sit for my Board of Certification exam in March. So far, I have taken 3 practice exams. In preparation for them I have been looking over my textbooks which heavily look over rehabilitation and therapeutic progressions. I also plan to look over some specifics of emergency care and modalities. I feel once I am up to par on these areas of the practice I will be very ready for the Board of Certification exam. On my first practice exam I did pretty well. I scored an overall score of 73.44. I did well on all domains except for domain 4. There I scored a 59.57 and I knew I would have to work hard to improve my score in this area. Since my first practice exam I have improved my score to a 63.5 and most recently a 77.14. I plan to continue my improvement because I am aware some tests do not emphasis domain 4 as heavily. I know I still have a good way to go to be the best I can for the exam. While domain 4 is my weakness, I have a strength in domain 3 and I do fairly solid in domain 1 and domain 5. I plan to review a few items of budgeting and items pertinent to domain 1 to strengthen these areas further. My overall score on my most recent exam was a 79.4 which I was super excited about. It made me feel more confident than I have with my other two exams. While I definitely have some areas to work on, I feel confident that I will pass the Board of Certification exam.
My final year semester in the athletic training program feels strange. I am going to miss my preceptors, professors and peers. At the same time, I am excited and anxious to put to use what I have been studying and practicing. My final semester I do not have very many Athletic Training courses: only Research & Design and Clinical. Another class I am taking that will still be relevant to athletic training is Abnormal Psychology. I am going to focus most of my attention on these courses to get the most out of them and top off my undergraduate Athletic Training knowledge to the best of my ability. In the clinic, I am mostly focusing on being confident with my decisions and trying to smooth out my processes. I want athletes feel more confident in my ability so they feel comfortable and satisfied with the care they are getting. This semester my goals are: I will prepare for the Bard of Certification exam by doing 5 questions from a Board of Certification prep book a day; I will improve my Board of Certification therapeutic interventions score by reviewing therapeutic interventions and appropriate progressions weekly with my preceptor; in addition to being fully responsible for at least one patient's entire rehab; I will improve the quality and technique of my evaluation skills by doing or simulating at least one evaluation every time I am in the clinic. If I can stick to these goal and improve my weaknesses before I graduate I will feel very confident in entering the profession and practicing in a new setting. Accomplishing these goals will also set me up to achieve my long term goals such as passing my Board of Certification Exam, getting into the grad school of my choice, and being hired as a Certified Athletic Trainer. In my last semester I am focusing hard to strengthen my weakness. I also want to have fun and enjoy my last semester with my friends and celebrate us all in the end when we have achieved are goals, and are on the path of life long success.
This semester was a really tough on for me in many aspects. I had a rough time with my health, my friends, and my academics. This is just another example of me persevering and pushing through a difficult time in order to make my number one priorities happen. My primary purpose is to get my education and become a certified athletic trainer. This semester I felt like my classes were all okay, but physiology was a bit harder than I expected it to be, and I had a large amount of stress from my connections class due to the amount of reading required for it. In terms of athletic training, I felt like I did okay, but nothing exceptional. I think this was due to the environment created by my preceptor. I had a lot of high hopes coming into this semester especially after my internship. I felt like I was ready to go and work on my own. Unfortunately, that is not a reality yet, and I have to work under someone and get their approval. The feedback I got from my preceptor was that I need to be more confident in my evaluations. I think this is a fair critique for me. I think I sometimes showed a lack of confidence, but this was because I wanted my preceptor to approve it before I go onto the next step. I only do this because I thought that is what my preceptor wanted me to do, but not I am not so sure. I felt like I had a lot of missed opportunities this semester. While I had some good time at the rugby matches, I did not get as much experience in the clinic as I wanted. In terms of my goals I set out this semester, I did not reach most of them. I wanted to improve my rehabilitation skills by having a few athletes of my own that I would be solely in charge, yet still under supervision of my preceptor. I did not get this opportunity. Going into the spring I am going to push my challenges of this semester behind me. I have a lot to look forward to and some great achievements to be made. I am planning to put in a lot of effort to refine my skills. I know I will be able to get more rehabilitation opportunities as well so I look forward to getting better at making effective and original rehabs for my athletes.
This week I was able to do my clinical hours under a different preceptor because my primary preceptor does not have many hours right now. Instead, I was able to clinically experience with the athletic trainer who is over the men’s and women’s swim team and baseball. This was nice because I have not had many rehab hours this semester, and she gets a lot of baseball rehabs with a good amount for swim pre-treatments. I was able to see a baseball player on Wednesday and make his rehab for Friday which I got to work with him again. He is working on strengthening his posterior muscle to correct his posture and help his pitching. It is also suspected that he may have a small SLAP tear and the athletic trainer is taking precautions with that as well. The rehab I made consisted of a warm up on the upper body ergometer followed by some stretching. Then I had him do sky punches, gunslingers, banded ABC’s and perturbations. I really enjoyed getting to work on this rehab. The patient is really easy going and works hard on his rehab. This was also good timing because I was finishing up a project to calculate how much revenue I could generate over two weeks. I was happy to have more patient contacts this week then I have had most of the semester. I feel like it gives me a closer representation on my worth-value study than if I were to only have a few patient contact for the whole two weeks. While the shoulder is not my favorite to evaluate, I really enjoy doing rehabs. It’s very different from the ankle or hip which have been my primary rehabs that I have been a part of. If I had to choose my favorite part of the body to eval and rehab I think I would go with the ankle and wrist. These are just two areas that the anatomy makes more sense in my head so it is easier to find what is wrong and how to fix it.
Of the five domains of athletic training I feel that domain three and domain one are my strengths and domain four is my weakness. Domain one is prevention of injuries and domain three is immediate emergency care. I believe I do well in these two domains because I have always been interested and engaged in these topics of health care even when I was in middle school. I believe I just have a natural ability to learn these skills and have them stick. In my mind I almost prioritize these domains because I can practice and come up with rehabs as long as I want, but I do not have time to research the best way to handle an emergency situation. Something I believe helps me in domain one and three is that it is almost common sense and I have to make it a force of habit.
Domain four is about therapeutic rehabilitation. I would not say I am terrible at rehabs, but I do struggle with coming up with exercises. I know in my head what needs to be fixed, but coming up with new and interesting exercises and progressing them at the right time is something I struggle with. That is why this semester I made it my goal to be engaged with a few rehabs and be in control of them, but it seems there was a lack of athletes with long term injuries that I was able to interact with. Maybe I should have been more proactive and asked to be involved with another preceptor’s athlete. Another one of my goals that I geared to helping this domain is practicing manual muscle testing. I think it is important to be able to isolate specific muscles in order to strengthen them. I think my rehab skills will become more developed overtime. I think what I struggle with the most is that I never want the athlete to feel bored or disinterested so I try to come up with exercises that are new, but I do not necessarily know what else to do. In terms of other parts of therapeutic rehab, I believe my knowledge in modalities is very sufficient and my technique in manual therapy is fairly strong. So I do not think I am a lost cause in domain 4, but I need more hands on opportunities to have my own rehabs and be in charge of them from the time of injury all the way through full recovery when possible.
My favorite part of clinical this semester has been doing clinical experience with the rugby team and educating the players on what we do as athletic trainers and how we are supposed to be there to support them as a team. It has been very interesting to watch them go from being a small group of guys who have never had an athletic trainer before or even knew what we were to being able to have two full teams to practice with and having players from other sports who know what an athletic trainer is and how we are here to help them. My preceptor and I have played a large role in teaching the rugby team the culture we as athletic trainers have. Over the course of the semester we have taught the team the essentials of prevention for their sport. It was extremely stressful for the first rugby game when there was a huge miscommunication. We got out to the field and the whole team walked up to me and the head athletic trainer to be taped and braced, mean while we had been sitting in the athletic training clinic for 2 hours before their game waiting for them to come in to tape them. After this first game we were able to better communicate to the team that we are in the clinic before their games and practices to prepare them for their activity. It had to be heavily enforced that they would be able to receive more and better care if they were to come in beforehand as well. While it took a few weeks for the players to truly understand what we were trying to convey to them, they now have the understanding and many of them will come into the athletic training clinic before and occasionally after practice and games for treatments. This has been special for me because it gave me many opportunities to promote the profession, talk to coaches, and practice being a professional. This also gives me more opportunities reach my clinical goals. There has not been anyone with chronic injuries in rugby for me to have any as a long term patience and be in charge of their rehab, but as more of them become understanding and reliant on our service I am positive there will be someone who will be a more chronic case for me to work on and build my experience with.
As a senior athletic training student it is important to demonstrate professionalism. This prepare me for when I am in the work force. A way I demonstrate professionalism is by acting as a responsible student and acting as a rational person in the athletic training clinic. I believe it is important to treat my clinical hours and my school work as my job. While I know it is always different transitioning from school to clinical practice in the work force, I believe me treating school as a job prepares me to be better and have a smoother transition. It teaches me to have discipline and work the long hours needed to be an athletic trainer. Another way I model professionalism is by always speaking positively of athletic training. Athletic training is what I want my career and future to be. Being able to understanding athletic training to the fullest potential and speaking positively of the profession is a good way to show respect for the career. I also highly advocate for athletic training by telling everyone what athletic training is able to do, if they should see an athletic trainer if they are injured, and encouraging others too look for a career in athletic training.
I have been a mentor for younger students in the past. Here I showed them the ropes of the program and helped in the clinic and in the classroom as needed. The most recent thing I do as a role model and resource for other students is being a supplemental instructor for the applied anatomy and kinesiology class. I highly excelled in this class so it makes sense that I am able to help other in this more difficult class. I have found that I am a good teacher. I am able to explain concepts in many different ways for people to understand and I can often come up with tricks to remember ideas better. I am also able to adapt to many people’s different learning styles. I believe being a supplemental instructor gives me the ability to reach out to more students and show and example of what a good athletic training student should be like. It also gives me an opportunity to find the future of athletic training and hopefully set them up on a path for success.
This semester my most challenging class is physiology. I was really excited for this class at the beginning of the year and I still am really enjoying it, but dang is it hard. I think what is so difficult about it is that everything is on a microscopic and chemical level and my brain functions more on the big picture cause and effect level. I have been doing well with class participation and I feel like when Dr. Fleet is lecturing I understand, but when I come to taking a test, the end results have not been so great. I think some of this might be because of my study techniques. Usually, my method works for other classes but it has not been for this class. My typical study technique is to look at my notes and review alongside a textbook. This did not work too great for the first test so the second test I tried to review my notes and fill in a study guided, I also increased my amount of time I study for this test and increased when I started studying for it. This test grade was lower than my first one. The way I have been coping with this class is by talking with Dr. Fleet and identifying strengths and weaknesses before I take the test. I also look over what went wrong after the test. I have another study method that I am going to try for our last test coming up. After we finish a chapter in class I will read my text book and my notes over again and work on the study guided as we cover it in class. Then after we finish the chapter I will go in and meet with Dr. Fleet to make sure I am understanding things the way I will need for the test. There is another project in the class that I know is going to help my grade a lot so I am not super worried. However, in order to get the grade I really want in this class, I am going to have to do better on our final test. I am hopeful that my new strategy will be beneficial.
My clinical question is in endurance athletes what is the most effective program to prevent medial tibial stress syndrome?
I decided I wanted to pursue this question after my internship experience with DCI. Many injuries and pain the performers had were due to medial tibial stress syndrome and a few of these injuries progressed to injuries more strenuous such as stress fractures. Among 150 members, each day I saw on average 40 members with complaints of lower extremity pain. The main complaints of the members were calf pain and shin splints, arch issues, iliotibial friction syndrome, and hip flexor tightness. My clinical placement this semester is with cross country and cheer and dance. Both of these sports are also more likely to have lower extremity injuries and for cross country it is very likely that at some point in their lives they have experienced shin splints. I believe this research will result in a beneficial strategy for these groups of athletes to prevent lower extremity injury. My ultimate goal with this is to come up with a prevention program that I can suggest to other DCI medical staff and athletic trainers to help prevent lower extremity injuries such as medial tibial stress syndrome.
My investigation committee is Beth Funkhouser, ATC, Joe Lynch, ATC, and Mike Caro, CSCS. I chose these people to be a part of my committee because they are all heavily involved in literature and I know they will be beneficial when it comes to finding evidence and journals. I specifically chose Mike Caro as my content expert because he is highly competent in creating prevention programs himself so he must have evidence to support his practice.
I am excited to work on this PIO question and to ultimately turn it around into something beneficial for clinical practices.
Often times when students are in the clinic there may be times where a preceptor does something one way and it will be completely different from what the student has read in a textbook or has experience with other preceptors or clinicians in the past. I think when this happens it is important to not freak out and automatically assume what they are doing is wrong. A way I like to approach this difference is by asking the preceptor or clinician how they found this technique and what resources they have used. This to me is a good way to learn a new technique or skill. However, they are times where I find myself seriously questioning if what the preceptor is doing is truly effective or achieving the goal they have explained. In this case I would go and ask another preceptor if they can explain it to me. As a student I would never want to over step a preceptor’s way of practice, but If I found something they are doing wrong after looking into everything by text and by other clinicians then I might ask about the technique described in the text. Preceptors are people too and they make mistakes. I wouldn’t want to embarrass anyone. I believe if I just ask about what the texts say and they are actually doing something wrong this would make the preceptor go back into their textbooks and references and hopefully he or she would make the correction. Most importantly to me as a student I wouldn’t want to offend and over criticize the way someone practices. If at the end of the day someone will not change and they are truly wrong, then you just have to ignore it to the best of your ability and cover yourself in case something bad were to occur and there is a legal pursuit.
This weekend I had a really exciting time during the rugby match verses Radford University. This was my first time getting to watch a rugby match so it was interesting to see how plays and tackles actually happen compared to how it happens during practice. One thing that I found interesting was that as an athletic trainer I was able to run out onto the field while the game was still in play. This is different than any other sport. With this rule it made it important to do a scene safety evaluation before running out onto the field. The first injury of the game was definitely the most exciting. There were two Radford guys going in for a tackle on one of our player who pulled a spin move and got out of the way. The two Radford guys smacked faces and immediately fell to the ground. It was scary because one guy wasn’t moving at all and the other was just barely moving. At first it definitely seemed like a cervical spine injury. Upon inspection there was blood everywhere. The certified athletic trainer and I went to the guy who wasn’t moving at all. Once I saw that he was verbal and moving and the certified was handling him I went to the other guy. I saw that he had bit through his lip and I put my gloves on. As I was pulling gauze out of my kit to apply, the player was screaming at the other guy saying, “shake it off man, we need to get back into this game” and tried to run off. I had to be very firm and tell him to come back and that he wasn’t going to play anymore. It was evident that he needed stitches. The other player who wasn’t moving finally was stable enough to walk off the field. I was instructed to call 911 once I got to the sideline because we hadn’t been able to control the bleed from his two-and-a-half-inch laceration on his forehead. I gave the operator my location and stated the issue, but just as I did it the player’s parents came and were able to take him to the emergency room. Before they left we were able to control the bleed. It stopped because once he sat up blood flow from his face was lower. We sent both players to the emergency room for stitches. The rest of the game was just ankle sprains and cramps. I got to run out onto the field 5 or 6 times. It was exhilarating. I really enjoy the level of intensity of this game. This experience allowed me to see something I wouldn’t typically in any other sports. It also required me to act quickly which tested my ability to manage injuries under pressure. This weekend inspired me to want to work with sports similar as a career such as hockey, wrestling, or boxing.
At this moment, my plans for after graduation are either to go to grad school or go find a job. I still need to add schools to my list to apply for, but I really want to go to University of North Carolina. I have read about their post graduate program and it seems like a program I really want to be a part of. Some things I want to do in the near future is get a campus tour of Chapel Hill and have a conversation with the program director. In addition to University of North Carolina I am looking into Pennsylvania State University and Possibly at University of Tennessee. I need to do more research on post graduate programs in areas that I would like to be. So far these three schools are the only ones I am considering. I have looked at requirements for these grad schools and I meet the criteria for most of them, with the exception of a GRE score. Something I am doing right now to prepare me for grad school is that I am trying to boost my GPA. Right now I have a 3.550 which is good, but when I start applying I would like to have a 3.6 or higher overall GPA. I don’t think GPA is a large determining factor, but if I can get it higher then this would be one more benefit to my application.
My other plan is to go find a job after graduation. This would be the case if I do not go to one of those graduate schools for whatever reason. I would prefer to work in a college or high school setting. I would also like to stay within Kentucky, Virginia, North Carolina and Tennessee. Over the summer I got to travel A LOT of the united states; Through living in and around these areas long enough I have come to find these are just places I enjoy and find comfort in.
Essentially, I will be applying for a few schools and probably double the amount for jobs. I think this will give me a good variety of options so when it comes time to decided what I do after graduating from Emory & Henry I know I will have given myself as many open doors as possible.
In addition to responding to my prompt, this week I had some clinical excitement. This weekend I have been traveling with my golf team. We are at the Bridgewater Invitational. I had just finished a hole when my coach pulls up and asks me to look at one of my teammates hands. He explains she had hit hard behind the ball and she felt her hand pop and they had been icing it. My immediate thought was that she had probably just slightly strained her wrist. Once I finally saw her and looked at her hand I knew it was much worse. I didn’t have enough time to do a thorough eval, but could visibly see a lump on the top of her hand. I manual muscle tested her flexor digitorum which was 1/5. I also took her fingers through passive range of motion, both flexion and extension were 10/10 painful. In my short eval I could only determine she had strained it. I instructed my coach to contact the hosting team’s coach to call the Bridgewater AT to the course. I was surprised because they were able to get an AT to her pretty quickly. She ended up going to an urgent care where they did imaging and determined she tore her flexor retinaculum. Although I am sad my teammate is injured, I’m proud she was able to push through her pain and finish her round. I am also happy I was able to be a part of a first response to an injury at the golf tournament. Although I wasn’t able to do much, I was able to relay enough information to get my teammate the necessary help she needed.
This semester my clinical goals are: I want to get better at therapeutic interventions by being responsible for 3 different rehabs this semester; I want to prepare for the BOC by doing 10 questions from a BOC prep book in my 2 weakest domains when I am in the clinic; I want to remember special test and MMT better by reviewing 5 every time I am in the clinic. So far I have had the most progress with my second goal, I want to prepare for the BOC by doing 10 questions from a BOC prep book in my 2 weakest domains when I am in the clinic. My preceptor, Joe Lynch, has been very helpful in ensuring I accomplish this goal. Every time I am in the clinic I do ten questions and the next time I am in the clinic we review them and do another 10. I think this will help me because researcher shows that having to think about material I have not thought about in a while will actually make me learn it better. My two weakest domains from the practice Board of Certification exam I took were Domain IV, Treatment and Rehabilitation, and V, Organization and Professional Health and Well-Being. Considering I am just now taking the class which covers domain V and I scored 73% correct, I am not too worried about this domain. I really need to review and recover domain IV. This is an important domain not only because it is a large portion of the exam, but it is things I need to know well in order to be a good athletic trainer. My other two goals need to be worked on more. There are a couple athletes I am able to work on often, but I feel like it is not as often as I would like. This just depends on my and the athlete’s schedule. The 2 patients I would like to work with the most are cross country runners. One is a female who had an ACL surgery in high school who complains of tightness throughout her lower chain. Upon inspection, she lacks terminal extension in her surgery leg 3 years post-surgery. So far we have been working on flexibility and activating her VMO to reeducate it to fully extend her leg. This is a patient I have had the most contact with, but often times schedule conflicts happen. Another athlete I would like to work with just is never in the clinic when I can be there. He is experiencing Over training syndrome. I would like to see how this is affecting him and be a part of the rehab process. This is something have never truly dealt with so I think it would be interesting to be a part of. My final goal I just have not got to yet. I think when I run out of questions in the one BOC book I am working on now I will ask Joe to start helping me with this goal. With this goal, I think I just need to be drilled and work hard on not only memorizing the test and how to do them but, really ingraining the important tests into my head so I know which test will be more helpful than not during an evaluation. Overall, I think I am making good early progress on my goals. These are definitely achievable and reasonable things I will accomplish over this semester.
This week included my final preseason as an un-certified athletic trainer. This pre-season was very different for me compared to any other preseason before. This year I came a week late because I was still traveling with DCI’s Oregon Crusaders as they concluded their season. While everyone here was learning advanced techniques and helping out with football, I was keeping 150 band members healthy as they finished their last 3 shows of the year. While I definitely was making good connections and gaining good experience, there was still a part of me that missed being at Emory & Henry for pre-season. It was always super fun to come back and go over emergency techniques. It’s a good time to see how you have improved on those techniques and compare to the previous pre-season.
As a senior I feel very different compared to any year before. Having my summer experience with DCI has taught me so much on how to create good connections with my athletes, how to think quickly to resolve an issue, and most importantly to be confidence in my evaluations and not rely on my preceptor to double check me on everything I do. Not having to be scared of being wrong and having a preceptor correct and check me on everything is liberating. I feel very confident in my skills and my techniques. Of course I still need to learn finesse in some areas, but now after having my experience with DCI I feel confident and excited for my future as an athletic trainer.
I don’t believe three years ago I could have ever predicted how well I would be doing or feeling about being an athletic training student as I do now. My growth as an athletic training student has definitely influenced my interactions with my patients and preceptors. I have many athletes who choose to come to me for specific things because they trust me or they like the way I do something. I also have athletes recognize my good work and my frequency in the clinic. This makes me happy to know I can make an effect on people in a positive way to where they want to come be treated and tell their teammates to come to the clinic as well. As for preceptors, I feel like I have earned a good level of respect. At times it feels almost like the preceptors are my co-workers. They know I am a dependable student and if they need me to help them, I will be there and if I ever need help from them I know I can count on any preceptor to help me.
I am excited to begin this semester and refine my skills as an athletic trainer.
This is where I do my weekly clinical blog assignment. There is either a prompt I am responding to, or I just talk about something exciting I saw during the week.