tutorial

1. CLINICAL PRECEPTOR
TUTORIAL
Penn State
Athletic Training Education Program
Lauren C Kramer, PhD,
ATC
Program Director
John L Vairo, PhD, ATC
Clinical Education Coordinator

2. DEFINITIONS RELATED TO
ACCREDITATION AND CLINICAL
EDUCATION
Primer

3. National Athletic Trainers’
Association (NATA)
• Professional membership association of
athletic trainers (ATs) that acts in the
interest of its members
• Does not certify ATs
• Does not accredit athletic training
education programs (ATEPs)

4. Organizations Influencing Entry-
Level Athletic Training Education
• BOC
– Board of Certification
• CAATE
– Commission on Accreditation for Athletic
Training Education
• PEC
– Professional Education Committee

5. BOC
• Mission: To protect the public by
identifying competent athletic training
practitioners
• Devising credentialing examinations
• Monitoring of continuing education
standards for ATs

6. CAATE
• Oversees accreditation of education
programs in athletic training
• Establishes standards and guidelines for
entry-level ATEPs
–Standards: requirements
–Guidelines: examples for interpreting
the standards

7. PEC
• Acts as a "clearinghouse" for educational
policy, development and delivery for entry-
level, graduate, specialty and continuing
education.
• Establish competencies and proficiencies
that ATEPs must teach and assess.

8. CLINICAL PRECEPTOR
PRINCIPLES & CLINICAL
EDUCATION MODEL
Module 1

9. What is an ATEP
Clinical Preceptor?
• A clinical preceptor (CP) is a health care
professional who has completed CP the
corresponding tutorial administered by the ATEP.
• The CP is recognized by the CAATE as adjunct
faculty in the ATEP.

10. Penn State ATEP
Clinical Preceptor Tutorial Mission
• To provide CPs with an education-based model
and related strategies for interfacing with ATSs
while operating in a clinical context to be able to
successfully serve as effective instructors,
supervisors and mentors.

11. CAATE Clinical Preceptor
Qualifications
• Be credentialed in a medical or allied
health care profession
• Not be currently enrolled in the entry-level
ATEP at the institution
• Receive planned and ongoing education
form the ATEP deigned to promote a
constructive learning environment

12. CAATE Clinical Preceptor
Responsibilities
• Supervise ATSs during clinical education
• Provide instruction and assessment of the current
knowledge, skills and clinical abilities designated by
CAATE
• Provide instruction and opportunities for the ATS to
develop clinical integration proficiencies, communication
skills and clinical decision-making during actual
patient/client care
• Provide assessment of ATSs’ clinical integration
proficiencies, communication skills and clinical decision-
making during actual patient/client care
• Facilitate the clinical integration of skills, knowledge and
evidence regarding the practice of athletic training
• Demonstrate understanding of and compliance with the
ATEP’s policies and procedures

13. Deliberate Mentorship
• Intentionally demonstrate and describe complex
professional skills
• Seize opportunities for instruction through story-
telling; disclose salient personal experiences as a
means of teaching, reassuring and connecting
with the ATS
• Offer ATSs a model of coping, not a model of
mastery
• Confront self-defeating, unprofessional or career-
inhibiting student behavior
• Encourage innovative thought and creative
problem solving

14. Clinical Education Coordinator
• A faculty member within the ATEP
responsible for overseeing administrative
matters related to clinical education
such as:
• ATS clinical progression
• ATS evaluation
• Clinical site evaluation
• CP training
• CP evaluation

15. CAATE Clinical Education
Requirements
• Clinical education must follow a logical
progression that allows for increasing
amounts of clinically supervised responsibility
leading to autonomous practice upon
graduation.
• The clinical education plan must reinforce the
sequence of formal instruction of athletic
training knowledge, skills and clinical abilities,
including clinical decision-making.
– Clinical education is the planned clinical
integration of the knowledge, skills and abilities
taught and evaluated in the classroom.

16. CAATE Clinical Education
Requirements
• Clinical education must provide ATSs with
authentic, real-time opportunities to
practice and integrate athletic training
knowledge, skills and clinical abilities,
including decision-making and
professional behaviors required of the
profession in order to develop proficiency
as an AT.
– Clinical education is the real-world
development of the ATS.

17. CAATE Clinical Education
Requirements
• Clinical education must allow ATSs opportunities to
practice with different patient populations, care providers
and in various allied health care settings relative to the
ATEP’s mission statement.
• Clinical education assignments cannot discriminate
based on sex, ethnicity, religious affiliation or sexual
orientation.

18. CAATE Clinical Education
Requirements
• ATSs must gain clinical education experiences that address the
continuum of care that would prepare an ATS to function in a variety
of settings with patients engaged in a range of activities with
conditions described in athletic training knowledge, skills and clinical
abilities, the role delineation study and standards of practice
delineated for an AT in the profession.
• Examples of clinical experiences must include but should not be
limited to:
» Individual and team sports
» Sports requiring protective equipment (e.g., helmet and shoulder
pads)
» Patients of different sexes
» Non-sport patient populations (e.g., outpatient clinic, emergency
room, primary care office, industrial, performing arts, military)
» A variety of conditions other than orthopedics (e.g., primary care,
internal medicine, dermatology)

19. CAATE Clinical Education
Requirements
• All clinical education sites must be evaluated by the
ATEP on an annual and planned basis and the
evaluations must serve as part of the ATEP’s
comprehensive assessment plan.
• An AT certified by the BOC who currently possesses the
appropriate state athletic training practice credential
must supervise the majority of the ATS's clinical
coursework. The remaining clinical coursework may be
supervised by any appropriately state credentialed
medical or allied health care professional.

20. CAATE Clinical Education
Requirements
• ATSs must be officially enrolled in the ATEP prior to
performing skills on patients.
– ATSs must be instructed on athletic training clinical skills prior to
performing those skills on patients.
– All clinical education must be contained in individual courses
that are completed over a minimum of two academic years.
Clinical education may begin prior to or extend beyond the
institution’s academic calendar.
– Course credit must be consistent with institutional policy or
institutional practice.

21. CAATE Clinical Education
Requirements
• All clinical education experiences must be educational in
nature.
– The ATEP must have a written policy that delineates a
minimum/maximum requirement for clinical hours.
– ATSs must have a minimum of one day off in every seven-day
period.
– ATSs must not receive any monetary remuneration during this
education experience, excluding scholarships.
– ATSs will not replace professional athletic training staff or
medical personnel.

22. CAATE Clinical Education
Requirements
• The ATEP must include provision for supervised clinical
education with a CP.
– There must be regular communication between the ATEP and
CPs.
– The number of ATSs assigned to a CP in each clinical setting
must be of a ratio that is sufficient to ensure effective clinical
learning and safe patient care.
» A maximum ratio that has been suggested is 8:1.
– ATSs must be directly supervised by a CP during the delivery of
athletic training services. The CP must be physically present
and have the ability to intervene on behalf of the ATS and the
patient/client.

23. Penn State ATEP
Clinical Education Model
• Prepare ATSs to be critical thinkers through the process
of graded autonomy and progression of learning
experiences in the clinical setting.
• Provide formalized instruction and specific feedback to
ATSs during their clinical experiences through
management of real cases or through scenarios.
• Serve as a mentor (through advice and modeling) for
ATSs to prepare them for the practical aspects of the
profession of athletic training while emphasizing the
foundational behaviors of the profession.
• Encourage ATSs to become engaged learners by
requiring students to come prepared to their clinical sites
with specific goals (weekly, monthly or semester) and by
setting clear expectations for each ATS.

24. Penn State Clinical Education
Exposure Emphases
• Upper extremity intensive
• Lower extremity intensive
• Equipment intensive
• General medical
• Both genders
• Off campus/High school setting

25. Penn State ATEP Faculty
• Lauren C Kramer, PhD, ATC
– Instructor of Kinesiology & Program Director
• John L Vairo, PhD, ATC
– Instructor of Kinesiology & Clinical Education Coordinator;
– Co-Director, Sports Medicine Clinical Research Agenda
• WE Buckley, PhD, MBA, ATC
– Professor of Exercise & Sport Science and Health Education
• Sayers John Miller, PhD, PT, ATC
– Assistant Professor of Kinesiology
• Alison R Krajewski, MS, ATC
– Instructor of Kinesiology;
– UOC Clinical Coordinator;
– SCAHS Head AT

26. Entrance to Athletic Training Major
• Students identify an
interest in AT major
(wait list)
• Prerequisites
– KINES 202: Anatomy
– KINES 135: Intro to AT
– KINES 231: Clinical AT
Skills I
– KINES 233: Emergency
Care in AT
• Competitive admission
(Sophomore fall)
– Cumulative GPA > 2.5
– Prerequisite GPA > 3.0
– Feedback from clinical
preceptors
– Entrance interview
• Max of 36 students
admitted at the end of
each fall semester
– Usually 15-25

27. Sophomore Spring Semester
• KINES 232: Clinical Athletic Training Skills II
– Instructors: Kramer & Krajewski
• Basic rehabilitation & modality skills
• Limited AT clinical rotations
• KINES 334: Lower Extremity Physical Exam
– Instructor: Vairo

28. Junior Fall Semester
• KINES 395F: Practicum in Athletic Training
– Instructors: Kramer & TBD
• Seminar
• Athletic training clinical rotation
• Physical therapy clinic observation
• KINES 335: Upper Extremity Physical Exam
– Instructor: Vairo
• KINES 434: Lower Extremity Therapeutic Exercise
– Instructor: Miller

29. Junior Spring Semester
• KINES 395G: Practicum in Athletic Training
– Instructor: Buckley
• Seminar
• Athletic training clinical rotation
• Strength and conditioning observation
• KINES 336: General Medical Aspects in Athletic Training
– Instructor: TBD
• KINES 435: Upper Extremity Therapeutic Exercise
– Instructor: Miller
• KINES 436: Therapeutic Modalities in Athletic Training
– Instructor: Vairo

30. Senior Fall Semester
• KINES 395I: Practicum in Athletic Training
– Instructor: Buckley
• Seminar
• Athletic training clinical rotation
• General medical observation (orthopaedic surgery)
• KINES 438W: Administration and Issues in
Athletic Training
– Instructor: Buckley

31. Senior Spring Semester
• KINES 495F: Field Practicum in Athletic
Training
– Instructors: Kramer & TBD
• Seminar
• Athletic training clinical rotation
• General Medical Rotation (Primary Care/Allied
Health Care)

32. EDUCATIONAL
COMPETENCIES
Module 2

33. Competency and Competent
• Competent
– Properly or sufficiently qualified; capable
• Competency
– Competencies are knowledge and skills that
serve as instructional goals for a curriculum

34. Bases of the Athletic Training
Educational Competencies
• Provides ATEP personnel and others with the
knowledge, skills and clinical abilities to be mastered
by ATSs enrolled in related professional preparation
programs.
• Mastery of these competencies provides the entry-
level AT with the capacity to provide athletic training
services to clients and patients of varying ages,
lifestyles and needs.
• Serve as instructional goals that should be used to
structure the curriculum.
• Developed by the PEC of the NATA.

35. Association Between Educational
Competencies and Role Delineation Study
• Role Delineation Study
– Performed by the BOC as a means to define the
minimal knowledge, skills and behaviors
necessary for BOC certification as an AT.
• Educational competencies encompass the
Role Delineation Study but are broader and
more specific.
– Ensures the growth of our profession and
heightened abilities of future AT professionals.

36. What is the Structure of the
Educational Competencies?
• Competencies are categorized according to
eight content areas comprising the knowledge
and skill set of the entry-level AT.
• Additionally the competencies contain the
clinical integration proficiencies that are used to
structure the clinical component of an AT’s
athletic training education.

37. Content Areas
• Evidence-Based Practice
• Prevention and Health Promotion
• Clinical Examination and Diagnosis
• Acute Care of Injuries and Illnesses
• Therapeutic Interventions
• Psychosocial Strategies and Referral
• Healthcare Administration
• Professional Development and Responsibility

38. Content Areas
• Additionally, the competencies contain Foundational
Behaviors of Professional Practice.
– Permeate every aspect of professional practice and represent
the common values of the athletic training profession.
– Seven foundational behaviors are:
• Primacy of the Patient
• Teamed Approach to Practice
• Legal Practice
• Ethical Practice
• Advancing Knowledge
• Cultural Competence
• Professionalism

39. Caveat to Educational Competencies
• Clinical Integration Proficiencies (CIPs) have
become more global in nature with a greater
emphasis on the evaluation of clinical integration
instead of isolated skills seen in the previous
iterations of the clinical proficiencies.
• Proficient
– To perform with expert correctness and facility
• Proficiency
– The synthesis and integration of knowledge, skills and
clinical decision making into actual patient/client care.

40. Clinical Integration Proficiencies and
the Clinical Preceptor
• Clinical evaluations should become more global in
nature, allowing the CP to more easily evaluate the ATS
as a clinician.
• The ATS can easily be evaluated multiple times on
his/her clinical proficiencies throughout the academic
program.
• Less simulated evaluations and testing; more ‘real world’
evaluations over the course of the ATSs clinical
responsibilities.

41. Clinical Integration Proficiency 1
• PREVENTION & HEALTH PROMOTION
– The ATS can administer testing procedures to obtain baseline data
regarding a patient’s/client’s level of general health (including nutritional
habits, physical activity status and body composition).
– Use this data to design, implement, evaluate and modify a program
specific to the performance and health goals of the patient. This will
include instructing the patient in the proper performance of the activities,
recognizing the warning signs and symptoms of potential injuries and
illnesses that may occur and explaining the role of exercise in
maintaining overall health and the prevention of diseases.
– Incorporate contemporary behavioral change theory when educating
patients/clients and associated individuals to effect health-related
change. Refer to other medical and health professionals when
appropriate.

42. Clinical Integration Proficiency 2
• PREVENTION & HEALTH PROMOTION
– The ATS can select, apply, evaluate and modify appropriate
standard protective equipment, taping, wrapping, bracing,
padding, and other custom devices for the client/patient in order
to prevent and/or minimize the risk of injury to the head, torso,
spine, and extremities for safe participation in sport or other
physical activity.

43. Clinical Integration Proficiency 3
• PREVENTION & HEALTH PROMOTION
– The ATS can develop, implement and monitor prevention
strategies for at-risk individuals (e.g., persons with asthma or
diabetes, persons with a previous history of heat illness, persons
with sickle cell trait) and large groups to allow safe physical
activity in a variety of conditions.
– This includes obtaining and interpreting data related to
potentially hazardous environmental conditions, monitoring body
functions (e.g., blood glucose, peak expiratory flow, hydration
status) and making the appropriate recommendations for
individual safety and activity status.

44. Clinical Integration Proficiency 4
• CLINICAL ASSESSMENT & DIAGNOSIS / ACUTE CARE /
THERAPEUTIC INTERVENTION
– The ATS can perform a comprehensive clinical examination of a patient with
an upper extremity, lower extremity, head, neck, thorax and/or spine injury
or condition.
– This exam should incorporate clinical reasoning in the selection of
assessment procedures and interpretation of findings in order to formulate a
differential diagnosis and/or diagnosis, determine underlying impairments
and identify activity limitations and participation restrictions.
– Based on the assessment data and consideration of the patient’s goals,
provide the appropriate initial care and establish overall treatment goals.
– Create and implement a therapeutic intervention that targets these
treatment goals to include, as appropriate, therapeutic modalities,
medications (with physician involvement as necessary) and rehabilitative
techniques and procedures.
– Integrate and interpret various forms of standardized documentation
including both patient-oriented and clinician-oriented outcomes measures to
recommend activity level, make return to play decisions and maximize
patient outcomes and progress in the treatment plan.

45. Clinical Integration Proficiency 5
• CLINICAL ASSESSMENT & DIAGNOSIS / ACUTE
CARE / THERAPEUTIC INTERVENTION
– The ATS can perform a comprehensive clinical examination of a
patient with a common illness/condition that includes appropriate
clinical reasoning in the selection of assessment procedures and
interpretation of history and physical examination findings in
order to formulate a differential diagnosis and/or diagnosis.
– Based on the history, physical examination and patient goals,
implement the appropriate treatment strategy to include
medications (with physician involvement as necessary).
– Determine whether patient referral is needed and identify
potential restrictions in activities and participation.
– Formulate and communicate the appropriate return to activity
protocol.

46. Clinical Integration Proficiency 6
• CLINICAL ASSESSMENT & DIAGNOSIS / ACUTE
CARE / THERAPEUTIC INTERVENTION
– The ATS can clinically evaluate and manage a patient
with an emergency injury or condition to include the
assessment of vital signs and level of consciousness,
activation of emergency action plan, secondary
assessment, diagnosis and provision of the
appropriate emergency care (e.g., CPR, AED,
supplemental oxygen, airway adjunct, splinting, spinal
stabilization, control of bleeding).

47. Clinical Integration Proficiency 7
• PSYCHOSOCIAL STRATEGIES & REFERRAL
– The ATS can select and integrate appropriate psychosocial
techniques into a patient’s treatment or rehabilitation program to
enhance rehabilitation adherence, return to play and overall
outcomes.
– This includes, but is not limited to, verbal motivation, goal
setting, imagery, pain management, self-talk and/or relaxation.

48. Clinical Integration Proficiency 8
• PSYCHOSOCIAL STRATEGIES & REFERRAL
– The ATS can demonstrate the ability to recognize and refer at-
risk individuals and individuals with psychosocial disorders
and/or mental health emergencies.
– As a member of the management team, develop an appropriate
management plan (including recommendations for patient safety
and activity status) that establishes a professional helping
relationship with the patient, ensures interactive support and
education, and encourages the AT’s role of informed patient
advocate in a manner consistent with current practice guidelines.

49. Clinical Integration Proficiency 9
• HEALTH CARE ADMINISTRATION
– The ATS can utilize documentation strategies to effectively
communicate with patients, physicians, insurers, colleagues,
administrators and parents or family members while using
appropriate terminology and complying with statues that regulate
privacy of medical records.
– This includes using a comprehensive patient-file management
system (including diagnostic and procedural codes) for
appropriate chart documentation, risk management, outcomes
and billing.

50. Clinical Skill Development
• After initially learning how to perform the skill,
more learning must take place.
• Necessities for mastery of a skill:
– Continued practice of skill in lab settings and in
clinical practice settings.
– Integration of particular skill with other related skills
(e.g. Lachman’s test with comprehensive knee
evaluation).
– Decision-making in clinical context.

51. EVALUATION OF STUDENT
PERFORMANCE AND FEEDBACK
Module 3

52. Clinical Integration Proficiencies
• CIPs represent the synthesis and integration of knowledge, skills
and clinical decision-making into actual patient/client care.
• CIPs have been reorganized into this section to reflect their global
nature.
• In most cases, CIP assessment should occur when the ATS is
engaged in real patient/client care and may be necessarily
assessed over multiple interactions with the same patient/client.
• In a few instances, assessment may require simulated scenarios, as
certain circumstances may occur rarely but are nevertheless
important to the well-prepared practitioner.
• The incorporation of evidence-based practice principles into care
provided by ATs is central to optimizing outcomes.
• Assessment of ATS competence in the CIPs should reflect the
extent to which these principles are integrated.
• Assessment of students in the use of Foundational Behaviors in the
context of real patient care should also occur.

53. Formal Evaluation of Clinical
Integration Proficiencies
• Must be done by an ATEP CP who is
physically present during the evaluation.
• Must be in a 1:1 ATS-to-CP ratio.
• Ideally performed in a ‘live’ clinical context
with patients/clients.
• Alternative methods for assessing the
CIPs may consist of case study
examinations and objective structured
clinical examinations.

54. Evaluating Clinical Skills
• CP must evaluate performance of the essential
components of clinical skills.
• More than one right way to perform most clinical skills.
– There are definitely wrong ways!
• Example: Lachman’s Test
– Skill is initially taught, practiced and formally evaluated in KINES
334.
– Skill is practiced and reinforced in clinical setting
• Teachable moments by CPs
• Integration of skill into clinical practice under mentorship of the CP
– Skill is formally assessed again in a clinical context

55. Clinical Evaluation
• Clinical evaluation is not a one-time ‘check-
off’ assessment.
• ATSs are to be evaluated on their ability to
utilize their knowledge and skills in the
management of real patients.
• This is done by observing and interacting with
ATSs while they provide real AT services.
• It is understood that some clinical
proficiencies do not lend themselves to ‘real
world’ practice, but most do.

56. Clinical Evaluation
• A CP cannot be an expert in everything.
• All teachers must continually learn in order to
fairly evaluate. Some proficiencies may
require additional learning by the CP prior to
ATS evaluation; if a CP is unsure regarding a
CIP, he/she should contact the clinical
education coordinator for clarification.
• The clinical evaluation must be performed by
the CP assigned to the ATS.

57. Clinical Evaluation
• Proficiencies that are listed for a particular
practicum level in an ATS’s booklet must be
evaluated prior to the end of the semester.
• The responsibility for ensuring this is both the
ATS’s and the CP’s. The CP must be willing
to allow the ATS to be involved in patient
care and the ATS must be willing to be
involved.
• If a proficiency does not naturally occur, then
it is acceptable to use mock scenarios for
ATS evaluation.

58. Clinical Evaluation
• Not everything an ATS does in the clinical setting
gets evaluated.
• There are many duties that an ATS will perform
that are a necessary part of the clinical experience
(i.e. cleaning coolers, folding towels, etc.).
– It is important for the ATS’s professional development
that he/she is involved in these duties; however, these
duties should be performed in addition to the ATS’s
clinical proficiencies development not instead of them.

59. Clinical Evaluation
• The ATS will be evaluated twice during a
clinical rotation. Once at midterm as a
formative evaluation and once at the end
of the rotation as a summative evaluation
of their clinical proficiency.
• If only a few of the clinical proficiencies
are evaluated at the midterm a plan of
action for the remainder of the rotation
must be developed.

60. Clinical Evaluation
• CIPs that have been evaluated during a
previous rotation are subject to re-
evaluation on all subsequent rotations.
• These should be re-evaluated only as they
naturally occur.
• If an ATS receives an unsatisfactory mark,
the proficiency MUST be repeated in a
subsequent evaluation.

61. Clinical Evaluation Errors
• Evaluating ATSs on skills and knowledge
prior to formal instruction and evaluation in
the classroom or lab.
• Failure to evaluate the ATS on clinical skills
and just ‘giving’ the ATS a grade.
• Using an evaluation scoring system other
than the one described on the evaluation
document.
• Using mock scenarios and discussions for
the majority of clinical evaluations.
• Allowing other unqualified persons to conduct
the ATS’s evaluation.

62. Documentation of Clinical
Integration Proficiencies
• ATS Portfolios
– Course syllabi
– Skill sheets
– Practical exams
– Assignments
• Clinical documentation and administrative exercises
• Critically-appraised topics
• Plans of care
• Case studies
– Evaluations by CPs

63. Clinical Preceptor Comprehensive
Critique of Athletic Training Students
• ATSs overall clinical education performance
gauged at midterm and end of the semester.
• Created to measure the Foundational Behaviors
of ATSs as well as competence in knowledge
and skills.
– Use ATS expectation sheets as one measure of
progression with emphasis on assessing the following
characteristics:
• Universal traits
• Clinical skills
• Psychosocial qualities

64. Athletic Training Student Self-Appraisal &
Evaluation of Clinical Preceptors and Sites
• Completed online via Penn State Qualtrics
software program.
• Use feedback from ATSs to assist them in
establishing individual goals and
expectations
• Use input as a means to improve the
performance of CPs and clinical education
sites.

65. LEARNING STYLES AND
INSTRUCTIONAL SKILLS
Module 4

66. Learning Styles
• Comprise different approaches or ways of
learning.
• It is proposed that specific individuals prefer a
particular method of interacting with, taking in
and processing stimuli or information.
• Approximately 70 different models of learning
styles have been developed.
• Learning is a complex process and learning
style models are often an attempt to simplify
that process; thus, the models are by nature
incomplete and evolving.

67. Learning Styles
• The VARK model describes learning
preferences based on mode of information input.
• The VARK model describes four basic types of
learners.
– Visual learners (learn by seeing)
– Auditory learners (learn by hearing)
– Reading/writing learners (learn by processing text)
– Kinesthetic learners (learn by doing)

68. Learning Styles and
Clinical Instruction
• Since ATSs have different learning preferences
and many have mixed learning preferences,
information in the clinical setting should be
presented using all four components of the VARK
model.
– Demonstrate skills to promote Visual learning.
– Discuss information to promote Auditory learning.
– Provide and suggest sources to promote
Reading/Writing learning.
– Allow ‘hands on’ practice to promote Kinesthetic
learning.

69. Effective Clinical Instruction
1. Demonstrate skills while the ATS
observes.
2. Closely supervise the ATS as he/she
practices skills.
3. Monitor the ATS as he/she
independently performs skills (taking into
account to not allow harm to come to the
patient).
4. Assist the ATS by discussing skills
before they are attempted and
constructively evaluating the ATS
afterwards.

70. Using Andragogy & Pedagogy
• Pedagogy = teaching children (novices)
• When using the pedagogical style, the
instructor decides what is taught and how
it is taught.
• The learner is motivated by grades and
rewards.
• The teaching focus is building a
foundation of knowledge or skill.

71. Using Andragogy & Pedagogy
• Andragogy = teaching adults
(experienced)
• When using the andragogical style, the
instructor serves as a facilitator and
resource for the learner.
• The learner is motivated by the internal
desire for competency.
• The teaching focus is appropriate
integration of knowledge, skill and
professional behavior.

72. Effective Clinical Preceptors
• An effective CP should use both styles of
teaching in the clinical setting.
• At times, the CP needs to take control of
the learning process to ensure the ATS
has a solid skill and knowledge base
(Pedagogy).
• At other times, the CP must allow the ATS
to direct the learning experience based on
the ATS’s self-assessment of his/her
competence (Andragogy).

73. ATEP AND INSTITUTIONAL
POLICIES & PROCEDURES
Module 5

74. Athletic Training Education
Program Handbook
• Please familiarize yourself and keep current with
ATEP and related Penn State policies,
procedures and protocols stated in the provided
handbook before accepting ATSs to your clinical
site.
• Abide by and enforce these regulations to
remain in compliance with associated governing
bodies.
• Contact the program director or clinical
education coordinator regarding questions with
as necessary.

75. SUPERVISION, MENTORING AND
ADMINISTRATION
Module 6

76. Clinical Supervision
• The process of observing the ATS as
he/she develops clinical abilities in athletic
training.
• Can only occur with interaction between
the CP and the ATS.

77. Clinical Supervision
Responsibilities
• Direct supervision of the ATS during formal acquisition, practice and evaluation of the
Entry-Level Athletic Training Clinical Integration Proficiencies.
– The ATS must be supervised by the CP(s) assigned to the ATS.
• Intervention on behalf of the patient/client if the ATS might put the patient/client at risk
or harm.
• Encouragement of the ATSs to arrive at clinical decisions on their own according to
their level of education and clinical experience.
• Provide feedback to ATS from information acquired from direct observation,
discussion with others and from review of patient/client documentation.
• Presentation of clear performance expectations to ATSs at the beginning and
throughout the learning experience.
• Treat the ATSs' presence as educational and not as a means for providing additional
staff.

78. Clinical Preceptors as Mentors
• A mentor is an experienced and trusted
advisor.
• Mentoring an ATS goes beyond teaching
and providing feedback regarding an
ATS’s clinical learning.
• Being a mentor involves giving the ATS
advice and counsel as an expert in the
field that the ATS cannot get from didactic
materials.

79. Mentoring Responsibilities
• Be a good professional role model.
• Listen to the ATSs.
• Be available.
• Be honest.
• Share your opinions.
• Be positive.
• Care about your ATSs and your patients.
• Introduce ATSs to other professionals.

80. Clinical Education
Administration
• Performing the duties required by the
ATEP to ensure required policies and
procedures are followed.

81. Clinical Education
Administration
• Complete the ATSs’ evaluation forms required
by the ATEP in a timely fashion.
• Provide the program director and/or clinical
education coordinator with requested materials
as required for the accreditation process.
• Collaborate with ATSs to arrange quality clinical
education experiences which are compatible
with the ATS’s academic schedule
• Application of the clinical education policies,
procedures and expectations of the ATEP.
• Inform the ATSs of relevant policies and
procedures of the clinical setting.

82. LEGAL AND ETHICAL
CONSIDERATIONS
Module 7

83. Athletic Training in Pennsylvania
• The practice of athletic training in
Pennsylvania (PA) is regulated by the State
Board of Medicine.
• Any individual who wishes to perform the
duties of an AT must obtain a license from
the State Board of Medicine prior to doing so.
• No individual may use the title of AT in PA
without first obtaining a related license.
• Practicing athletic training in PA without a
license is a criminal misdemeanor.

84. Athletic Training in Pennsylvania
• Obtaining a license in PA requires the submission of
verification materials along with an affidavit of moral
character and a written protocol with a physician
licensed in PA.
• Performing health care duties other than those
described in the protocol may constitute malpractice.
• Individuals licensed to practice in PA are
acknowledged with the initials ATC, LAT.
• Information regarding licensure in PA may be found at:
http://www.portal.state.pa.us/portal/server.pt/community/sta

85. NATA Code of Ethics
• Written to make the membership aware of the principles of ethical behavior
that should be followed in the practice of athletic training.
• Primary goal is to assure a high quality of health care.
• Standards set forth presents aspirational standards of behavior that all
members should strive to achieve.
• The principles cannot be expected to cover all specific situations that may
be encountered by the practicing AT but should be considered
representative of the spirit with which ATs should make decisions.
• Written generally and the circumstances of a situation will determine the
interpretation and application of a given principle and the Code as a whole.
• When there is a conflict between the Code and legality, the law prevails.
• Guidelines set forth in this Code are subject to continual review and revision
as the athletic training profession develops and changes.

86. NATA Code of Ethics
• Principle 1: Members shall respect the rights,
welfare and dignity of all individuals.
– 1.1: Members shall not discriminate against any legally protected
class.
– 1.2: Members shall be committed to providing competent care
consistent with both the requirements and the limitations of their
profession.
– 1.3: Members shall preserve the confidentiality of privileged
information and shall not release such information to a third
party not involved in the patient’s care unless the person
consents to such release or release is permitted by law.

87. NATA Code of Ethics
• Principle 2: Members shall comply with the laws and
regulations governing the practice of athletic
training.
– 2.1: Members shall comply with applicable local, state and
federal laws and institutional guidelines.
– 2.2: Members shall be familiar with and adhere to all NATA
guidelines and ethical standards.
– 2.3: Members are encouraged to report illegal or unethical
practice pertaining to athletic training to the appropriate person
or authority.
– 2.4: Members shall avoid substance abuse and, when
necessary, seek rehabilitation for chemical dependency.

88. NATA Code of Ethics
• Principle 3: Members shall accept responsibility for
the exercise of sound judgment.
– 3.1: Members shall not misrepresent in any manner, either
directly or indirectly, their skills, training, professional credentials,
identity or services.
– 3.2: Members shall provide only those services for which they
are qualified via education and/or experience and by pertinent
legal regulatory process.
– 3.3: Members shall provide services, make referrals and seek
compensation only for those services that are necessary.

89. NATA Code of Ethics
• Principle 4: Members shall maintain and promote high standards in the
provision of services.
– 4.1: Members shall recognize the need for continuing education and participate
in various types of educational activities that enhance their skills and knowledge.
– 4.2: Members who have the responsibility for employing and evaluating the
performance of other staff members shall fulfill such responsibility in a fair,
considerate and equitable manner, on the basis of clearly enunciated criteria.
– 4.3: Members who have the responsibility for evaluating the performance of
employees, supervisees, or students, are encouraged to share evaluations with
them and allow them the opportunity to respond to those evaluations.
– 4.4: Members shall educate those whom they supervise in the practice of athletic
training with regard to the Code of Ethics and encourage their adherence to it.
– 4.5: Whenever possible, members are encouraged to participate and support
others in the conduct and communication of research and educational activities
that may contribute knowledge for improved patient care, patient or student
education and the growth of athletic training as a profession.
– 4.6: When members are researchers or educators, they are responsible for
maintaining and promoting ethical conduct in research and educational activities.

90. NATA Code of Ethics
• Principle 5: Members shall not engage in any form of conduct
that constitutes a conflict of interest or that adversely reflects
on the profession.
– 5.1: The private conduct of the member is a personal matter to the
same degree as is any other person’s except when such conduct
compromises the fulfillment of professional responsibilities.
– 5.2: Members of the NATA and others serving on the Association’s
committees or acting as consultants shall not use, directly or by
implication, the Association’s name or logo or their affiliation with the
Association in the endorsement of products or services.
– 5.3: Members shall not place financial gain above the welfare of the
patient being treated and shall not participate in any arrangement that
exploits the patient.
– 5.4: Members may seek remuneration for their services that is
commensurate with their services and in compliance with applicable law.

91. Ethical Practice of Athletic
Training
• Know your professional code of ethics.
• Recognize situations where ethical concerns are present.
• Consult whenever there are questions.
• Refer when the concern is beyond your legal scope of practice or
competence.
• Refer if you might become a primary party in an ethical dilemma.
• Document carefully and often.
• Reflect and consider prior to making ethical decisions.
• Fully disclose your roles to patients.
• Allow patients to make their own fully informed choices.

92. Patient Confidentiality
Considerations in Clinical Education
• Care must be taken by the CP and the
ATS to ensure patient confidentiality.
• ATSs should only be allowed access to
information necessary for effective patient
management.
• Inform patients of the ATSs’ role in
providing healthcare.

93. Ethical Behavior Considerations in
Clinical Education
• The relationship between the CP and
the ATS is a teacher-pupil
relationship.
• Relationships beyond this may lead to
unethical or the perception of
unethical behavior.

94. EFFECTIVE COMMUNICATION
IN CLINICAL EDUCATION
Module 8

95. Effective Communication
• Quality clinical education requires effective
communication between CPs, ATSs and
the ATEP.

96. Need to Define Athletic Training
Student Responsibilities
• Establish acceptable AT responsibilities in
the athletic training/sports medicine facility
and at practice.
• Establish acceptable ATS responsibilities
when traveling to away events.
– (See Travel Policy)

97. Communication with ATEP
Administration
• CPs must communicate with the Program Director and
Clinical Education Coordinator regarding ATS progress
towards clinical education goals at regularly scheduled
intervals determined by the ATEP.
– To ensure adequate instruction and evaluation, effective
communication must exist between CPs and ATEP
administrators.
• Clinical education coordinator will have presence in the
clinical settings via scheduled site visits.

98. Communication Skills in
Clinical Education
• CPs must use appropriate forms of communication to
clearly and concisely express him/herself to ATSs, both
verbally and in writing.
• Effective learning requires timely and constructive
feedback.
• Often clear verbal instructions and feedback are
sufficient but at times written instructions and feedback
will be necessary to adequately instruct and evaluate the
ATS.

99. Constructive Critiquing
• CPs must provide appropriately timed and constructive
formative and summative feedback to ATSs.
– Formative feedback = developmental feedback for future
practice and skill development
– Summative feedback = final evaluation
• To effectively develop clinical skills, ATSs must be given
formative feedback throughout a clinical rotation.
– Evaluation of an ATS at the end of a clinical rotation without
giving the ATS formative evaluations and practice opportunities
throughout does not allow the ATS to fully develop the skills prior
to the final evaluation. This does not allow the ATS to change
his/her behavior and makes the final summative evaluation
biased.

100. Facilitating Communication in
Clinical Education
• CPs must facilitate communication with ATSs through
open-ended questions and directed problem solving.
– Full evaluation of the ATS’s clinical ability is evaluated by
gaining knowledge of the ATS’s cognitive and psychomotor
abilities relative to a clinical proficiency.
– This is accomplished through questioning and problem solving
along with skill observation.

101. Professional Discourse
• CPs must ensure time for on-going professional discussions with
the ATS in the clinical setting.
– Professional development of the ATS requires regular input from the
CP.
– A CP that is not available for discussion creates a stand-offish
atmosphere that discourages professional involvement by the ATS.
• CPs must communicate with ATSs in a non-confrontational and
positive manner.
– The CP must remember that the ATS is a student and not an employee;
accordingly, the ATS is developing skills and abilities.
– Positive constructive communication gives the ATS a sense of their
strengths and weaknesses as an AT.
– Negative, confrontational communication is not effective in promoting
improved clinical performance.

102. Clinical Preceptor Feedback
• CPs will receive feedback from the program director and
clinical education coordinator as well as ATSs.
• A CP must be prepared to receive constructive input
from the program director and clinical education
coordinator as well as feedback from the ATSs.
• The purpose of this feedback is to assist the CP in
identifying their areas of strength and weakness in
clinical education and supervision.

103. INTERPERSONAL
RELATIONSHIPS IN CLINICAL
EDUCATION
Module 9

104. Positive Interpersonal Relationships
in Clinical Education
• As a CP, you will be closely observed by
ATSs who desire to become an AT;
therefore, it is extremely important that
you demonstrate interpersonal
relationships that encourage ATSs
regarding the profession of athletic
training.

105. Clinical Preceptor and Athletic
Training Student Relationships
• CPs must form appropriate and
professional relationships with ATSs.
• The CP must be seen as a professional
supervisor by the ATSs. Any relationship
beyond that is inappropriate.

106. Clinical Preceptor Relationships
• CPs must model appropriate and professional
interpersonal relationships when interacting with
colleagues, patients/clients and administrators.
• An effective CP must demonstrate appropriate
relationships with the individuals that he/she
interacts with while performing his/her
professional duties.
• Inappropriate relationships discourage future
professionals and may constitute unethical
behavior.

107. Advocating for
Athletic Training Students
• CPs should appropriately advocate for
ATSs when interacting with colleagues,
patients/clients and administrators.
• The ATS represents the future
professional.
• The effective CP should advocate for
ATSs when discussing their involvement
in the health care of patients/clients.

108. Clinical Preceptors as
Positive Role Models
• CPs are a positive role model and mentor for
ATSs.
• The CP who does not serve as a positive role
model discourages future ATSs from entering
the profession.
• Athletic training is an allied health care
profession; thus the CP’s behavior and
interpersonal relationships should reflect this.

109. Nondiscrimination and
Demeanor
• CPs must demonstrate respect for gender, racial, ethnic,
religious and individual differences when interacting with
people.
• Allied health care providers provide quality services to all
individuals; hence, CPs must demonstrate this to ATSs
by their words and actions.
• CPs must have an open and approachable demeanor to
ATSs when working in the clinical setting.
• ATSs want to learn from CPs. A CP that is not open and
approachable creates an atmosphere where the ATS
feels that he/she is not welcomed and therefore will not
seek the CP’s instruction and evaluation.

110. Managing Problems with
Athletic Training Students
1. Initial communication between CP(s) and ATS
– Documentation recommended
1. Contact clinical education coordinator if
repeated problems occur or severity of incident
is extreme
– Documentation recommended
1. Schedule meeting(s) between CPs, ATS,
clinical education coordinator and program
director to discuss conflict resolution
– Documentation required

111. FOUNDATIONS OF
CLINICAL KNOWLEDGE
AND SKILLS
Module 10

112. Clinical Proficiency of the
Clinical Preceptor
• CPs must demonstrate a solid basis for
clinical knowledge and skills that meet or
exceed the athletic training clinical
proficiencies.
• An individual that does not meet or exceed
the clinical proficiencies should not serve
as a CP.

113. Clinical Instruction and
Evaluation
• CPs must be capable of instructing and evaluating the
clinical proficiencies that are particular to their practice
setting.
• CPs must read and understand the CIPs prior to
accepting an ATS. Any remediation or clarification in the
clinical area must take place prior to the acceptance of
an ATS for supervision.
• If a CP is uncertain as to how to evaluate a clinical
proficiency, the Program Director or Clinical Education
Coordinator should be contacted prior to attempting the
assessment.

114. Current Skill Sets and
Evidence-Based Practice
• The CP’s clinical skills must be current
and reflect care decisions supported by a
scientific foundation and evidence-based
practice.
• As allied health care practitioners, ATs
must utilize current related methodologies
and be prepared to justify clinical
management decisions based on
evidence that the intervention is safe and
effective.

115. Continuing Education and the
Clinical Preceptor
• The CP must continually learn in order to stay
current with his/her clinical knowledge base and
skill set through participation in continuing
education programs.
• Participation in continuing education programs,
related presentations and self-study are a
necessity for the AT to become and remain an
effective CP.

116. THANK YOU FOR YOUR TIME AND
ATTENTION TO THIS
INFORMATION
ATs will receive a certificate for
5.0 BOC continuing education
units.