Perceived stress and coping skills in professional master's level athletic training students

Background: As athletic training education continues to expand, it is important to consider the amount of stress students experience and what coping skills they use to mitigate it. Although there is considerable research on athletic training students and perceived stress (PS), there are few studies related to students enrolled in professional master's programs (MAT) regarding stress.Methods: Cross-sectional design with current students in Commission on Accreditation of Athletic Training Education (CAATE) accredited MAT programs (males=42, females=99, age=23.42 ± 2.91 years). Program directors were asked to forward a link to students in their respective MAT programs. The survey included a brief demographics section (age, gender, year in school, learning model). Two surveys were included: The Perceived Stress Scale (PSS) (reliability a=0.78) to measure perceived stress (PS), and the Coping Orientation to Problem Experience (COPE) inventory (reliability a=0.73) to measure coping skills (CS). Means and standard deviations were calculated for the PSS and 15 subscales of the COPE. One-way ANOVA's were calculated for PSS utilizing demographic variables. Pearson correlation analysis was used to calculate most significant CS, and the impact of them.Results: A mean PSS score (24.84 ± 7.267) revealed a moderate level of PS in MAT students. ANOVA demonstrated increased PS in females, in comparison to males (F(1,139) =4.93, p=.03). Pearson correlation analysis established multiple significant coping skills. Age revealed positive correlations with positive reinforcement (r=0.168, p=0.05), active coping (r=0.25, p <0.01), and acceptance (r=0.25, p <0.01); and negative for PS (r= - 0.18, p=0.03). Gender revealed significant correlations for females in venting (r= -0.19, p=0.02), social support (r= -0.22, p <0.01), and emotional support (r= -0.20, p=0.02). Year 2 of schooling demonstrated a significant correlation with mental disengagement (r=0.25, p <0.01). Learning model presented significant correlations with venting (r=0.18, p <0.01) and mental disengagement (r= -0.171, p <0.05). Perceived stress demonstrated significant correlations with positive reinforcement (r= -0.25, p <0.01) mental disengagement (r=0.188, p <0.05), venting (r=0.36, p=0.00), active coping (r= -0.27, p=0.001), denial (r=0.25, p <0.01), behavioral disengagement (r=0.39, p=0.00), substance use (r=0.25, p <0.01), and planning (r= -0.30, p=0.00).Conclusions: Our data suggests that female MAT students experience more PS than males. As age increases, the use of constructive coping skills increases. However, overall, MAT students use CS that are more detrimental to stress. These results can assist students and professors in recognizing and using healthier alternatives to cope with stress

Evaluation of firefighters' functional movement

According to previous research, firefighters have a higher rate of being overweight, or obese, than the general population. these higher risk predict mortality, morbidity, short and long medical costs. Various programs in conjunction with acute care will allow for athletic trainers to utilize a variety of skills and improve the quality of health care provided for firefighters while reducing the fiscal bottom line.Firefighters who exercise regularly on-duty were found to have nearly half the odds of suffering a non-exercise- related injury compared with those who do not regularly on duty. One-third of the injuries reported among firefighters was the result of physical training or exercise, which are the most common sprains and strains

Association between sport specialization and risk of musculoskeletal injury in high school athletes: A critically appraised topic

Context: Sport specialization is defined as intensive, year-round training in a single sport to the exclusion of other sports. The increased training and competition loads secondary to this trend have been hypothesized to contribute to psychological burnout and overuse injuries. High school athletes, in particular, are of interest due to the increased intensity and level of competition compared to youth sports. By classifying levels of sport specialization and analyzing injury history of subjects, correlations have been made to the relationship between sport specialization and the prevalence of musculoskeletal injuries in high school athletes. Thus, the question being investigated in this critically appraised topic is Is sport specialization association with an increased risk of musculoskeletal injury in high school athletes?Objective: To determine if sport specialization is associated with an increased risk of musculoskeletal injury in high school athletes.Data Sources: An electronic database search included PubMed, SPORTDiscus, and Medline. Search terms included high school athletes AND sport specialization AND musculoskeletal injury OR injury.Study Selection: Studies were included if they investigated both male and female high school athletes, were level 3 evidence or higher, in English, and published within the past 10 years (2009-2019). Studies were excluded if the participants were too young to participate in high school sports, investigate non-musculoskeletal injuries, or investigate a population from only a single sport (ex: only baseball players).Data Extraction: Three cross-sectional and one cohort study were included and appraised using the Checklist for Measuring Quality.Data Synthesis: All four studies utilized a 3-question sport participation survey in order to classify participants as either high, moderate, or low specialization and an injury history survey. Two studies included high school athletes from 29 different high schools, one included high school athletes from 2 different high schools, and one included high school athletes from only one high school. Three studies analyzed in this appraisal found positive correlations between moderate and high levels of sport specialization and musculoskeletal injuries while one did not. Additionally, two of the studies found a positive correlation between time-loss injuries and participation in club sports.Conclusions: Evidence suggests that sport specialization is associated with a higher risk of musculoskeletal injuries in high school athletes. However, other factors, such as training volume, competition volume, and club sport involvement may all also play a role in this relationship.Strength of Recommendation:

Can self-efficacy predict first year medical students' academic success?

Background: Self-efficacy (SE), the ability for an individual to believe in their own capabilities, has been connected to an individual's ability to succeed, deal with resistance and failures, and cope with challenges, all skills that are essential for competent physicians. SE has been found to have a positive impact on college student academic performance, but has not been evaluated in medical students. The purpose of this study was to measure first year medical students' SE and to determine what characteristics impacted their academic success in their first semester of medical school.Summary of Work: 61 (29 male, 32 female) first year medical students at a single osteopathic medical school were asked to complete the SE scale and additional demographics. Data was combined with undergraduate (UG) GPA, MCAT score, first semester GPA, and class rank. Basic descriptives, means, standard deviations, and Pearson correlation values were calculated.Summary of Results: Four variables were found to be significantly correlated with first semester GPA (level of athletic performance of UG r=.311, p=.015; number applications submitted r= -.414, p=.000; UG GPA r=.488, p=.000; science GPA r=.467, p=.000) and three with class rank (number applications r=.355, p=.005; UG GPA r= -.483, p=.000; science GPA r= -.495, p=.000). General SE was significantly correlated to the size of hometown (r=.256, p=.049).Discussion & Conclusions: This study determined that medical students' first semester academic success was better predicted by academic preparation rather than a student's self-efficacy. This is in contrast to current undergraduate literature that demonstrates a significant impact on GPA and retention. Self-efficacy may therefore be more applicable to astute clinical skills rather than pre-clinical academic performance.Take Home Message: While this study did not find SE to be a predictor of first year medical student academic performance, the ability to control thoughts, feelings, and actions in stressful situations is critical to overall success as a physician. Academic programs should seek out options to assess and improve these skills prior to entering the clinical setting

Patient perceptions in receiving LGBTQIA culturally competent health care

Background: There is a large amount of documented evidence demonstrating that health care providers are caring for diverse populations. This warrants a level of cultural competence (CC) when making health care decisions. Traditionally, Race and ethnicity have been the focus in CC. However, criteria such as sexual orientation and gender identity are often forgotten, or left out altogether. Because of this, patients whose sexual orientation or gender is a minority, may often receive inadequate treatment. This is in part due to the health care providers lack knowledge in this type of CC or present sexual prejudices. Because of this, research is needed to investigate the perceptions of patients that identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, ally (LGBTQIA) when receiving health care.Methods: Cross-sectional design consisting of 140 participants (male=78, female=50, transgender=5, other=7; heterosexual=16, gay/lesbian=72, bisexual=43, other=9, mean age=26.97 ± 7.67). Participants were recruited using a snowball sampling method via email and list-serves. A modified version of the Gay Affirmative Practice (GAP) (reliability a = 0.962), was delivered online to participants to determine need of LGBTQIA cultural competent treatment by health care providers. Means and standard deviations were calculated for each variable (gender, sexual orientation), as well as an overall GAP score (out of 150). Two, single one-way ANOVAs (gender and sexual orientation) were performed with GAP score as the dependent variable.Results: Calculated GAP scores: All=128.82 ± 18.48, male=128.49 ± 15.60, female=130.35 ± 17.10, transgender=129.80 ± 9.31, other=143. 57, heterosexual=129.33 ± 17.12, gay or lesbian=128.25 ± 15.85, bisexual/omni/pansexual/queer/non-monosexual=132.79 ± 14.99, other=131.38 ± 20.37. ANOVA results were modified with Kruskal-Wallis adjustments due to violation of normality and homogeneity of variance, and now are represented by Chi Squares. Gender was the single significant outcome, (X2(3) =8.01, p <0.05). Post hoc testing of gender demonstrated statistical significant in comparing males vs. other.Conclusions: Patients do find it necessary for health care providers to have specific training and/or knowledge in LGBTQIA CC. A majority of results demonstrate strongly agree that health care providers need better CC in LGBTQIA. In comparison of GAP scores in gender, the category of other demonstrates a great need for CC in LGBTQIA in health care providers. Males demonstrated a much lower score, indicating a low priority for LGBTQIA CC in health care. With an increasing LGBTQIA patient population, patients feel the ever increasing need for health care providers to provide knowledgeable, competent, and fair treatment/care

Effectiveness of corrective exercises to improve posture in patients with upper cross syndrome and scapula dyskinesis: a critically appraised topic

Clinical Scenario: Upper Cross Syndrome (UCS) is an abnormal posture defined by a muscular imbalance pattern in the neck, torso, and scapula muscles that commonly results in scapular dyskinesis. The National Academy of Sports Medicine (NASM) and Comprehensive Corrective Exercise Program (CCEP) address the cause of imbalances and incorrect movement patterns that lead to problems with posture, balance, and systemic coordination then modifies the imbalances that improves overall exercise quality. This Critically Appraised Topic (CAT) served to review the current evidence regarding whether corrective exercises can be used to address UCS and scapular dyskinesis thereby providing clinicians with more options to address the condition.Focused Clinical Question: Does corrective exercise improve scapula dyskinesis and upper cross syndrome by modifying the musculoskeletal disorders of scapula and alignment of their upper body?Summary of Key Findings: Three studies investigated the effectiveness of corrective exercises to improve posture in patients with upper cross syndrome and scapula dyskinesis.Clinical Bottom Line: Based on the results of the studies included in this critically appraised topic, there is moderate evidence to support the use of corrective exercises for improving UCS and scapular movement patterns in adults.Strength of Recommendation: Upon review of the three studies, there is Level B evidence that exists that CCEP or NASM exercises program could potentially improving postural alignment, muscle activation, and movement pattern of scapula

Relationship between isometric hip strength and incidence of noncontact ACL injuries in female athletes: A critically appraised topic

Clinical Scenario: Noncontact ACL injuries are prevalent among athletes in multi-planar sports, but especially among female athletes. Hip strength may be a factor that contributes to the incidence of noncontact ACL injuries because of the dynamic movement patterns it creates at the knee.Clinical Question: Does hip strength impact the incidence of noncontact ACL injuries in female athletes?Summary of Key Findings: A search of the literature was conducted for the relationship between hip strength and noncontact ACL incidence. Three prospective cohort studies that measured isometric hip strength and then recorded the number of noncontact ACL injuries that occurred within a set time period were included in this critically appraised topic. One study found that a lower isometric hip adductor to abductor ratio was associated with noncontact ACL injuries. Two studies found that subjects who sustained noncontact ACL injuries had greater isometric hip strength measures.Clinical Bottom Line: The evidence suggests that greater isometric hip strength and poor isometric hip adductor to abductor strength ratio may be a risk factor that is associated with noncontact ACL injuries in female athletes. Future research should continue to study the impact that hip strength has on the incidence of noncontact ACL injuries, across all genders, and why.Strength of Recommendation: Based on the Center of Evidence Based Medicine, these studies provide Level 3 evidence that hip strength is a positive factor associated with the risk of noncontact ACL injuries in female athletes

Improving interprofessional practice and cultural competence with interprofessional education

Challenge/Issue: Interprofessional education (IPE) and cultural competence (CC) training have become a staple in healthcare education programs with the ultimate goal of improving patient care. IPE, where students from two or more professions learn from, about, and with each other to optimize care, resulting in great team building, sharing of knowledge, communication, and collaboration. CC involves an individual’s ability to recognize, assess, appreciate, and respect unique backgrounds such as race, ethnicity, sexual minorities, gender, identity, religion, and age, to make greater informed decisions in healthcare and minimize inequities. Within educational programs, both constructs can occur simultaneously to optimize learning and patient-centered outcomes.Objective: To identify the impact of a Diversity, Equity, and Inclusion IPE single-day event on the perceptions of interprofessional practice and ability to provide culturally competent care instudents enrolled in Doctor of Osteopathy (DO), Pharmacy, and Athletic Training (AT) education programs.Approach: An experimental design used pre- and post-test measures of IPE and CC knowledge with a one day conference as the intervention. Participants included students (205- pre and 200- post) enrolled in DO, pharmacy, and AT programs at two Midwestern universities. Participants completed the Interprofessional Collaborative Competences Attainments Survey (ICCAS) and three modified components of the Tool for Assessing Cultural Competence Training (mTACCT) before and after the event that included baseline information about the different professions, three CC presentations, and two case studies with small group discussions. Due to uneven sample sizes in the pre- and post-test, and violations of normality and homogeneity of variance, Kruskal Wallis tests were used to assess differences in the intervention.Results: Five items on the ICCAS and all items on the mTACCT demonstrated statistical significance. On the ICCAS, students demonstrated increases in their ability to; “actively list to Interprofessional (IP) team members’ ideas and concerns”, “working effectively with IP members to enhance care", “recognizing how others’ skills and knowledge complement and overlap with their own”, “to develop an effective care plan with IP team members”, and “negotiate responsibilities with overlapping scopes of practice”. This demonstrated that discussing the professions in general and utilizing case studies and small group discussions allowed students to understand the roles, skills, and responsibilities of their peer professionals which will lead to better communication and teamwork resulting in improved patient outcomes and satisfaction for both patients and staff. The results of the mTACCT demonstrated overall improvement in skills but highlighted students are consciously incompetent, where they recognize a deficiency but demonstrate a desire for greater understanding. Students felt that initially they lacked the ability to identify bias and stereotyping in healthcare but after the intervention felt better equipped. It is important to note that while we found improvements within CC, a single event should not be the only point of CC inclusion within curriculums. Our intervention provided students from three different healthcare programs with an educational opportunity to strengthen their skills in both IPE and C

Perceptions of HIV cure research among people living with HIV in Australia

Participation in HIV cure-related clinical trials that involve antiretroviral treatment (ART) interruption may pose substantial individual risks for people living with HIV (PLHIV) without any therapeutic benefit. As such, it is important that the views of PLHIV are considered in the design of HIV cure research trials. Examining the lived experience of PLHIV provides unique and valuable perspectives on the risks and benefits of HIV cure research. In this study, we interviewed 20 PLHIV in Australia about their knowledge and attitudes toward clinical HIV cure research and explored their views regarding participation in HIV cure clinical trials, including those that involve ART interruption. Data were analysed thematically, using both inductive and deductive coding techniques, to identity themes related to perceptions of HIV cure research and PLHIV’s assessment of the possible risks and benefits of trial participation. Study findings revealed interviewees were willing to consider participation in HIV cure research for social reasons, most notably the opportunity to help others. Concerns raised about ART interruption related to the social and emotional impact of viral rebound, including fear of onward HIV transmission and anxiety about losing control. These findings reveal the ways in which PLHIV perspectives deepen our understanding of HIV cure research, moving beyond a purely clinical assessment of risks and benefits in order to consider the social context

Implementation of Cultural Competence Education into Athletic Training Programs: A Qualitative Report

Cultural competence education is a foundational behavior of professional practice that Athletic Training Programs (ATPs) have been tasked to incorporate into their curriculums. Ten ATP faculty were individually interviewed to determine the current methods used to teach provision of culturally competent care. Four major themes were identified: 1) Barriers to cultural competence education implementation in a didactic setting, 2) Strategies for incorporation into an existing didactic curriculum, 3) Barriers to cultural competence education in a clinical setting, and 4) Strategies to implement cultural competence education into an existing clinical model. Further research is necessary to determine the effectiveness of specific strategies