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Bridging The Gap Between Program Directors, Clinical Opportunities, and Athletic Training Students


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Target Audience: Student AT, Program Director, Employee of an Emerging Setting

Discuss the value of “off-site” clinical opportunities
What is the COES Database?
What roadblocks are present for both the student and clinical sites?
Future goals in bridging the gap between students, program directors and clinical opportunity sites?

Published in: Health & Medicine, Education
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Bridging The Gap Between Program Directors, Clinical Opportunities, and Athletic Training Students

  1. 1. Erik T. Nason, MBA, ATC, MS, CSCS Inomedic Health Applications RehabWorks -Kennedy Space Center, FL
  2. 2.   Internship – traditional name/title given to outreach programs with educational programs  Changed term “Internship” to Clinical Opportunities (CO)  Clinical Opportunities in Emerging Settings Database (COES)  Emerging Settings?  Occupational Health  Public Safety (police/fire/rescue)  Military  Performing Arts  Hospitals  Physician Extender  Hospital Administration Terminology
  3. 3.   Target Audience: Student AT, Program Director, Employee of an Emerging Setting  Discuss the value of “off-site” clinical opportunities  What is the COES Database?  What roadblocks are present for both the student and clinical sites?  Future goals in bridging the gap between students, program directors and clinical opportunity sites? Objectives
  4. 4.  Located at the Kennedy Space Center in FL  Provide free on-site rehabilitation to all employees (approx. 8,000 employees)  In operation since 1997  Treating post op, chronic injuries, acute injuries, and work and non-work related injuries.  Educational outreach programs  Additional entities such as:  Ergonomics  OHSA (Health and Safety)  Marketing  Unique medical illnesses  Occupational and Preventative Medicine KSC RehabWorks
  5. 5.   Proud of our Clinical Opportunity Program  Accepting student for over 16 years RehabWorks’ Clinical Opportunity Program
  6. 6. 2 Student TestimonialsSara Sullivan, ATC - HSin Tarpon Springs, FL (Liberty University) “ My KSC internship challenged me in waysthat I did not expect. The tasksthat I faced mademe grow asa student, asa young adult, asa professional, and asa Certified Athletic Trainer.” DeWayne A. Smith, ATC, CSCS, NASM-CPT, CES, PES - National Academy of SportsMedicine (Concord College) “ During my RehabWorksinternship, I learned to push my own boundaries, bean independent thinker, and step outside of the box asan Athletic Trainer. Thischallenging program doesa stellar job in identifying weaknesses, and promoting positive change. Erik isgreat mentor and servesasa pivotal source of encouragement.”Kaitlyn Warner – University of Ohio, GA-University of Florida “ Asan intern at RehabWorks, I believe that I have been given an amazing opportunity to explore theindustrial athletic training setting. I learn best by doing and I believe that thishands-on experience isthe perfect chance for me to critique and learn new athletic training skills. I also believethat by working one-on-one with a variety of patientsof different ages, I will be ableto improve my communication skillsand becomea moreconfident athletic training student.” Jordan Dorrien East Stroudsburg University “ Interning at RehabWorksis providing methe opportunity to improvemy skillsand is challenging meto think about new conceptsand ideasof clinical treatment. Through its uniquesetting and diverse experiences, RehabWorkshas become an amazing asset to my future goal asan athletic training professional in an emerging setting.” The RehabWorks staff hasmore than 40 yearsof combined experience aslicensed athletictrainersin the occupational health and industrial setting. https:/ / / KSC RehabWorks ATHLETIC TRAINING CLINICAL ROTATIONS Kennedy Space Center, Florida Developed in 1997, RehabWorks hasbeen providing musculoskeletal rehabilitation to employeeswith work related and non-work related injuriesincluding providing post op rehabilitation. Through thisprogram we are able to decreaselost work time, increase job productivity, and keep financial costsat a minimum. Internship Components Presentations, article reviews, rehab design, injury progression Outreach Presentations and creation of educational materials for employees Ergonomics Shadow and understand the role of industrial hygiene in Occ. Med. Safety and Health Participate in understanding OSHA rules and guidelines Professional Development Short and long term goals, SWOT analysis, BOC prep and personal finances Biodex SD Balance System, Biodex Gait Trainer, Rebound Diathermy, Game Ready, Intermittent Compression, M atrix Weight Machine, Ultrasound, Electric Stimulation, Shuttle Recovery, Full FitnessCenter The RehabWorksprogram hasbeen developed to provide all Kennedy Space Center (KSC) employeeswith a free and convenient meansof receiving rehabilitation servicesby Certified/ Licensed Athletic Trainers(AT). The RehabWorks staff can provide injury assessment and rehabilitation servicesto theindustrial athlete in order to maximize long-term recovery and reducelost work time. The KSC RehabWorksProgram offersathletic training internshipsthat providea valuable learning experiencein an occupational medicine and industrial work setting. Wecan help you reach new heightsin Athletic Training!!! Educational Experience componentsof musculoskeletal rehabilitation, occupational health, ergonomics, environmental health & safety, corporate fitness& wellnessand public speaking . Over 60 studentshave completed clinical rotationsat RehabWorksfrom all over the US. RehabWorkshas launched studentsinto top- level graduate programsand helped land competitive employment.
  7. 7.  Schools Represented  Eastern Kentucky University  High Point University  Grand Valley State  Florida Southern College  Illinois State University  Northern Illinois University  Clarion University  Central College  Longwood University  Western Illinois University  East Stroudsburg University  University of Florida  Florida International University  University of Central Florida  Stetson University  Ball State  Columbia University  University of North Carolina - Wilmington  University of South Florida  University of Wisconsin-Milwaukee  California Baptist University  University of Wisconsin – Madison  Mercyhurst College  Bowling Green State University  University of Nebraska-Omaha  Logan University  West Virginia Wesleyan College  Mars Hill College  University of Connecticut  Ohio University  University of Tulsa  Gustavus Adolphus College  Lewis University AND MANY MORE……..
  8. 8.   10,500 students graduate annually from undergrad programs  336 of CAATE accredited program (plus 28 master programs)  30,000 members – 8546 are in emerging settings  This represents about 3,000 facilities in emerging settings  If 10% offered COs (300 facilities), 3 student per site avg = only 900 CO openings, = 8% of graduating AT students  SUPPLY and DEMAND  More students = more opportunities  Growth of the Emerging Setting Let’s Set the Stage
  9. 9.   Program Directors! Are our students being exposed to all elements of our profession?  What emerging settings are available to your students?  Students! What could a clinical opportunity in an emerging setting offer you that your school couldn’t?  Emerging Settings! Do you have a setting that could offer AT students a valuable and unique experience when it comes to patient care? Let’s Set The Stage
  10. 10.   “To Improve is to change; to be perfect is to change often” – Winston Churchill  “If there is no struggle, there is no progress” – Frederick Douglass  “Conformity is the jailer of freedom and the enemy of growth.” John F. Kennedy Grow, Change, Explore
  11. 11.   Students need new opportunities to expand their “book smarts” in new and challenging ways within settings that demand them to dive deep and go far into uncharted territories, to cultivate critical thinking skills, exposure to a wide range of demographics, to risk failure and to realize that the human body does more than just play sports through life….it ages and fails frequently.  The emerging setting does not have to be a career choice but it should be a tool that cultivates and fine tunes the professional medical skills that an AT is expected to produce. What is Missing??
  12. 12.   Creates excitement  Breaks down a students comfort zone  Generates innovative ideas for our profession within young minds  Broadens the student’s horizons – new experience in life  Exposes them to physical medicine aspects that are not readily available in an athletic setting  Develops skills in educational outreach training  Business development  Branding, marketing, ROI, the value of the AT outside the sports world, etc. Exposure to Emerging Settings
  13. 13.  Bridging The Gap
  14. 14.   Create a database that consists of an up to date list of available athletic training clinical opportunities among emerging settings for students  This database will allow student athletic trainers to search for specific criteria that meets their location, financial, setting and educational needs.  Evaluate the supply and demand of CO’s and determine what role COPA could play in helping emerging settings create new CO’s Purpose of COES Database
  15. 15.   Only active members (both professionals and students) will have access to this database  Database will be found on the COPA home page  Links to COES Database  Educators page  Student page  Employment page (Career development)  Database can be edited or deleted at anytime by submitting member.  All members have to accept a disclaimer before entering the database Database Key Facts
  16. 16.   Do you have a Clinical Opportunity program at your site?  How many students do you take per semester?  What setting are you representing?  District  State  POC info  Application process  Social media links Questions on the Survey
  17. 17.  Would you or your facility be interested in creating an educational athletic training clinical rotation?  Since you do not have a current clinical rotation program what reasons would best describe your barriers.  If NATA/COPA could offer examples and resources such as: program design, application requirements, legal forms, contract samples, security suggestions, etc., would this help in the development of a clinical rotation at your facility.  Would you like to see a session on the development and management of an effective clinical rotation program at Survey Questions (stage two of survey)
  18. 18.   Email survey out to over 8,000 emerging setting ATs  721 responses (11%)  294 (41%) had active CO for student ATs  110 individual sites with publishable data for the COES Database (some duplicate/ ATs at the same site)  427 of 721 responded – they do not offer COs  274 of 427 (64%) were interested in learning more about developing a CO within their setting  100 (23%) did not want to host students Survey Results
  19. 19. 
  20. 20. Current Facility Listing Data 1 2 3 4 5 6 7 8 9 10 Number of Opportunites per District 5 19 15 51 8 7 6 8 26 4 0 10 20 30 40 50 60 NumberofFacilities Number of Opportunites per District
  21. 21. What users are looking for? 1 2 3 4 5 6 7 8 9 10 Total Pageviews 12 6 8 5 7 4 1 10 3 0 0 2 4 6 8 10 12 14 Page Views by District Search
  22. 22. 0 10 20 30 40 50 60 70 Clinical Outreach Clinical/Ortho/Physician Extender College Corporate/Occupational High School Hospital/Outreach Military/Government/Law Enforcement Other Performing Arts Professional Sports Facilities Per Setting Current Facility Listing Data
  23. 23. 0 10 20 30 40 50 Clinical College Corporate/Occupational High School Hospital Outreach Military Other Performing Arts Professional Sports Sales Total Page Views by Setting Search What Users Are Looking For?
  24. 24. 0 1 2 3 4 5 6 7 8 9 10 Arts ATS Chiropractic Dance Deaf Des Moines Film Graduate Assisstant Internship Military NASA New ULM Obesity Care Performance Medicine Performing Arts Physician Extender Police Professional Sports Rehabilitation Student Student Internship Summer Ulnar Collateral Ligament Total Page Views by Keyword Search What Users Are Looking For?
  25. 25. 0 5 10 15 20 25 Alabama Arizona California Florida Georgia Illinois Indiana Kansas Kentucky Louisiana Maryland Michigan Minnesota Mississippi Missouri Nebraska Nevada NewHampshire NewJersey NewYork NorthCarolina Ohio Oregon Pennsylvania RhodeIsland SouthCarolina Tennessee Texas Utah Vermont Virginia Washington WestVirginia Wisconsin Facilities per State Current Facility Listing Data
  26. 26. 0 5 10 15 20 25 30 35 40 AK AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY MA MD ME MI MN MO MS MT NC ND NE NH NJ NV NY OH OK OR PA SC TN TX UT VA WA WI WV Page Views by State Search What Users Are Looking For?
  27. 27.  Interested in Starting a CO  Top Settings Interested In Starting a CO  Clinical/Ortho/PE (25%)  Clinical Outreach (25%)  Other (17.95%)  Hospital/Outreach (13.3 %)  Military/Government/Law Enforcement (7.18%)
  28. 28.  Roadblocks in Starting a CO  What is stopping the creation of new CO’s?  Never been asked (20.19%)  Don’t know where to start (14.08%)  No local universities (10.8%)  Not enough staff for supervision (8.69%)  Declined by Management (7.28%)  Legal issues (6.34%)
  29. 29.  How Can NATA Help
  30. 30.   Is the CO ran and overseen by ATs  How many ATs on staff?  How many students have they taken in the past?  How many years has the CO program been in operation?  Is there a detailed application process?  Are there documented educational components within the CO?  Will there be hands on experience and not just observation?  Examples of ancillary projects and site visits  Phone or in person interview with the ability for the students to ask questions about day to day operations.  Quality website and social media – possible testimonies from past schools and students. Things To Look For in a CO
  31. 31.  Concerns About CO Sites  HIPAA  Security  Liability  No preceptor?  Educational components?  Site visits?  Value and work ethics  Supervision
  32. 32. Internship Application Internship Application Attention: Due to heightened security and badging requirements at this government facility, it will not be possible to except Non-US citizens at this time. Please accept our apologies. Personal Information First Name: Last Name: US Citizen: Date of Birth: / / Place of Birth: School Information School Name: Street Address: City: State: Zip: Year/Classification: Address Information Street Address: City: State: Zip: Phone: Email: Permanent Address Information Street Address: City: State: Zip: Phone: Evaluations Therapeutic Modalities Rehabilitation Design Anatomy Understanding of Injuries Knowledge of Rehabilitation Exercises Outreach (presentations, educational material design) Leadership Skills Emergency Care Chronic Injury Care Post Surgical Rehabilitation Administration Tasks (SOAP notes, progress notes, time management) Select your top three weaknesses in athletic training: Injury Evaluations Therapeutic Modalities Rehabilitation Design Anatomy Understanding of Injuries Fitness/Strength Training Knowledge of Rehabilitation Exercises Outreach (presentations, educational material design) Leadership Skills Emergency Care Acute Injury Care Chronic Injury Care Post Surgical Rehabilitation Administration Tasks (SOAP notes, progress notes, time management) At this time in your education, if you were to choose your final professional occupation what would it be: ATC PT PTA PA OT Orthopedic Surgeon General Practitioner Paramedic/EMT Educator Researcher/Ex Phys. Other: If you were to work as an ATC what employment setting would you desire: High School College Industrial/Corporate Clinical Professional Sports Arts/Dance Hospital Military Other: Answer the following questions on a scale of 1-5. (1=poor, 2=below average, 3=average, 4=above average, 5=excellent) How do you feel about your skills in evaluating? 1 2 3 4 5
  33. 33. SAMPLE NASA EDUCATIONAL AGREEMENT IN PRINCIPLE AA-B-1 Dear The Aerospace Medicine and Occupational Health Branch at the National Aeronautics and Space Administration, John F. Kennedy Space Center (herein after “NASA-KSC”) and the University of *** (herein after “UNIVERSITY”) have discussed the placement of University students in the NASA-KSC Aerospace Medicine and Occupational Health Branch’s Health and Medical Education Program, as an unpaid intern. NASA-KSC and University acknowledge this agreement is not legally binding or enforceable. The purpose of this Agreement In Principle (AIP) is to permit University students majoring in the areas of Medicine, Physical Medicine and Musculoskeletal Rehabilitation, Health and Wellness, Public Health, Exercise Science, and other areas as appropriate, to intern in the Aerospace Medicine and Occupational Health Branch. This AIP will enable University to provide opportunities for its students to gain practical experience. NASA-KSC and University intend to work together to create meaningful internships for University students, but neither is obligated to provide or place students. Students will be placed only when the Aerospace Medicine and Occupational Health Branch has productive and educational work assignments available. It is anticipated that students will be provided an opportunity on a predetermined basis and will be selected by University. University of Central Florida intends to: 1. Provide NASA-KSC, in writing, prior to any student being permitted to come on center, with the names of the students1 assigned by University to participate in the internship program. However, NASA-KSC may set limits on the number of students who may participate at any given time, and NASA-KSC is not obligated to allow placement of students into the program. 2. Designate a member of University faculty to coordinate the educational experience of students participating in the Program with the NASA-KSC Liaison, and provide NASA-KSC with the name of University faculty representative. 1 A student as defined by 5 U.S.C. §3111 (a) is: An individual who is enrolled, not less than half-time, in a high school, trade school, technical or vocational institute, junior college, college, university, or comparable recognized educational institution. An individual who is a student is deemed not to have ceased to be a student during an interim between school years if the interim is not more than 5 months and if such individual shows to the satisfaction of the Office of Personnel Management that the individual has a bona fide intention of continuing to pursue a course of study or training in the same or different educational institution during the school semester (or other period into which the school year is divided) immediately after the interim. Experience must be uncompensated. Sample Agreement in Principle • NASA does not sign school learning contracts. • Most clinics/emerging settings do not want and can’t sign contracts with schools. • CO need to create a AIP or educational agreement.
  34. 34. Modality and Equipment Competency Orientation Verification From This form is to verify the competencies of incoming students/interns with modalities and rehabilitation equipment that will be used in the KSC RehabWorks facility. All competencies will reflect the guidelines of the established Standing Orders and Protocols for the KSC RehabWorks program. Student Name: ____________________________________________ ______________ University Name:__________________________________ Year in School: _________ Internship Start Date: ______________________End Date:_______________________ This forms verifies that you have been oriented and have shown competency in the functional capabilities, operations, and precautions found with the modalities and equipment listed above that will be used during your internship at KSC RehabWorks. Also this form indicates that you have read and understood KSC RehabWorks Standing Orders and Protocols. Student Signature: _________________________________ _______ Date:__________ Staff ATC Signature ________________________________ _______ Date:__________ Modality/Equipment Date Competency Verification ATC Initials Cryotherapy Hydrotherapy Thermotherapy Ultrasound Electrical Stimulation Iontophoresis Whirlpool Game Ready/Cryo Cuff Intermittent Compression Shortwave Diathermy Wound Care Free Weights Machine Weights (Fitness Center and RehabWorks) Cardio Weights (Fitness Center and RehabWorks) Goniometer/Inclinometer
  35. 35. CONFIDENTIALITY ACKNOWLEDGEMENT STATEMENT The undersigned hereby acknowledges his/her responsibility under applicable Federal and state law and/or regulations, including but not limited to regulations under the Health Insurance Portability and Accountability Act (“HIPAA”) and the Privacy Act, to keep confidential any information regarding Facility patients, as well as all confidential information of the Facility. The undersigned agrees, under penalty of law, not to reveal to any person or persons any specific information regarding any Facility patient, except to authorized clinical staff and associated personnel of the Facility and, as necessary, to other Program Participants at that Facility who are supervising or assisting the undersigned in the provision of services at Facility. The undersigned further agrees not to reveal to any third party any confidential information of Facility, except as required by law or as authorized by Facility. Dated this _____ day of _____________________, 20___. Program Participant Print Name: Witness
  36. 36. KSC RehabWorks Internship Health, Safety, Security and IT Training Requirements Athletic Training Student: _______________________________ University/College: ______________________________________ Semester/Year: _______________________ REQUIRED TRAINING COMPLETION DATE EXPIRATION DATE TITLE TRAINING SOURCE CPR/AED for the Professional Rescuer Completed at school, on own or at KSC. Bring proof. First Responder Completed at school, on own or at KSC. Bring proof. OSHA GHS Hazard Comm. Standard QG213KSC Classroom Hazard Communication QG210OSH Classroom Workplace Violence SS-LCHR_01_A04_LC_ENUS Satern HIPAA Privacy Rules SS-LCO0301 Satern “Infection Control Practices” Power point Course PowerPoint Bloodborne Pathogens QG308KSC PowerPoint Initial IT Security Briefing ITS-013-001 Classroom Initial IT Security Briefing KSC-ITS-PB Satern Fire in the Workplace QG227KSC PowerPoint - Satern Safety/QA NEW HIRE –“Safety/QA New Hire Orientation Classroom Mike Runion Student Signature: _________________________________Date:_______________ Intern Coordinator:_____________________________ Date:_____________
  37. 37. OCCUPATIONAL MEDICINE STANDING ORDER/PROTOCOL ATHLETIC TRAINING STUDENT INTERN COMPETENCIES A. Onsite Education and Orientation 1. Upon starting his or her internship, all students/interns will be given an orientation within the KSC RehabWorks facility consisting of a review of procedures, health and safety precautions, contraindications and indications of the following modalities and equipment prior to utilization during his or her internship. All training will be in compliance with RehabWorks’ Standing Orders and Protocols. a. Cryotherapy b. Hydrotherapy c. Thermotherapy d. Ultrasound e. Electrical Stimulation f. Iontophoresis g. Whirlpool h. Game Ready/Cryo Cuff i. Intermittent Compression j. Shortwave Diathermy (Rebound) k. Wound Care l. Free Weights m. Machine Weights n. Cardio Machines o. Goniometer/Inclinometer 2. The Modality and Equipment Competency Orientation Verification Form will be used to document the understanding and competency of each modality and/or equipment listed above. Each form will be signed by the supervising ATC. B. Standing Orders and Protocols 1. Each student will read and review the Standing Orders and Protocols for RehabWorks’ within the first week of his or her internship and approved by Internship Coordinator. C. Therapeutic Exercise 1. Each student will complete the therapeutic exercise chart assignment during the first week of his or her internship. This therapeutic exercise chart will demonstrate the student’s current ability to select and implement therapeutic exercises in regards to specific muscles and according to specific levels of injury.
  38. 38. JOHN F. KENNEDY SPACE CENTER RehabWorks Internship Program Voluntary Services Consent Name:_______________________________________ Effective Date:________________ School Name:__________________________________ State of School:_______________ This Voluntary Services Consent (VSC) document is specific to the KSC RehabWorks program and is an addendum in accordance to the Agreement In Principle (AIP), a learning agreement between NASA and the university that has been separately delivered. By my signature below, I signify my voluntary donation, without condition, of my services to the National Aeronautics and Space Administration, at the John F. Kennedy Space Center, for its use and benefit pursuant to subsection 203(c)(4) of the National Aeronautics Space Act of 1958 as amended (42 U.S.C. §2473 et. seq.), and my agreement with the following additional understandings and provisions: 1. My services will be gratuitous-I understand that I will receive no financial or material compensation of any kind for those services; 2. The times and location of my voluntary services will be determined by mutual agreement with the designated Kennedy organization receiving those services, and their performance will be subject to the direction or oversight of that organization. I will ensure that the RehabWorks Internship Coordinator is kept informed in writing of the times and location of my services; 3. While performing my voluntary services, I will comply with all applicable laws, regulations and instructions governing the conduct of employees in the workplace and the proper use of facilities and equipment at Kennedy; 4. I understand that I will not have clearance for access to classified information while performing voluntary services except as granted by special approval and arrangement through the NASA Personnel Security Program; 5. Whatever product or data may result from my services will be NASA property subject to its sole control and disposition, including unlimited rights to all data and in all inventions that may result from my services; 6. I understand that, as an individual rendering services without pay to an agency of the United States, I will nevertheless be deemed a Federal employee as provided by 5 U.S.C. §8101(1)(B) and the law governing compensation for injury, disability or death resulting from personal injury sustained while in the performance of such services; and that I will also be deemed a Federal employee as provided by 28 U.S.C. §2671 for the purpose of determining my rights under the Federal Tort Claims Act in regard to any such injury, disability or death;
  39. 39.  Future Goals  Develop a certification for clinical opportunities  Certification to last for 2 years??  Collection of specific requirements such as:  Educational components for the student through lectures, presentations, etc.  Involvement of site educational outreach opportunities - (patient/employee/athlete/performer education)  Site specific projects for patient education or site marketing and branding  Established Agreement in Principal  Standard operating procedures for the student AT  HIPAA guidelines  Site specific guidelines ( security, liability, transportation, housing)  Emergency plans  Modality calibration records  Etc….
  40. 40.   Create a program to help emerging settings start their own CO and help manage the challenges  Promote the COES database to program directors and AT students.  Increase the number of CO listed in the COES database  Encourage program directors to think outside the box and create new opportunities for their students. Future Goals
  41. 41.  Thank You KSC RehabWorks Erik Nason, MBA, ATC, MS, CSCS KSC RehabWorks IHA-008 Kennedy Space Center, FL 32899 321-867-8004