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thesis entitled

THE RELATIONSHIP BETWEEN SELF-EFFICACY AND
CLINICAL EXPERIENCE IN SENIOR ATHLETIC TRAINING
STUDENTS

presented by
AMANDA J. SCHINDLER

has been accepted towards fulﬁllment
of the requirements for the

MS. degree in Kinesiology

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THE RELATIONSHIP BETWEEN SELF-EFFICACY SCORES AND CLINICAL
EXPERIENCE IN SENIOR ATHLETIC TRAINING STUDENTS

By

Amanda J. Schindler

A THESIS
Submitted to
Michigan State University
in partial fulﬁllment of the requirements
for the degree of
Master of Science

Department of Kinesiology
2004

ABSTRACT

THE RELATIONSHIP BETWEEN SELF-EFFICACY SCORES AND CLINICAL
EXPERIENCE IN SENIOR ATHLETIC TRAINING STUDENTS

By

Amanda J. Schindler

The purpose of this study was to examine the relationship between self-efﬁcacy
scores, pertaining to clinical proﬁciencies and certiﬁcation examination
preparedness, and the number of clinical hours an athletic training student has
completed. The investigator developed the Student Athletic Trainer Efﬁcacy
Scale (SATES) from the National Athletic Trainers” Association’s (1999) clinical
proﬁciencies to measure self-efﬁcacy. In addition, students were asked about
their preparedness for the certiﬁcation examination. The scale was administered
to college undergraduate students currently enrolled in their senior year of an
athletic training program accredited by the Commission on Accreditation of Allied
Health Education Programs (CAAHEP). Items pertaining to the clinical
proﬁciencies were grouped into eight subdomains. Correlations performed
between clinical proﬁciency subdomains and clinical hours revealed a moderately
low correlation (r=.18, p<.05) between the assessment and evaluation
subdomain and clinical hours. All others were not signiﬁcant. Correlations
performed between examination preparedness and clinical hours revealed no

signiﬁcant relationship.

ACKNOWLEDGMENTS

I have many people that I would like to thank for helping me complete not
only this thesis, but also my degree. A general thank you goes out to all of my
friends, from Michigan State, La Crosse and Chippewa, who were constantly
supportive and always willing to lend a hand. Thank you from the bottom of my
heart!

Most importantly, I would ﬁke to thank my parents, sister and brother-in-
law for their constant love and support. You may not completely understand the
choices I make but are always there to encourage me and pick me up when I am
down. You instilled in me a drive that would never let me give up, even when
circumstances looked fairly bleak. Thank you for making me laugh and relax
when I needed it most. Nikki and Dave thank you for bringing a new source of
happiness to my ﬁfe; she is a huge blessing. You are my heart and soul and I am
truly blessed for having all of you in my life. I love you.

Secondly, thank you to my committee, Dr. Gail Dummer and Dr. John
Powell, for your constant support and patience. I did not make things easy on
either of you, but your insight and expertise are priceless to me. Dr. Powell, thank
you for stepping in when my committee was incomplete. I appreciate both of your
commitments to my project.

Next, I would like to thank two very important doctoral students. Thank you
Trffanye Tonsing for your assistance on content, proofreading, and your

friendship. You helped me get off the starting blocks with formatting my proposal.

iii

Without you I would still probably be contemplating how to put it all together. A
huge thank you. To Nick Myers, thank you for all your statistical help. I was very
afraid of never ﬁnding a way to make my participant number and number of
factors work; you accomplished that with your expertise. I am forever grateful to
you.

Finally, thank you to Dr. Deborah Feltz, my academic advisor. I came to
Michigan State University not even knowing if I wanted to, or was capable of,
completing a project of this magnitude. It was no easy task to attempt to drive me
through this thesis but your guidance, insight, and expertise all helped me
complete this project. Thank you for never giving up faith and always offering
encouragement when I needed it. I will never forget your commitment to me as a

student and scholar.

iv

TABLE OF CONTENTS

LIST OF TABLES ................................................................................................ vii

CHAPTER 1

INTRODUCTION .................................................................................................. 1
Nature of the Problem ................................................................................ 1
Athletic Training Programs ......................................................................... 2
NATABOC Certiﬁcation Examination ......................................................... 6
Self-efﬁcacy ................................................................................................ 7
Hypotheses .............................................................................................. 1O
Assumptions and Delimitations ................................................................ 10
Abbreviations and Deﬁnitions ................................................................... 11

CHAPTER 2

REVIEW OF RELATED LITERATURE ............................................................... 12
History of Athletic Training Education ....................................................... 12
Structure of Athletic Training Education Programs ................................... 15
Developing Conﬁdence in Athletic Training Knowledge and Skills ........... 19

CHAPTER 3

METHODS .......................................................................................................... 25
Participants .............................................................................................. 25
Instrumentation ........................................................................................ 28
Procedure ................................................................................................. 31
Treatment of Data .................................................................................... 32

CHAPTER 4

RESULTS ........................................................................................................... 34
Hypothesis 1: Self-efﬁcacy for Required Competencies ........................... 34
Hypothesis 2: Self-efﬁcacy for Preparedness on the Certiﬁcation

Examination ................................................................................... 39

CHAPTER 5

DISCUSSION ...................................................................................................... 41

APPENDICES
A. Informed Consent Form ....................................................................... 47
B. Senior Athletic Trainer Efﬁcacy Scale .................................................. 48
C. lntradomain Correlations for the SATES .............................................. 51
D. Script for Questionnaire Proctor .......................................................... 54
E. Hour Reporting Chart ........................................................................... 55

REFERENCES ................................................................................................... 56

LIST OF TABLES

Table 1. Distribution of NATA Competencies by Content Area ............................. 3
Table 2. Sample Characteristics ......................................................................... 26
Table 3.Clinical Experience Hours Reported by Athletic Training Program
Directors ................................................................................................... 27
Table 4. Credit Hours Reported by Athletic Training Students ............................ 27
Table 5. Semesters Completed Reported by Athletic Training Students ............ 28
Table 6. lntemal Reliability Characteristics of the SATES .................................. 31

Table 7. Self-Efﬁcacy Ratings for Required Athletic Training Competencies ...... 35

Table 8. Relationships between Clinical Hours, College Semesters Completed,
and Credit Hours Completed with Self-Efﬁcacy Scores for Required
Athletic Training Competencies ................................................................ 38

Table 9. Self-Efﬁcacy Ratings for the NATABOC Certiﬁcation Examination ....... 39
Table 10. Relationships between Clinical Hours, College Semesters Completed,

and Credit Hours Completed with Self-Efﬁcacy Scores for the NATABOC
Certiﬁcation Examination .......................................................................... 40

vi

CHAPTER 1
INTRODUCTION

Nature of the Problem

The design of an undergraduate athletic training program leads to its
overall effectiveness for creating highly qualiﬁed graduates. Accredited athletic
training programs aim to educate well-rounded professionals and do so with an
extensive list of competencies. However, psychological preparation of future
athletic trainers is often ignored. One psychological variable in terms of
preparation is self-efﬁcacy, the belief that one can perform speciﬁc skills
successfully (Bandura, 1977, 1997). Self-efﬁcacy is important when an employee
is responsible for providing proper care for athletes. Efﬁcacious, well-trained
athletic training graduates will be much more effective in providing proper
treatment, assessments, and rehabilitation programs than self-doubting ones.
The efﬁcacious athletic trainer also will be more able to decisively and effectively
make decisions that affect his or her patients. Psychological preparation of
students” self-efﬁcacy is also important because of the stressful nature of the
certiﬁcation examination, which tests students’ mastery of a vast number of
competencies. Thus, it is important to examine how prepared graduates really
are and how conﬁdent they feel about their skills.

The clinical education component of athletic training education is
particularly interesting with respect to the development of self-efﬁcacy. Self-
efﬁcacy theory (Bandura, 1977, 1997) suggests that one’s practical experiences

are a reliable and stable source of self-efﬁcacy information. No research has

been conducted on the self-perception of the clinical proﬁciencies or the self-
perception of competency to pass the certiﬁcation examination of athletic training
students. This study will determine if a relationship exists between self-efﬁcacy of
athletic training students regarding the required proﬁciencies and ability to pass
the certiﬁcation examination, and the number of hours athletic training students
accumulate in practicum work.
Athletic Training Programs

Reform has been called for in the educational programs of athletic training
(Denegar & Hertel, 2002). Clinical proﬁciencies, along with required coursework,
have become the source of success measurement rather than simply counting
hours. There are roughly 1,230 individual clinical proﬁciencies for which a student
is responsible, which are grouped into 12 content areas (see Table 1) (Starkey,
Koehneke, Sedory, & Turocy, 2003). These content areas contain overlapping
information to develop three major competencies: cognitive, psychomotor, and

affective.

Table 1

Distribution of NA TA Competencies by Content Area

 

Competencies

Total

Content Areas

 

Risk management and injury prevention 108

Pathology of injuries and illnesses 289

(Estimated; Contained within risk
managementfrnjury prevention and

assessment/evaluation)

Assessment and evaluation 327
Acute care of injury and illness 57
Pharmacology 66
Therapeutic modalities 68
Therapeutic exercise 75
General medical conditions and 133
disabilities

Nutritional aspects of injury and illness 24
Psychosocial intervention and referral 12
Health care administration 60
Professional development and 1 1

responsibilities

Total 1230

 

Cognitive competencies focus on the understanding of techniques,
theories, and concepts. A student’s ability to physically perform a skill is included
in the psychomotor competency. Affective competencies relate to professional
and ethical standards that students should practice (Starkey et al., 2003).
Students must be knowledgeable in 12 major subject areas, with multiple speciﬁc
teaching objectives and outcomes for each. The 12 major subject areas are risk
management and injury prevention, pathology of injuries and illnesses,
assessment and evaluation, acute care of injury and illness, pharmacology,
therapeutic modalities, therapeutic exercise, general medical conditions and
disabilities, nutritional aspects of injury and illness, psychosocial intervention and
referral, health care administration, and professional development and
responsibilities. Examples of teaching objectives include, but are not limited to,
students performing anthropometric measurements, demonstrating client-speciﬁc
ﬂexibility exercises, performing record-keeping skills, applying therapeutic
modalities, and designing general nutrition programs for athletes.

Speciﬁc outcomes included in the above teaching objectives are: (a)
competent assessment of height, weight, blood pressure, pulse, etc.; (b)
selection of range—of-motion exercises for all major muscle groups; (c) use of
standardized record keeping methods and use of progress notes; (d) selection of
appropriate parameters for cryotherapy, thennotherapy, electrotherapy,
ultrasound, traction, intermittent compression, and therapeutic message; (e) and
assessment of nutritional guidelines for weight loss, weight gain, and ﬂuid

replacement (NATA, 1999).

In addition to the many proﬁciencies required for successful completion of
an accredited athletic training program, students must fulﬁll the NATABOC
(National Athletic Trainers’ Association Board of Certiﬁcation) course
requirements. Students must take courses in the following subject areas: (a)
health (examples include personal health, pathology, nutrition, pharmacology,
drug/substance abuse/use); (b) human anatomy and human physiology; (c)
kinesiologylbiomechanics; (d) exercise physiology; (e) basic athletic training
(examples include introduction to athletic training, training room management,
care and prevention of athletic injuries); (f) advanced athletic training (examples
include therapeutic modalities, rehabilitative exercise) (NATABOC, 2003a).

Besides clinical proﬁciencies and coursework, the NATABOC has many
additional guidelines for various aspects of the clinical education portion of
athletic training programs in order for their students to become eligible for
certiﬁcation. The duration of the clinical experience must take place in no less
that 2 academic years and during this time the program director is responsible for
documenting learning over time regarding the clinical proﬁciencies. Athletic
training students should be assigned to an approved clinical instructor and their
clinical experiences should include assignments at various locations (i.e., four
year colleges and universities, two year colleges, high schools, clinics, hospitals,
industrial rehabilitation clinics, professional and Olympic sports). In addition to
various placements, the job responsibilities must include practice and game
coverage, pre-event preparation and post-game tear down, and athletic training

room coverage (NATABOC, 2003b).

Little research has been conducted on the required competencies and
beneﬁts of clinical hours. Miller and Bany (2002) investigated how students spent
their time during clinical placements. The authors found that 59% of time was
spent unengaged, performing behaviors that seemed to have no relationship to
athletic training. It is important to consider the amount of time athletic training
students are engaged so that gains in knowledge and conﬁdence can be made.
Clinical education is an important component of ATEP and if clinical placements
are designed properly, gains can be seen. In 2002, Mensch and Ennis, through
qualitative interviews, found that hands-on and observational athletic training
experiences enhanced students’ conﬁdence more than classroom experience.
The design of clinical education may be more important for professional
development than the number of clinical hours completed.

NA TABOC Certiﬁcation Examination

Even less research has been conducted on clinical proﬁciencies and the
ability to pass the NATABOC certiﬁcation examination. Of the few studies
conducted, the focus has been on determining predictors for passing the
examination (Harrelson, Gallaspy, Knight, & Leaver-Dunn, 1997; Turocy, 2002).
These studies found that a student’s overall Grade Point Average was the most
predictive factor of examination scores. Research has not investigated the
relationship between self-perceptions for passing the examination and its speciﬁc
sections and examination scores.

Self-efﬁcacy perceptions may be important to examination success for

athletic training students because of the nature of the examination environment.

The NATABOC certiﬁcation examination consists of three sections: written,
written simulation, and practical. The written portion of the exam consists of
multiple-choice questions testing all aspects of course work the athletic training
student has completed. The written simulation portion of the examination puts
student athletic trainers into “real life” situations. Students are given multiple
scenarios, are presented with several options of care, and must decide which
option is correct by highlighting his or her choice. During the practical portion of
the examination, students are called out of the test area and are taken to a
private room with a model and two proctors. The proctors read a skill that the
student is to perform and the student has a given amount of time to demonstrate
competency in that skill on the model. This is a high-pressure environment for the
examinee. As the student is performing the task, both proctors evaluate the
student on a standard checklist. Each area of the examination tests an athletic
training student’s knowledge in all areas; however, each portion does so in a
slightly different manner. Given the intense atmosphere of the examination, how
well prepared students feel they are may be the deciding factor in whether they
pass individual portions or the whole examination.
Self-efﬁcacy

As previously stated, the research questions of this thesis are whether
more clinical hours are associated with higher self-efﬁcacy beliefs for athletic
training students regarding the clinical proﬁciencies and success on the
certiﬁcation examination. According to Bandura’s (1977, 1997) theory of self-

efﬁcacy, self-efﬁcacy is a determinant of four sources of information:

performance accomplishments, vicarious experiences, verbal persuasion, and
physiological states. Performance accomplishments are based on an individual’s
successful experiences. Repeated successes will continue to raise an
individual’s expectations, while repeated failures will lower expectations. If an
individual has developed strong efﬁcacy through continued success, then the
effect of failure will be reduced. Performance accomplishments are believed to
be the strongest inﬂuence on an individual’s self-efﬁcacy and seem to be the
most abundant throughout an athletic training program. After successes at many
of the proﬁciencies, a student will feel more efﬁcacious about his or her behavior.
Vicarious experience, as a source of efﬁcacy information, includes seeing
others perform a task successfully without any harmful consequences, thus
increasing one’s conﬁdence. This determinant is weaker than performance
accomplishments; therefore, the expectations that stem from modeling behavior
are more likely to change than those attained through an individual’s own
success. \ﬁcarious experience can be seen throughout the ﬁrst year of any
athletic training program, when athletic training students are only allowed to
observe clinical proﬁciencies. The concept that people are often inﬂuenced by
suggestion is addressed in the idea of verbal persuasion. Again, this determinant
is weaker than performance accomplishment because it does not give the
individual concrete success to base his or her expectations. Many individuals
also utilize the level of emotional arousal (physiological states) to determine their
perceived self-efﬁcacy in a certain situation. Emotions are used to determine how

anxious or vulnerable an individual feels when faced with a particularly stressful

experience. Thus, if an athletic training student becomes anxious when
performing a proﬁciency, it might be interpreted by the student to mean that he or
she lacks the requisite skills, which in turn, inﬂuences efﬁcacy judgments.
Although all four sources of efﬁcacy information have the potential to inﬂuence
the efﬁcacy beliefs of athletic training students, performance accomplishments, in
the form of clinical experience, appear to have the strongest potential inﬂuence.
The amount of clinical experience may be positively related to self-efﬁcacy and
clinical proﬁciencies as well as a sense of preparedness for the certiﬁcation
examination.

Preparation for an examination can be viewed as critical because it has
been shown to be a good predictor of success. College students who felt
optimistic about their preparation on a self-report for an oral examination had
higher self-efﬁcacy scores (Schweizer, 2000). Vrugt, Langereis, and Hoogstraten
(1997) found that individuals with higher self-efﬁcacy beliefs performed better on
an examination than did individuals with low self-efﬁcacy beliefs. Self—efﬁcacy
judgments, due to environmental or situational circumstances, are often made
under uncertainty (Vaughn, 1999). Therefore, preparing for the exact
environment and situations that an athletic training student may confront during
the certiﬁcation examination will lessen the uncertainty of these judgments, thus
aiding in a better performance.

Assessing self-efﬁcacy judgments requires use of a measurement
instrument that is speciﬁcally tailored to the domain of functioning of interest.

Because no instrument for measuring self-efﬁcacy in senior athletic training

students exists, the present study consisted of, ﬁrst, developing the Senior
Athletic Trainer Efﬁcacy Scale (SATES) and, second, determining if there was a
relationship between self-efﬁcacy and clinical hours completed.
Hypotheses
This study seeks to address the following hypotheses:
H1: A positive relationship will exist between number of clinical experience
hours and self-efﬁcacy scores for required competencies in eight subject
areas for senior athletic training students enrolled in a CAAHEP
accredited program.
H2: A positive relationship will exist between number of clinical experience
hours and self-efﬁcacy scores for preparedness on the certiﬁcation
examination for senior athletic training students enrolled in a CAAHEP
accredited program.
Assumptions
The major assumption of the study is that program directors will accurately
report the number of clinical hours that an athletic training student in his or her
program has completed. We also assume that the athletic training student has
accurately and properly recorded his or her hours, not including travel time or
unsupervised hours.
Delimitations
The results of the study may be generalized only to other senior athletic

training students in a CAAHEP accredited curriculum program.

10

AMA
ATEP

CAAHEP

JRC-AT

NATA

NATABOC

Abbreviations and Deﬁnitions
American Medical Association

Athletic Training Education Programs
CAAHEP accredited undergraduate athletic training programs.

Commission on Accreditation of Allied Health Education Programs
Non-profit allied health education organization whose purpose is
to accredit entry level allied health education programs (CAAHEP,
2003).

Joint Review Committee on Educational Programs in Athletic
Training

The organization that is responsible for monitoring the curriculum
of accredited athletic training programs and for making sure that
clinical and coursework requirements are met.

National Athletic Trainers’ Association
The national organization that works to advance the profession of
athletic training.

National Athletic Trainers’ Association Board of Certification
The organization that is responsible for administrations of the
certification examination, certification of athletic trainers, and
overseeing all certified athletic trainers.

ll

CHAPTER 2
REVIEW OF RELATED LITERATURE

The present discussion has several purposes. First, the history of athletic
training education in the United States is discussed. The second purpose is to
provide a description of the structure of ATEP. Third, self-efﬁcacy is examined in
ATEP and other Ieaming contexts.

Multiple authors have examined the history of the NATA, the NATABOC,
and ATEP (Delforge & Behnke, 1999; National Athletic Trainers’ Association,
1999; National Athletic Trainers’ Association Board of Certiﬁcation, 2003a;
Weidner & Henning, 2002). Since recent changes in the requirements for
undergraduate athletic training students have been made, investigators have
begun to examine the structure of ATEP (Denegar & Hertel, 2002; Mensch &
Ennis, 2002; Turocy, 2002). Aside from simply studying ATEP and their structure,
investigating self-efﬁcacy and how to enhance it within a Ieaming and
motivational context is pertinent (Chen, Gully, & Eden, 2004; Schunk, 1981,

1 995).
History of Athletic Training Education

The NATA was founded in 1950; however, it was not until 1956 that an
investigation of avenues to enhance the professionalism of athletic training was
introduced. The ﬁrst athletic training curriculum model was introduced in 1959
and consisted of speciﬁc required courses and a strong emphasis on the
importance of athletic trainers obtaining a secondary-level teaching credential.

Athletic trainers were to be trained in education, mostly health and physical

12

education. Along with a teaching credential, the curriculum was designed around
prerequisites for physical therapy school because further education at a physical
therapy school was seen as an opportunity for professional growth. This early
curriculum possessed few courses that differentiated it from a physical education
major because athletic training had not been introduced formally in higher
education (Delforge & Behnke, 1999).

A 10-year void existed from the time of the introduction of the ﬁrst
curriculum model until the ﬁrst four undergraduate education programs were
recognized by the NATA. In the midst of the development of undergraduate
education programs, the American Medical Association (AMA), in 1967,
recognized the professional efforts of the NATA and in the years following,
several other professional organizations followed suit, including the Joint
Commission of Competitive Safeguards and Medical Aspects of Sports and the
American Association for Health, Physical Education, and Recreation, as well as
several state medical associations (Delforge & Behnke, 1999).

The 1970’s proved to be a decade of major change for ATEP. The NATA
education committee constantly reviewed course work and clinical experience
requirements to remove irrelevant content. The NATA Committee determined
that there was a lesser need for athletic trainers to fulﬁll prerequisites for physical
therapy school and obtain a teaching credential (Delforge & Behnke, 1999). A
laboratory or practical experience relevant to athletic training was added to the
curriculum model. This required students to complete 600 supervised clock hours

prior to graduation (Weidner & Henning, 2002). The number of clock hours

13

continued to change through 2000. In an approved or accredited (discussed
below) program, students were required to complete 600 to 800 hours (Weidner
& Henning, 2002). The ﬁrst document outlining the development and
implementation of undergraduate ATEP was incorporated during the 1970’s. A
list of behavioral objectives and Ieaming outcomes for each course was
developed, along with a skill competency checklist to monitor a student’s clinical
skills (Delforge & Behnke, 1999).

In June 1990, the professional growth of athletic training came to a peak
as the AMA formally recognized athletic training as an allied health profession.
This allowed athletic training to seek educational program accreditation by the
AMA Committee on Allied Health Education and Accreditation (CAHEA),
currently known as CAAHEP. Several months later, the American Academy of
Family Physicians and the American Academy of Pediatrics joined the AMA and
the NATA to create the JRC-AT. The American Orthopaedic Society for Sports
Medicine joined 5 years later. The JRC-AT worked to development standards
that governed review and accreditation of entry-level programs (Delforge &
Behnke, 1999). The JRC-AT evaluates programs working toward initial or
continuing CAAHEP accreditation.

A major recent change in 2002 eliminated the clinical hour requirement of
ATEP, focusing more on the successful completion of clinical competencies
(Denegar & Hertel, 2002). This change showed the gradual evolution from an
emphasis on clinical education to a model with a balance of clinical education

and coursework.

14

anrcture of Athletic Training Education Programs

Clinical education. The goal of an athletic training program is to prepare its
students successfully, both clinically and in the classroom, for the NATABOC
certiﬁcation examination. This section describes the structure of both clinical
education and coursework requirements.

Laurent and Weidner (2002) examined which standards of clinical
education settings certified athletic trainers perceived as helpful. According to the
certiﬁed athletic trainers in their study, 53% of professional development as an
athletic trainer was perceived to come from clinical education. Clinical education
provides more realistic experiences for students and is a signiﬁcant component
of most health care education. The NATA (2003) has established several
guidelines for clinical education that are used to aid in the student’s development
of competencies (Laurent & Weidner, 2002). The clinical education experience
can be offered in clinical academic courses, such as a laboratory class, an
internship, and/or a ﬁeld experience course, or through academic credit, such as
receiving credit for work in the athletic training facility. The clinical education
experience should last at least 2 academic years and there should be “no fewer
than four clinical education courses in semester-based programs or six courses
in a quarter-based program” (NATA, 2003). A variety of settings, such as four-
year colleges, high school, clinics, etc, must be utilized, along with multiple
coverage experiences. Supervision must be done by an approved clinical
instructor and must offer multiple opportunities for feedback and evaluation on a

daily basis. Supervision also offers an opportunity to ensure that students are

15

engaged during the majority of their clinical experience. Miller and Barry (2002)
found that 59% of clinical placement hours were spent unengaged (i.e.
performing behaviors that have no apparent relationship to athletic training). It is
imperative that students are performing tasks that aid them in the acquisition of
new skills.

An important component of clinical education is the clinical proﬁciencies
developed by the NATA (1999) Education Council. One purpose of these
proﬁciencies is to outline common skills that entry-level athletic trainers should
possess while the other purpose is to deﬁne what is expected of the clinical
education system in ATEP. Since the elimination of clinical hour requirements,
more focus has been on the successful completion by students of these clinical
proﬁciencies. Denegar and Hertel (2002) stress that it is important not only to
learn the clinical proﬁciencies but also for students and certiﬁed athletic trainers
to seek evidence that supports their everyday decisions regarding treatment and
rehabilitation. For instance, it is important to teach various forms of cryotherapy;
however, the more important issue is whether or not the student can integrate
cryotherapy into their patients treatment (Starkey et al., 2003). Denegar and
Hertel (2002) further this by saying that each proﬁciency needs to be examined
and it clinical effectiveness must be determined.

The clinical proﬁciencies developed to outline the clinical skills that each
graduate of a CAAHEP accredited program should possess encompass a wide
variety of areas. The proﬁciencies are organized into 12 major subject areas,

which include risk management and injury prevention, pathology of injuries and

16

illness, assessment and evaluation, acute care of injury and illness,
pharmacology, therapeutic modalities, therapeutic exercise, general medical
conditions and disabilities, nutritional aspects of injury and illness, psychosocial
intervention and referral, health care administration, and professional
development and responsibilities. Each subject area has multiple teaching
objectives and each teaching objective has speciﬁc outcomes. For example, the
major subject area of acute care of injury and illness has a teaching objective
stating that the student should be able to enact an emergency action plan. This
teaching objective then has two speciﬁc outcomes: (a) the student will be able to
enact the plan for an activity, setting, or event; and (b) the student can correctly
triage an emergency situation (NATA, 1999). There are roughly 1,230 individual
skills that an athletic training student is expected to learn (Starkey et al., 2003).
It is imperative that each clinical proﬁciency can be measured and
evaluated and is done so on a regular basis. During initial program accreditation,
three factors are important to take into consideration for each proﬁciency: (a) the
class where the student will be taught the proﬁciency; (b) where the proﬁciency is
evaluated; and (c) when the proﬁciency will be evaluated. Also important is that a
student is able to determine which tests are appropriate to perform on speciﬁc
patients. The student must be able to analyze the problem and the facts that he
or she knows and make a decision about which tests should be performed. For
example, a student who performs every special test while evaluating a knee is
not able to discriminate beMen information he or she has Ieamed (Starkey et

al., 2003).

I7

Coursework requirements. Didactic Ieaming is also an important part of
athletic training education. Students must be able to take information Ieamed in
the classroom setting and successfully transfer it to their clinical education
experiences. Athletic training students are expected to be knowledgeable in and
complete several courses in many areas in order to gain eligibility for the
NATABOC certiﬁcation examination. Two human anatomy and human
physiology courses must be completed with emphasis on the human body
covering all systems of the human body. Kinesiology/biomechanics must be
addressed in a course that studies how the joints, bones, tendons, and muscles
of humans move. The exercise physiology course that an athletic training student
completes must included how exercise affects the systems of a healthy human
body. Two athletic training courses, basic and advanced, must be completed with
the basic course covering an introduction to athletic injuries and prevention and
treatment of athletic injuries, and the advanced course covering therapeutic
modalities and rehabilitative exercise. A course in human health or nutrition must
also be completed (NATABOC, 2003a). In addition, although not required, the
NATABOC recommends coursework in physics, pharmacology, health care
administration, professional development and responsibility, recognition of
medical conditions, chemistry, psychosocial intervention and referral, and
pathology of injury and illness (NATABOC, 2003b).

After successfully completing the clinical proﬁciencies and required
coursework, a student is eligible to sit for the NATABOC certiﬁcation

examination. During the time of undergraduate program advancements, the

18

national certiﬁcation examination was developed , with the ﬁrst examination being
administered in 1970. The examination consists of three sections, written,
practical, and written simulation, which test the knowledge students have
acquired during their progression through ATEP. The certiﬁcation examination is
administered on speciﬁc days at various sites around the country by the
NATABOC. The structure of athletic training programs allows students to
experience a multitude of opportunities to gain knowledge in various areas.
Clinical education proﬁciencies have become the standard to gauge a student’s
progress through ATEP. However, the psychological components that make up
Ieaming environments and contribute to an effective entry-level athletic trainer
are rarely discussed.
Developing Conﬁdence in Athletic Training Knowledge and Skills

Bandura’s self-efﬁcacy theory. Self-efﬁcacy refers to an individual’s belief
that he or she can successfully complete a task. Bandura (1977) states that self-
efﬁcacy is inﬂuenced by four sources of information: (a) performance
accomplishments; (b) vicarious experience; (c) verbal persuasion; and (d)
physiological states. Performance accomplishments are the most reliable and
stable source of self-efﬁcacy and are based on individual successes. Repeated
successes increase self-efﬁcacy while repeated failures tend to decrease self-
efﬁcacy. Vicarious experience involves observing others successfully perform a
task, thus increasing the observer’s self-efﬁcacy. This source is weaker and less
stable than performance accomplishments. Verbal persuasion involves the

concept that individuals are affected by others. Persuasion does not give

19

individuals concrete information in which to base their successes and is therefore
not a reliable source of self-efﬁcacy. Physiological states involve interpreting
arousal to determine self-efﬁcacy. Emotions are used to determine how anxious
or vulnerable an individual feels in certain situations.

Evidence in support of Bandura’s theory. Self-efﬁcacy affects not only
one’s conﬁdence at completing speciﬁc tasks but also one’s effort, persistence,
choice of activities, and achievement (Bandura, 1977). By inﬂuencing these
aspects of people’s personalities, self-efﬁcacy affects the ability to change
behavior. Schunk (1995) presented a model of behavioral change that highlights
the role of self-efﬁcacy. Individuals differ in their self-efﬁcacy at the beginning of a
task due to three features, namely personal qualities, prior experience, and social
support. Personal qualities include their attitudes and abilities. Prior experience
may have occurred at the same or similar types of events. Social support
involves the extent to which individuals’ parents or signiﬁcant others encouraged
them and taught them speciﬁc skills to foster change (Ericsson, Krampe, &
Tesch-Romer, 1993). As individuals participate in tasks, personal inﬂuences (i.e.,
goal setting and information processing) and situational inﬂuences (i.e., rewards)
begin to affect them. The ﬁnal stage of the model involves an increase in
motivation and self-efﬁcacy when individuals perceive that they are performing
well and becoming more competent (Schunk, 1995).

Self-efﬁcacy has been signiﬁcantly and positively correlated to Ieaming
cognitive skills and task motivation. Motivation and self-efﬁcacy have been

shown to account for signiﬁcant increases in successful performances (Schunk,

20

1995). Chen, Gully, and Eden (2004) found that employees with higher self-
efﬁcacy were more motivated and persistent and more effective especially in
employment with occasional setbacks, as they had longer sustained effort
despite the setbacks than employees with lower self-efﬁcacy.

Self-efﬁcacy theory in ATEP. ln ATEP, focus is on the acquisition of skills,
as practical testing and practice assessments are often used as tools for
Ieaming. Quite often if a student can successfully perform a skill, clinical
educators may believe that the student is fully conﬁdent in his or her abilities.
However, Starkey et al. (2003) cautions that having a student perform a skill is
not as important to his or her conﬁdence as having the student explain why the
skill would be performed or in what other situations the same skills could be
used. This conﬁdence is reinforced through the relationships that athletic trainers
nurture on a daily basis with patients, instructors, coaches, and parents. Clinical
conﬁdence should increase as a student progresses through the ATEP. A senior
student should have the skills and conﬁdence close to that of an entry-level
certiﬁed athletic trainer. The authors continue by saying that becoming an athletic
trainer is not simply Ieaming basic skills and knowledge; it also involves
strengthening relationships and meeting patients’ needs (Starkey et al., 2003). In
order to fulﬁll each expected duty, an athletic trainer must feel conﬁdent in his or
her ability to do so.

Mensch and Ennis (2002) investigated the pedagogic strategies used in
ATEP to enhance students’ Ieaming. They based their research on two

constructs, self-determination theory and self-efﬁcacy motivation theory. Self-

21

efﬁcacy motivation theory suggests that when instructors aid students in correctly
judging their abilities in speciﬁc tasks, academic motivation is enhanced. The
results, through qualitative interviews, showed that authentic athletic training
experiences, including hands—on Ieaming and observational Ieaming, enhanced a
student’s conﬁdence more than classroom experiences.

In their discussion, Mensch and Ennis (2002) emphasized the importance
of increasing student conﬁdence, which was related to autonomy, authenticity
and positive relationships. Allowing successful performance accomplishments to
occur by building on knowledge the student already has, instructors are able to
foster self-efﬁcacy. Competent performances will not occur if the general skills
and knowledge required for the performance are lacking (Schunk, 1995). Also
important in encouraging self-efﬁcacy is the use of observational peer Ieaming
experiences (Mensch & Ellis, 2002). By observing competent individuals, either
peers or instructors, the student gathers information on how to act successfully at
certain skills (Schunk, 1995). Children who had low math achievement and were
exposed to cognitive modeling showed greater gains in perceived efﬁcacy. Their
efﬁcacy levels were also more closely related to their actual abilities than those
children who received didactic instruction (Schunk, 1981). It is important to note
that observers need to feel they are similar to the models in order to see gains in
self-efﬁcacy (Schunk, 1995). The level of self-efﬁcacy that students possess
inﬂuences their efforts and persistence, as well as their choice of activities.
Merely obtaining the skills taught in clinical education is not enough to ensure an

athletic training student will be effective or will be able to apply those skills in a

22

practical situation. Thus, enhancing a student’s self-efﬁcacy in turn enhances his
or her educational experience in an athletic training program (Mensch & Ennis,
2002).

As discussed earlier, Bandura (1977) proposed four sources of self-
efﬁcacy. By examining the structure of ATEP, one can ﬁnd many examples of
these four sources. Performance accomplishments are the most popular source
of self-efﬁcacy in ATEP. By successfully performing skills on practical
examinations and in the athletic training setting, individuals should gain
conﬁdence in their ability to successfully complete the same task at a later time.
However, unsuccessful performances may serve to decrease self-efﬁcacy in
individuals, making them less conﬁdent in their abilities. Vicarious experience is
also prominent in ATEP. The ﬁrst year of an athletic training student’s education
is purely observational, Ieaming from watching others. After the ﬁrst year, the
undergraduates continue to Ieam by observing seniors and certiﬁed athletic
trainers. If a junior student witnesses a senior student properly performing a
Lachman’s test for the knee, the junior may feel more conﬁdent in his or her own
ability to perform the same skill.

Verbal persuasion may be involved in the initial Ieaming of a clinical skill.
The instructor may continually tell the student that he or she can successfully
perform a speciﬁc skill. If told enough times, this may result in an increase in the
individual’s self-efﬁcacy. However, verbal persuasion does not give the student
any concrete experiences to base his or her conﬁdence upon and therefore, the

increase may not be permanent. Lastly, self-efﬁcacy as a result of physiological

23

states may occur if a student experiences arousal when performing certain tasks.
It a student did not perform well on his or her wrist practical in class, he or she
may feel anxious about performing a wrist assessment on an athlete. If a student
performed extremely well, however, the student may feel arousal and interpret it
as excitement and conﬁdence in his or her abilities to successfully assess the
wrist of an athlete. Athletic training students receive many opportunities to
practice their skills. Clinical education is the setting in which they integrate all
course work they have Ieamed with their clinical skills. The more time students
have to gain the above sources of self-efﬁcacy the more conﬁdent they should be
in their abilities. This study attempted to determine if senior athletic training
students who had completed more clinical hours and experiences would be more

conﬁdent in their ability to perform various clinical proﬁciencies.

24

CHAPTER 3
METHODS

Participants

Participants in this study consisted of 133 college students (81 females
and 52 males) currently enrolled in one of their two ﬁnal semesters (i.e., senior
year) in a CAAHEP accredited undergraduate athletic training education
program. Because the self-efﬁcacy measure contained 47 items, a sample size
of 300 was needed to perform proper statistical analysis (T abachnick 8. F idell,
1996). Therefore, over 300 participants were recruited by contacting, via email,
program directors from all 259 accredited programs. A list of contact information
for program directors was obtained at the CAAHEP website. Thirty-six accredited
undergraduate athletic training programs with 301 participants initially agreed to
participate. This represented an agreement rate of 14% of all accredited
programs. Due to the ending of the school term, 276 questionnaires were sent.
Packets were received from 26 programs for a program response rate of 72%.
One hundred sixty-two questionnaires were received for an individual response
rate of 59%. Of the 162 questionnaires received, 133 questionnaires (82%) were
useable. Many questionnaires contained unanswered items, which were treated
as missing data and not included in analysis. Characteristics of the sample can
be found on Tables 2 through 5. Human subjects approval was granted through
the University Committee on Research Involving Human Subjects (UCRIHS).
lnforrned consent forms (see Appendix A) were attached to individual

questionnaires. Submission of the completed instrument signiﬁed consent.

25

Table 2

Sample Characteristics

 

 

Variable N Data Range
Semesters of college 131 M=8.10 3-13
completed (SD=1 .50)
Semester credit hours 119 M=132.17 80-200
completed (SD=20.55)
Clinical experience hours 133 M=1384.49 600-3126
completed (SD-499.78)
Gender 133 Males=52
Females=81
Completed course in basic 132 99.24%
athletic training
Completed course in 132 96.97%
evaluation skills
Completed course in 132 96.21%
therapeutic modalities
Completed course in 132 97.27%
rehabilitation principles
Completed course in athletic 132 94.70%
training program
administration
Completed course in 132 93.18%
nutrition
Completed course in 132 67.42%
pharmacology
Athletic training program 132 71.97%
offers organized preparation
for the NATABOC

certiﬁcation examination

 

26

Table 3

Clinical Experience Hours Reported by Athletic Training Program Directors

 

 

 

Clinical Experience Frequency
Hours
600-899 hours 23
900-1 199 hours 33
1200-1499 hours 25
1500-1799 hours 22
1800-2099 hours 17
2100-2399 hours 10
2400-2699 hours 1
2700-2999 hours 1
3000 or more hours 1
Table 4

Credit Hours Reported by Athletic Training Students

 

 

Credit Hours Frequency
80-95 credit hours 4
96-110 credit hours 4
111-125 credit hours 36
126-140 credit hours 51
141-155 credit hours 11
156-170 credit hours 4
171-185 credit hours 6

186 or more credit hours 3

 

27

Table 5

Semesters Completed Reported by Athletic Training Students

 

Semesters Completed Frequency

 

 

3.0-3.99 semesters 1
40-499 semesters 1
5.0-5.99 semesters 3
6.0-6.99 semesters 2
7.0-7.99 semesters 34
8.0—8.99 semesters 59
9.0-9.99 semesters 9
10.0-10.99 semesters 16
1 1011.99 semesters 0
12.0—12.99 semesters 4
13.0 or more semesters 2
Instrumentation

Development of the Senior Athletic Trainer Efﬁcacy Scale (SA TES). The
SATES was designed by the investigator to determine a student’s perceived self-
efﬁcacy on various skills included in the NATA’s clinical proﬁciencies (1999). The
SATES was developed within the guidelines of Bandura’s (n.d.)
recommendations for constructing self-efﬁcacy scales. The scale was
constructed on the basis of a conceptual analysis of NATA’s clinical proﬁciencies,
by determining which major subject areas were weighted more heavily in the

proﬁciencies, and was based on gradations of challenges. The clinical

28

proﬁciencies include risk management and injury prevention, pathology of injuries
and illnesses, assessment of evaluation, acute care of injury and illness,
pharmacology, therapeutic modalities, therapeutic exercise, general medical
conditions and disabilities, nutritional aspects of injury and illness, psychosocial
intervention and referral, health care administration, and professional
development and responsibilities. Initial development of the SATES began with
random selection of teaching objectives and speciﬁc skills involved,
corresponding proportionally to the actual number of competencies in that
subject area. The scale was then reviewed to make sure that no single skill was
focused on more than another (i.e., assessment skills versus rehabilitation skills).
Following revisions, the scale was reviewed by a director of undergraduate
athletic training education at a Division I university. Revisions were made as per
the director’s suggestions. Athletic training graduate students from a large
midwestem university then reviewed the content and structure of the
questionnaire. Final corrections were made regarding their suggestions following
discussion with the director of graduate athletic training education.

The SATES (see Appendix B) is a 51-item questionnaire, with 16 items
pertaining to risk management and injury prevention, 19 items examining
assessment and evaluation, 6 items pertaining to acute care of injury and illness,
2 items examining therapeutic modalities, and 1 item each pertaining to
pharmacology, therapeutic exercise, general medical conditions, and
psychosocial intervention. Subdomains with one item have fewer teaching

objectives and speciﬁc outcomes than those with a larger number of items. The

29

emphasis put on speciﬁc subject areas on the SATES is similar to that of the
clinical proﬁciencies. The ﬁnal four items examined success on the certiﬁcation
examination. Responses were rated on a 10-point Likert scale from 0 (not at all
conﬁdent) to 9 (extremely conﬁdent) using the stem, “How conﬁdent are you in
your ability to.

Psychometric Properties of the SA TES. Band ura (n.d.) suggests items
that tap the same domain of efﬁcacy should be correlated with each other and
with the total score in that domain. Thus, rather than conducting an exploratory
factor analysis on all 51 items, correlations and internal consistency reliabilities
(Cronbach alphas) were used to determine homogeneity of items. Correlations
between items and total score within each of the subdomains are found in
Appendix C. An internal reliability analysis using Cronbach alpha was performed
to determine internal consistency for SATES items 1-16, 17-35, 36-41, and 43-

44. lntemal reliability characteristics are found in Table 6.

30

Table 6

lntemal Reliability Characteristics of the SA TE S

 

SATES Domain Cronbach a

 

Reguired Athletic Training Competencies

 

 

Risk management and injury prevention (Items 1-16) .87
Acute care of injuries and illnesses (Items 36-41) .81
Assessment and evaluation (Items 17-35) .98
Therapeutic modalities (Items 43-44) .50

MTABOCanmwtion Examination
NATABOC certiﬁcation examination (Items 48-51) .93

 

Procedure

Packets with scripts (see Appendix D), informed consent forms,
questionnaires, envelopes for completed questionnaires, and return envelopes
were mailed to the program directors. Participants were asked to complete the
questionnaires within 4 weeks and return them to the investigator. The program
director at each school also received a sheet on which to accurately record the
number of hours of clinical experience for each student (Appendix E). These
hours were on ﬁle with the curriculum director per NATABOC requirements for
successful completion of an academic program and certiﬁcation. The program
director was asked to complete the sheet and return it with the questionnaires.

The program director or another certiﬁed athletic trainer employed at the

school proctored the questionnaire. The proctor read the script, instructing

31

students on the correct procedure. Participants received the questionnaire
packet, with the informed consent form attached, and an envelope in which to
place their questionnaire before returning it to the proctor. Participants ﬁrst read
the informed consent form. Students were then asked to provide a code
consisting of their birth date, gender, and university or college at the top of the
questionnaire, which allowed for matching of clinical hours and SATES results.
They then voluntarily completed the self-efﬁcacy scale, placed it in the envelope,
sealed it and returned it to the proctor. Students who did not wish to participate
placed the blank questionnaire in the envelope and returned it to the proctor. The
scale took approximately 15 min. to complete. Program directors placed the
completed, sealed questionnaires with the hours recording sheet in the provided
return envelope and placed it in the mail.
Treatment of Data

The SA TES. The total self-efﬁcacy proﬁciency scores were used to
calculate a Pearson correlation coefﬁcient with number of clinical hours to
determine if a relationship exists. Pertaining to examination preparedness, 3
Pearson correlation was performed with summed examination efﬁcacy scores
and the number of clinical hours. An exploratory factor analysis was not
considered for this study for a number of reasons. First, the primary purpose of
the study was to determine if a relationship exists between self-efﬁcacy and the
number of hours a training student has put into clinical work, not for scale
development. Second, the sample is not considered to be very high to obtain

correlations that can reliably be estimated in a factor analysis (T abachnick &

32

Fidell, 1996). Third, the scales were constructed within the guidelines of
Bandura’s (n.d.) recommendations for domain speciﬁcation and require only the

demonstration of item homogeneity within each domain relevant scale.

33

CHAPTER 4
RESULTS

The results are presented in two sections corresponding with the efﬁcacy
scores for each hypothesis. The two hypotheses were (a) a positive relationship
will exist between the number of clinical experience hours and self-efﬁcacy
scores for required competencies and (b) a positive relationship will exist
between the number of clinical experience hours and self-efﬁcacy scores for
preparedness on the certiﬁcation examination. In the ﬁrst section, the results of
the hypothesis and exploratory correlations for required competencies are
presented. In the second section, the same organizational format is used for
self-efﬁcacy for preparedness on the certiﬁcation examination.
Hypothesis 1 : Self-efﬁcacy for Required Competencies

Descriptive data for the subdomains are found in Table 7. Athletic training
students appear to have high self-efﬁcacy beliefs pertaining to required
competencies indicated by the mean of each subdomain. All means, with the
exception of general medical conditions and disabilities (M=6.82) and

psychosocial intervention (M=6.70) were 7.0 or higher.

34

Table 7

Self-Efficacy Ratings for Required Athletic Training Competencies

 

 

Category/Item M SD

Risk Management and Injury Prevention (16 items) 7.08 1.12

1. Properly perform anthropometric measurements 5.35 2.47

2. Evaluate vision using a Snellen eye chart 6.81 2.37

3. Evaluate the results of agility tests 6.56 1.77

4. Use a sling psychrometer 5.98 2.57

5. Check an activity setting for physical and/or environmental 7.62 1.47
hazards

6. Properly ﬁt a mouth guard 7.40 1.87

7. Properly ﬁt a protective helmet 7.55 1.74

8. Establish repetition maximum tests 6.70 2.03

9. Perform an isometric test on the hip 7.38 1.71

10. Instruct a patient on proper execution of range-of-motion 7.53 1.46
exercises on the cervical region

11. Demonstrate proper lifting technique for a power clean 7.60 1.66
exercise

12. Demonstrate proper spotting technique for a power clean 7.53 1.74
exercise

13. Apply an immobilization splint (i.e., thermoplastic, plaster, 7.07 1.68
ﬁberglass) to the forearm

14. Apply a checkrein device to the thumb 6.95 2.45

15. Tape the knee joint to limit range-of-motion 7.10 2.08

16. Apply an off-the-shelf brace to the wrist to limit range-of- 7.50 1.40
motion

Assessment and Evaluation (19 items) 7.36 1.02

17. Identity postural deviations (i.e., kyphosis, Iordosis, 7.47 1.36
scoliosis)

18. Assess predisposing knee conditions (i.e., genu valgum, 7.64 1.26
varum, recurvatum)

19. Identify body types as endomorph, ectomorph, and 6.49 2.46
mesomorph

20. Properly use SOAP record keeping methods 8.08 1.15

21. Palpate bony landmarks of the scapula 8.02 1.14

22. Identity primary circulatory structures 7.07 1.44

23. Evaluate motor function of the third cranial nerve 7.31 2.01

24. Assess active range-of-motion for the knee 8.53 0.88

25. Determine resistive range-of-motion for the shoulder 8.24 1.07

 

35

Table 7, continued

 

Category/Item M SD

 

26. Identify the signs and symptoms associated with hyphema 6.25 2.42

27. Perform Romberg’s test to assess cerebellar function 8.03 1.45

28. Identify the signs and symptoms associated with 4.53 2.95
pathological torticollis

29. Perform the Sulcus sign to assess glenohumeral instability 8.21 1.24

30. Identify a canying angle of the elbow that may predispose 6.71 2.05
athletes to injury

31. Distinguish between an extensor tendon rupture and volar 5.39 2.32

plate rupture of the ﬁnger
32. Perform the Fabere sign to assess sacroiliac function 7.83 1.73
33. Identify patellar alignment that may predispose athletes to 7.33 1.55
injury
34. Assess meniscal tears by performing Apley’s compression] 8.36 1.04
distraction
35. Perform Kleiger’s test on the ankle 7.77 2.17
Acute Care of Injuries and lllngg (6 items) 7.73 0.91
36. Correctly triage emergency situations 7.51 1.20
37. Properly dispose of hazardous waste 8.41 1.17
38. Select the appropriate splint to apply to a fracture 7.42 1.52
39. Treat heat exhaustion 7.52 1.24
40. Establish an airway in an athlete wearing protective head 7.13 1.52
gear
41. Properly ﬁt a patient with crutches 8.38 .88
Pharmacolggy (1 item)
42. Use the Physician’s Desk Reference to search for 7.49 1.80
information on the medications commonly prescribed to
athletes
Theramutic Modalities (2 items) 8.27 0.86
43. Properly select the parameters for an ice immersion 7.86 1.30
treatment
44. Properly apply a moist heat pack treatment 8.67 0.73

Theramutic Exercig (1 item)

45. Create a rehabilitation program to improve muscular power 7.62 1.42
of the lower body

General Mggical Conditions (1 item)
46. Identify the sigﬂﬂgworm 6.82 2.02

36

Table 7, continued

 

 

Category/Item M SD

Psychosocial Intervention (1 item)

47. Integrate imagery into the rehabilitation program of 6.70 1.84
athlete

 

Results of Hypothesis 1. Nine correlations were performed between each
subdomain and clinical hours. Correlation values are contained in Table 8 in the
ﬁrst column. One signiﬁcant correlation between the assessment and evaluation
subdomain and clinical hours was reported (F. 18, p<. 05). Hypothesis 1 was
partially supported in terms of the assessment and evaluation proﬁciencies.
However, the correlation was moderately low. The hypothesis was not supported

in the other subdomains.

37

Table 8

Relationships Between Clinical Hours, College Semesters Completed, and Credit
Hours Completed with Self-Efﬁcacy Scores for Required Athletic Training
Competencies

 

College Credit
Clinical Semesters Hours

 

Domains of Required Hours Completed Completed
Athletic Training Competencies r r r
Risk management and injury .00 .16* .14
prevention

Assessment and evaluation .18" .1 8* .22*
Acute care of injuries and illnesses -.01 .03 .04
Pharmacology -.05 -.07 -.05
Therapeutic modalities (Q 43) -.02 .08 -.02
Therapeutic modalities (Q 44) .03 .09 .03
Therapeutic exercise .06 .20* .06
General medical conditions and .05 .03 .05
disabilities

Psychosocial intervention -.08 -.12 -.07

 

*. Correlation is signiﬁcant at the 0.05 level (1-tailed).

Exploratory conelations. In addition to clinical hours completed, academic
coursework completed may be a source of efﬁcacy information based on
experience gained in the classroom. Therefore, Pearson Product-Moment
correlations also were calculated between self-efﬁcacy of required proﬁciencies
subdomains and college semesters and credit hours completed. These results
are presented in Table 8 in Columns 2 and 3. Results indicated that four
correlation coefﬁcients were signiﬁcant: Assessment/Evaluation and credit hours

completed, Assessment/Evaluation and college semesters completed, Risk

38

Management/Injury Prevention and college semesters completed, and
Therapeutic Exercise and college semesters completed.
Hypothesis 2: Self-Efﬁcacy for Preparedness on the Certiﬁcation Examination
Descriptive data for the certiﬁcation examination are found in Table 9.
When compared to the means of the required competencies, athletic training
students have lower self-efﬁcacy beliefs pertaining to the certiﬁcation
examination. This may be due the stressful nature and design of the
examination. Students felt most efﬁcacious on their ability to pass the practical
portion of the examination and least efﬁcacious on the written simulation. The
nature in which students are tested during the practical portion is very similar to
how they have been tested before during coursework and relatively similar to
their everyday duties in athletic training settings. The written simulation portion of
the examination tests students in a way they are not completely familiar. The
unfamiliar component of this section may be the reason their efﬁcacy is low.
Table 9
Self-Efficacy Ratings for NA TAB OC Certiﬁcation Examination

 

 

Category/Item M SD
NATABOC Certiﬁcation Examination (4 items) 5.25 1.84
48. Pass the Written Simulation portion of the NATABOC 5.33 2.03

examination on the ﬁrst attempt

49. Pass the Written portion of the NATABOC examination on 5.17 1.92
the ﬁrst attempt

50. Pass the Practical portion of the NATABOC examination 5.73 2.00
on the ﬁrst attempt

51. Pass all portions of the NATABOC examination on the ﬁrst 4.76 2.07
attempt

 

39

Results for Hypothesis 2. Participants’ summed scores on the four items

were correlated with clinical hours, semesters of college completed and credit

hours completed. Results are also contained in the ﬁrst column of Table 10. No

signiﬁcant relationship between examination preparation and clinical hours was

found and therefore, Hypothesis 2 was not supported.

Exploratory conelations. As in the ﬁrst hypothesis, academic coursework

completed was considered as a possible source of efﬁcacy information based on

experience gained in the classroom. Therefore, Pearson Product-Moment

correlations also were calculated between self-efﬁcacy beliefs for examination

preparedness and college semesters completed and credit hours completed.

Results are contained in columns 2 and 3 of Table 10. Results indicated no

signiﬁcant relationships.

Table 10

Relationships Between Clinical Hours, College Semesters Completed, and Credit
Hours Completed with Self-Efficacy Scores for the NA TABOC Certiﬁcation

 

 

Examination
College Credit
Clinical Semesters Hours
Hours Completed Completed
r r r
NATABOC Certiﬁcation .05 .1 1 .15
Examination

 

*. Correlation is signiﬁcant at the 0.05 level (one-tailed)

40

CHAPTER 5
DISCUSSION

Bandura’s (1977, 1997) theory of seif-efﬁcacy purports that both
performance accomplishments and vicarious experiences serve as sources of
information on which to judge one’s self-efﬁcacy. The clinical education
component of ATEP allows exposure to both of the above sources. Therefore, I
hypothesized that a higher exposure to performance accomplishments and
vicarious experiences, through clinical education, would lead to higher self-
efﬁcacy beliefs. In the current study I did not ﬁnd a relationship between
proﬁciency self-efﬁcacy or examination preparedness self-efﬁcacy and clinical
hours. Only a moderately low signiﬁcant relationship was found between the
assessment and evaluation competencies and clinical hours, which may be
explained by the abundance of assessment and evaluation skills students
perform during their clinical placements.

There are several possible explanations for a lack of signiﬁcant and strong
correlations between self-efﬁcacy and clinical hours in athletic training. First, the
sample size (N=133) used in this investigation was relatively small. A sample
size of 300 is adequate to perform proper statistical analysis on a measure with
47 items (T abachnick & Fidell, 1996). The self-efﬁcacy measure that was
developed for this investigation was not subjected to rigorous psychometric
evaluation through factor analysis, again due to the small sample size and small

participant-to-item ratio.

41

Second, the speciﬁc efﬁcacy subdomains were not correlated to speciﬁc
clinical hours that pertain to risk management and injury prevention, acute care
of injuries and illnesses, therapeutic modalities, and assessment and evaluation.
It would be extremely difﬁcult to divide each hour of a student’s clinical placement
into such domains. It is important to consider that the SATES was too speciﬁc for
the general clinical hours that students accumulate and that the participating
program directors reported.

A third possible explanation for the lack of relationship between efﬁcacy
beliefs and clinical hours was the lack of measure of “engaged time” during
clinical hours. Miller and Barry (2002) investigated how athletic training students
actually spend their clinical hours and what behaviors they engage in. They
suggested a relationship between engaged time and achievement; thus, the
more time athletic training students spend in engaged behaviors during their
clinical placements, the more they should Ieam. Miller and Barry found that 59%
of clinical placement hours were spent unengaged (“performing behaviors
seemingly unrelated to athletic training that appear to offer no apparent
educational or clinical value,” p. S-230). Clinical time (“total amount of time
subjects perform clinical skills and behaviors associated with athletic training,” p.
S-230) accounted for 23% of time, 11% of time was spent on managerial tasks,
and 7% was instructional time (“time subjects perform behaviors associated with
didactic, practical, or observational Ieaming,” p. S-230). This study showed that it
is necessary to account for all time spent in clinical placements and to make sure

that the majority of time is spent in beneﬁcial activities. In the current study, the

42

amount of engaged time in clinical placements was not measured, but it may be
related more positively to self-efﬁcacy beliefs than total clinical training hours.

Although no previous studies have investigated the relationship between
self-efﬁcacy and clinical hours of training in athletic training programs, literature
involving competency and clinical hours has been investigated (Battersby &
Hemmings, 1991; Laurent & Weidner, 2002; Miller & Barry, 2002; Weidner &
August, 1997). These authors support a recent change in the structure of ATEP,
the shifting from quantitative measures of competence by counting clinical hours
to more qualitative measures through the development of competencies by
challenging the assumption that increasing the number of clinical hours
automatically results in increased competence. Battersby and Hemmings (1991)
found that nursing students who had accumulated a larger number of clinical
hours did not differ signiﬁcantly in their competency or clinical performance levels
than students who had accumulated fewer hours. Therefore, more clinical hours
does not appear to be related to greater clinical competence.

Investigating predictors for success on the NATABOC certiﬁcation
examination is a common area of research. Many authors have attempted to
determine which factors lead to an individual passing the entire examination or
portions of the examination. Turocy (2002) found that overall Grade Point
Average (GPA) was the most predictive factor of passing all three sections of the
examination. Harrelson, Gallaspy, Knight, and Leaver-Dunn (1997) found that a
combination of overall GPA, athletic training GPA, academic minor GPA,

American College Testing composite scores, and the number of semesters

43

enrolled in the university predicted success on the certiﬁcation examination. The
ﬁndings of the current study are not surprising because little relationship has
been found between the accumulation of an excess of 2000 clinical hours and
passing the certiﬁcation examination (Draper, 1989). Turocy, Comfort, Penin,
and Gieck (2000) revealed that students who had accumulated 400 hours above
the 800 required clinical hours had a higher passing rate than those students
who had completed the minimal amount of hours or hours surpassing 1200.
Studies have shown that the number of clinical hours completed do not predict
success on the certiﬁcation examination. The current study found that the same
factor variable, clinical hours, as well as semesters of college completed and
credit hours completed, do not relate to the level of self-efﬁcacy a student has
pertaining to success on the certiﬁcation examination. Caution is warranted in the
ﬁndings due the to methodological problems previously mentioned.
Self-efﬁcacy, in terms of clinical competence, should increase as a student
progresses through the athletic training educational process. A senior athletic
training student should be able to perform, with conﬁdence, the skills close to that
of an entry-level certiﬁed athletic trainer (Starkey et al., 2003). While the current
study was not designed to address the change in self-efﬁcacy beliefs overtime, a
future investigation using a longitudinal design would be beneﬁcial to examine
whether students are becoming more conﬁdent as they progress through the
educational program. Because the current study did not ﬁnd a relationship
between self-efﬁcacy and clinical hours, investigations should continue explore

the antecedents of self-efﬁcacy beliefs of athletic training students. GPA, both

athletic training and overall, should be investigated for both proﬁciency and
examination self-efﬁcacy because these variables have been shown to affect
success on the NATABOC certiﬁcation examination. Future investigations also
should examine whether or not the amount of engaged time is signiﬁcantly
associated with the level of self-efﬁcacy in athletic training students, by
replicating Miller and Bany's (2002) study with a measure of self-efﬁcacy.

No study is without its limitations. In addition to the relatively low number
of participants compared to the large number of self-efﬁcacy items, the current
study was limited by the absence of a randomized sample. The sample was a
convenience sample not representative of athletic training programs. Geographic
location and school size was not taken into consideration. Experiences at a
larger university may differ from those at a smaller college. Also, some
questionnaires had missing items, which could not be included, and some
packets were returned without the hours reporting chart, which led to the
exclusion of those questionnaires.

Despite the aforementioned limitations, the current study contains
pertinent information for the development of ATEP. The lack of signiﬁcant
ﬁndings is alarming. With a curriculum driven by the required competencies, self-
efﬁcacy beliefs should be higher. It may be suggested that more attention should
be placed on how conﬁdent students are to apply the skills they are Ieaming to
their everyday clinical experiences. Also alarming are the efﬁcacy beliefs
pertaining to certiﬁcation examination preparedness. After progressing through

ATEP, students should be conﬁdent in their abilities to pass the examination.

45

Better, more speciﬁc preparation may be the key to simulate the examination
completely, reducing the unfamiliar component of the examination. Psychological
preparation with regards to clinical competencies and certiﬁcation examination
preparedness is an important part of developing an effective and efﬁcacious

athletic trainer.

46

APPENDIX A

lnfonned Consent Form

You are being asked to participate in a study conducted by graduate student Amanda
Schindler under the supervision of Dr. Deborah Feltz from Michigan State University.
The primary purpose of this study, entitled “The Relationship between Self-Eﬁicacy
Scores and Clinical Experience in Senior Athletic Training Students,” is to determine if a
relationship exists between experience and self-efﬁcacy. It is our hope that the research
project will help us in developing a more effective undergraduate athletic training

program.

As part of this research, you will be asked to complete a self-efﬁcacy questionnaire that
contains demographic information as well. You will only be asked to ﬁll out this
questionnaire one time and we estimate that it will take 10 to 15 minutes to complete.
Your responses to the questionnaire will remain anonymous and will be kept in a locked
cabinet in a locked room. Investigators will have sole access to the completed
questionnaires. Additionally, all subsequent results will be reported within larger group-
based ﬁndings. Your privacy will be protected to the maximum extent allowable by law.
In addition, you may receive a copy of the group results at the study’s completion if you
so choose.

Your participation in this study would be greatly appreciated. However, please know that
your participation is voluntary. You may choose not to participate or to discontinue
participation at any time without penalty. If you have any questions concerning
participation in this study, please contact the study’s principal investigator, Dr. Deborah
Feltz, at (517) 355-4730 [dfeltz@msu.edu] or Amanda Schindler at (517) 432-7121
[schindl4@msu.edu]. lfyou have any questions or concerns regarding your rights as a
study participant or are dissatisﬁed with any aspect of this study, you may contact-
anonymously, if you wish-the UCRIHS Chair, Dr. Peter Vasilenko, PhD, at (517) 355-
2180 [ucrihs@msu.edu].

Thank you for your time and cooperation,

 

 

Dr. Deborah F eltz, Principal Investigator Date

 

 

Amanda Schindler, Graduate Student Date

The completion of your questionnaire indicates your voluntary agreement to participate
in this study.

47

APPENDIX B

Senior Athletic Trainer Efﬁcacy Scale

Please write your birth date (mm/dd) and sex (M/F) in the space provided below.

_ _ /_ _ _

MM DD M/F

If you choose not to participate in this study, simply turn in the blank survey to the person
collecting completed forms.

Self-efﬁcacy refers to judgments that an individual has about what he or she can
accomplish with speciﬁc obtained skills. Think about how conﬁdent you are as an athletic
trainer. Rate your conﬁdence for each of the terms below.

How conﬁdent are you in your ability to—

 

 

 

 

 

 

 

 

 

 

 

Not at all Extremely
Conﬁdent Conﬁdent
1. properly perform anthropometric O l 2 3 4 5 6 7 8 9
measurements?
2. evaluate vision using a Snellen eye chart? 0 1 2 3 4 5 6 7 8 9
3. evaluate the results of agility tests? 0 l 2 3 4 5 6 7 8 9
4. use a sling psychrometer? 0 1 2 3 4 5 6 7 8 9
5. check an activity setting for physical and/or 0 1 2 3 4 5 6 7 8 9
environmental hazards?
6. properly ﬁt a mouth guard? 0 l 2 3 4 5 6 7 8 9
7. properly ﬁt a protective helmet? 0 1 2 3 4 5 6 7 8 9
8. establish repetition maximum tests? 0 1 2 3 4 5 6 7 8 9
9. perform an isometric test on the hip? O l 2 3 4 5 6 7 8 9
10. instruct a patient on proper execution of 0 1 2 3 4 5 6 7 8 9
range-of-motion exercises on the cervical
region?
1 1. demonstrate proper lilting technique for a 0 l 2 3 4 5 6 7 8 9

power clean exercise?
12. demonstrate proper spotting technique for a O 1 2 3 4 5 6 7 8 9
power clean exercise?

 

 

 

 

 

 

 

13. apply an immobilization splint (is. O 1 2 3 4 5 6 7 8 9
thermoplastic, plaster, ﬁberglass) to the

forearm?

14. apply a checkrein device to the thumb? 0 1 2 3 4 5 6 7 8 9
15. tape the knee joint to limit range-of-motion? O 1 2 3 4 5 6 7 8 9
16. apply an off-the-shelf brace the wrist to limit 0 l 2 3 4 5 6 7 8 9
range-of-motion?

l7. identify postural deviations (i.e. kyphosis, 0 l 2 3 4 5 6 7 8 9
lordosis, scoliosis)?

18. assess predisposing knee conditions (Lo. 0 l 2 3 4 5 6 7 8 9

 

 

 

 

 

 

 

 

 

 

 

 

_genu valgum, varum, recurvatum)?

 

48

Not at all Extremely

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Conﬁdent Conﬁdent

l9. identify body types as endomorph, O 1 2 3 4 5 6 7 8 9

ectomorph, and mesomorph?

20. properly use SOAP record keeping 0 l 2 3 4 5 6 7 8 9

methods?

21. palpate bony landmarks of the scapula? 0 l 2 3 4 5 6 7 8 9

22. identify primary circulatory structures? 0 l 2 3 4 5 6 7 8 9

23. evaluate motor function of the third cranial 0 l 2 3 4 5 6 7 8 9

nerve?

24. assess active range-of-motion for the knee? 0 1 2 3 4 5 6 7 8 9

25. determine resistive range-of-motion for the 0 l 2 3 4 5 6 7 8 9

shoulder?

26. identify the signs and symptoms associated O 1 2 3 4 5 6 7 8 9

with hyphema?

27. perform Romberg’s test to assess cerebellar 0 l 2 3 4 5 6 7 8 9

function test?

28. identify the signs and symptoms associated 0 l 2 3 4 5 6 7 8 9

with pathological torticollis?

29. perform the Sulcus sign to assess O l 2 3 4 5 6 7 8 9
Mohumeral instability?

30. identify a carrying angle of the elbow that O l 2 3 4 5 6 7 8 9

may predismse athletes to injury?

31. distinguish between an extensor tendon 0 l 2 3 4 5 6 7 8 9

rupture and volar plate rupture of the ﬁ_£ger?

32. perform the Fabere sign to assess sacroiliac 0 l 2 3 4 5 6 7 8 9

function?

33. identify patellar alignment that may 0 l 2 3 4 5 6 7 8 9

predispose athletes to injury?

34. assess meniscal tears by performing Apley’s O 1 2 3 4 5 6 7 8 9

compression/distraction?

35. perform Kleiger’s test on the ankle? 0 1 2 3 4 5 6 7 8 9

36. correctly triage emergency situations? 0 l 2 3 4 5 6 7 8 9

37. properly dispose of biohazardous waste? 0 l 2 3 4 5 6 7 8 9

38. select the appropriate splint to apply to a 0 l 2 3 4 5 6 7 8 9

fracture?

39. treat heat exhaustion? O 1 2 3 4 5 6 7 8 9

40. establish an airway in an athlete wearing O l 2 3 4 5 6 7 8 9

protective headgear?

41 . properly ﬁt a patient with crutches? 0 l 2 3 4 5 6 7 8 9

42. use the Physician’s Desk Reference to 0 l 2 3 4 5 6 7 8 9

search for information on the medications

commonly jrescribed to athletes?

43. properly select the parameters for an ice 0 1 2 3 4 5 6 7 8 9

immersion treatment?

44. properly apply a moist heat pack treatment? 0 l 2 3 4 5 6 7 8 9

45. create a rehabilitation program to improve 0 1 2 3 4 5 6 7 8 9

muscular power of the lower body?

46. identify the signs of ringworm? 0 l 2 3 4 5 6 7 8 9

 

 

 

 

 

 

 

 

 

 

 

 

 

49

Not at all Extremely

 

 

 

 

 

Conﬁdent Conﬁdent
47. integrate imagery into the rehabilitation 0 1 2 3 4 5 6 7 8 9
program of your athlete?
48. pass the Written Simulation portion of the O 1 2 3 4 5 6 7 9
NATABOC examination on the ﬁrst attempt?
49. pass the Written portion of the NATABOC 0 1 2 3 4 5 6 7 8 9
examination on the ﬁrst attempt?
50. pass the Practical portion of the NATABOC O 1 2 3 4 5 6 7 8 9
examination on the ﬁrst attempt?
51. pass all portions of the NATABOC 0 1 2 3 4 5 6 7 8 9
examination of the ﬁrst attempt?

 

 

 

 

 

 

 

 

 

 

 

 

 

Demographic Information
How many semesters of college have you completed?
Approximately how many credit hours have you completed?

In which of the following areas have you completed coursework?
Basic Athletic Training

Evaluation Skills

Therapeutic Modalities

Rehabilitation Principles

Athletic Training Program Administration

Nutrition

Pharmacology

Does your Athletic Training Program provide an organized preparation for the NATABOC
certiﬁcation examination?
__YES If ‘yes’, please describe the preparation and if NO

you receive credit for the preparation below.

 

50

APPENDIX C

lntradomain Correlations for the SATES

Acute Care of Injuries and Illnesses Correlations

 

L036 L037 L038 L039 L040 L041

036 .59 .71 .76 .75 .72 .72
037 .58 .43 .60 .63 .70 .59
038 .86 .82 .71 .83 .83 .85
039 .79 .78 .77 .64 .75 .77
040 .76 .83 .75 .74 .59 .76
041 .64 .62 .68 .64 .65 .52

 

 

Therapeutic Modalities Correlations

 

 

L043 L044
043 1 .39
044 .39 1

 

Examination Preparedness Correlations

 

Q48 Q49 Q50 Q51 Total Preparedness

 

048 1 .81” .72” .84” .86”
049 1 .73" .86” .87”
050 1 .72” .77"
051 1 .89”

 

51

Assessment and Evaluation Correlations

 

L017 L018 L019 L020 L021 L022 L023 L024 L025 L026

 

017 .60 .63 .64 .65 .64 .65 .65 .64 .64 .66
018 .64 .62 .64 .65 .66 .66 .66 .65 .64 .66
019 .42 .42 .31 .43 .43 .44 .45 .43 .43 .44
020 .57 .57 .56 .53 .56 .57 .57 .56 .55 .58
021 .67 .67 .67 .66 .64 .65 .66 .66 .66 .67
022 .49 .49 .51 .49 .47 .43 .48 .49 .48 .49
023 .68 .68 .70 .68 .67 .67 .61 .67 .67 .65
024 .60 .59 .61 .59 .59 .60 .59 .57 .57 .61
025 .68 .68 .68 .67 .67 .67 .67 .66 .64 .68
026 .59 .59 .59 .59 .59 .58 .57 .59 .59 .49
027 .69 .69 .71 .69 .68 .69 .68 .68 .68 .69
028 .58 .57 .57 .57 .57 .57 .57 .57 .57 .54
029 .65 .65 .65 .65 .64 .65 .65 .64 .63 .66
030 .70 .70 .68 .70 .70 .70 .69 .70 .68 .70
031 .65 .65 .64 .66 .66 .65 .66 .66 .65 .65
032 .68 .68 .69 .68 .68 .68 .68 .68 .68 .69
033 .70 .71 .71 .72 .71 .71 .71 .71 .70 .72
034 .70 .69 .72 .69 .69 .69 .69 .69 .69 .71
035 .64 .64 .64 .63 .64 .64 .64 .63 .61 .64

 

 

L027 L028 L029 L030 L031 L032 L033 L034 L035

 

017 .65 .66 .65 .66 .66 .65 .64 .65 .66
018 .66 .67 .66 .66 .66 .66 .64 .66 .67
019 .44 .43 .43 .43 .42 .44 .44 .44 .44
020 .57 .58 .58 .59 .59 .57 .58 .57 .57
021 .66 .68 .67 .68 .68 .67 .68 .66 .68
022 .49 .49 .49 .51 .49 .49 .52 .49 .50
023 .67 .69 .68 .68 .68 .67 .69 .67 .69
024 .58 .63 .59 .61 .62 .60 .58 .59 .59
025 .66 .69 .66 .67 .69 .68 .65 .67 .67
026 .59 .56 .59 .59 .59 .59 .60 .59 .59
027 .65 .71 .68 .69 .71 .68 .70 .68 .69
028 .57 .45 .58 .56 .55 .57 .59 .57 .57
029 .63 .68 .61 .63 .65 .63 .61 .64 .63
030 .70 .68 .69 .63 .68 .70 .70 .70 .69
031 .66 .63 .65 .64 .57 .66 .66 .66 .66
032 .67 .69 .67 .69 .69 .62 .66 .68 .67
033 .71 .73 .70 .70 .70 .70 .66 .70 .70
034 .69 .72 .69 .71 .71 .69 .70 .67 .69
035 .63 .63 .63 .63 .64 .62 .60 .63 .56

 

52

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53

APPENDIX D

Script for Questionnaire Proctor

“You are being asked to voluntarily participate in a research study. It is your
choice either to participate or not to participate.

I will be distributing a packet to each of you. The top page is an lnforrned
Consent form. Please read it thoroughly, as it outlines your rights as a
participant. If you do not agree to participate, simply return the blank packet to
me. If you agree to participate, complete the two-page questionnaire that
follows.

0 Fill in the month and day of your birth date and your sex. This will be used
to match your answers on the survey to the number of clinical hours you
have completed.

0 Read each statement beginning with “How conﬁdent are you in your ability
to...”

0 Rate yourself on the scale from 0 to 9, 0 being not at all conﬁdent and 9
being extremely conﬁdent.

0 Repeat for all 51 statements.

Complete the demographic information to the best of your ability.

0 Return questionnaire to me.

Thank you for your participation.”

54

APPENDIX E

Hour Reporting Chart

Program Director:

Please complete the following table for all of your senior athletic training
students. Please estimate their current number of clinical hours completed to the
best of your ability. The last column is for the investigator's use. Return this
form with the completed questionnaires.

Birthday (MM/DD) Sex Clinical Hours Survey Rod

1.
2.
3.
4.
5.
6.
7.
8.
9.
1 .

 

55

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58

   

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