The Debate: Part Deux

Our profession is involved in a heavy discussion.  No, not the name change, AGAIN.  For those of you following the developments on the entry-level master’s (ELM) discussion over the past 6-12 months, and in particular in the last few weeks after the release of the NATA’s Entry-level degree evaluation document, you may have an opinion one way or the other.

For those of you in the dark, you need to be brought into the light.  Please read now: http://www.nata.org/sites/default/files/The_Professional_Degree_in_Athletic_Training.pdf. 

Before we dive too much into this, let’s make a quick clarification.  What we have, as a profession, known to be an Entry Level Masters is what we are going to be here on referring to as a “professional degree.”  That increase in professionalism is the goal of this whole process.  As was stressed this weekend at the NATA Joint Committee Meeting, the “white papers” are just step one into the future of the profession.  Once NATA comes up with their recommendation, it will have to present to CAATE and the BOC, making this process very long.  It won’t be many, many years until this is enacted. If we make a parallel to the PT world, it took them 15 years to make the transition to their professional degrees. So we have to think as a profession as a whole, where are we headed, and where do we want to go?

As I said, the NATA Joint Committee meeting was held this past weekend in Dallas and served as an opportunity for all National Committee Appointments to gather and plan for the future of the NATA.  It was a valuable experience, allowing me to see what our volunteers in all of our special interest groups are up to.  Naturally, this Professional Degree was a large topic of discussion.  I had read the white papers prior to and was firmly planted on the fence, but, man!, the ladies and gentlemen behind this research have done a fantastic job thoroughly investigating it.  You may not for a moment think this is a hasty decision, I can promise you that.  So here are some things that I have heard in the last few weeks, and what I have learned regarding each one.

This first part that was super appealing to me was the idea that with Professional Degrees, we could align ourselves more with other Allied Health Care Professionals on campus.  I’m not sure this was spelled out so well in the white papers, but when some of the researchers were presenting, it was a major “AHA!” moment for me.  If you are taking a lower extremity course in a health care department, not a kines department, your classmates will be other health care professions.  We won’t have to prove how much we know when faced with other therapists because they will know what we know.  Our education foundation would be in the same EXACT class! Brilliant! On top of that, aligning ourselves with colleges of health care, not kinesiology, will allow us to escape the Rule of Athletics.  Like the super successful model at Boston University, this switch would pave the way for ATs who do not work for coaches and athletic directors.  That’s a whole other blog post, but, the job of an AT should not be influenced by a boss who has other motives.  This move will help that.

I also think the ECE’s point about basic courses competing with AT courses is valid. Letting the students get their GE requirements out of the way before being immersed in their clinical rotations will increase their drive, focus, and passion for athletic training.  I know first-hand, taking English and Modalities in the same semester, is a daunting task.  Why not let our students be fully immersed in what is they are trying to become?  

This new undergrad experience will allow for more science-based pre-requisites, one area identified as lacking in our Evidence Based world.  If you think for a second that physics are necessary for modalities and rehab, you are dead wrong.

One of the biggest draws, is student maturity and making athletic training a terminal profession.  I know the previous post already addressed this, so I won’t go bananas, but let’s all briefly reflect on the student we were at 18 and the student we were at 22.  For those of you in our secondary schools, its equivalent to the difference between a middle schooler and a high schooler, bless those little 7^th graders’ hearts!

One of the common “cons” is the cost of education vs. the salary return.  For most in our profession, I would be willing to venture, this is already a reality. I know GA positions are sold to us as being “free education,” but I still left grad school with loans as do most of our newest grads.  It was not free, nor was my stipend “liveable” for a certified professional.  Bringing academics into the graduate level allows for greater scholarships and grants. 

Again, this education reform is not the solution to our salary issue, nor is that the design, and I know that is what everyone wants. Until we align ourselves with peers deserving of an increased salary that will never happen.  Remember, we are classified as “technicians” in the current healthcare model because we lack a professional degree.  Translation: we are no more skilled than a medical assistant or an EMT.  I know that not to be true.  That alone should send everyone knocking down the ELM door.

Another argument I have heard through the grapevine is that we are eliminating the GA position and that is a bad thing.  This was one of the ones I sided with when I read through the white papers the first few times, but have changed my mind. From meeting with those involved in this investigation this weekend, our advanced degrees, included skilled residencies, Specialty Certifications, and higher education (Doctorates in Athletic training and Advanced Masters) will be enacted sooner than our Professional Degree.  The authors were unanimous in our need for higher education and more enriching educational opportunities, not just the letters behind the name.  In our current model, that is what grad school does.  It gets us the letters and attempts to make a bridge from student to certified professional.  But, speaking from experience, my GA position had very little bridging.  I was a (wo)man all unto myself.  Sure it was a valuable experience, but it was an unguided experience.  Name any other profession that an entry level job is a lone gig.  There is none.  No first year doctor would open his own practice.  No first year nurse, would run an ER by himself. No first year PT would open his own clinic.  But we surly send a first year ATC out to cover 1,000 of athletes at the high school level.  We are sending our lambs to the slaughter!!!

Residency programs are now being accredited by CAATE and will be the future of athletic training.  The pay is on-par with other professions’ residencies, and they are full time positions with benefits.  Which our GA positions are not.  An even bigger plus for the profession, they are guided, educational opportunities.

And the quickly on the R Word tied to the S word: Reimbursement.  Again, as long as we are classified as technicians, we won’t be eligible for reimbursement.  It’s a fight we will keep fighting for sure, but will continuously struggle with reimbursement until all states have licensure and until we have a professional education standard.

One more thing before I close would be to argue against one of the most common “cons” I have heard. Honestly, I felt the same way, until presented with truth and evidence this weekend at the Joint Committee meeting. “We are cutting clinical time and we are already lacking in clinical experience!!!!” “We expect students to get better in 2 years when they aren’t good in 4 years!” The Professional Degree would incorporate just as much, if not more, clinical experience than our traditional bachelors.  Remember, we are eliminating the “fluff” of undergrad: student organizations, general studies, Greek Life, etc. Also, the degree outline is non-stop, beginning June 1 and ending August 31, two years later.  There is no summer break and there are no lulls in education.  Many of the pilot programs have even allowed a full Fall (where we know we get some of our richest clinical experiences) to be strictly clinical rotations. That’s right folks: a full “40 hour work week” of just clinic for our students.  No undergrad is experiencing that right now.

In the name of time, this post will conclude.  Please send me your thoughts, comments and concerns, and I will do my best to share with you what I have learned.  Plus, you will give me fodder for Blog, Part 3. :)

-Tiffany McGuffin

One Side of the ELM Debate

After following the developments on the entry-level master’s (ELM) discussion over the past 6-12 months, and in particular after reading the NATA’s Entry-level degree evaluation document, I have hopped down off the fence and stepped confidently onto the side in favor of making this change to a Master’s degree.  What follows is one girl’s opinion including what I believe to be the most important points of this issue in favor of a transition to an ELM degree.  If you’re looking for evidence behind these points, you’ll find it in the degree evaluation document by following this link: http://www.nata.org/sites/default/files/The_Professional_Degree_in_Athletic_Training.pdf.  Be warned I am only presenting one side of the argument.  I was planning on presenting both sides but it turns out that one side of the story is pretty lengthy!!  Either that or I’m just long-winded…

For some historical perspective, it is important to note that the NATA’s Vision Quest (VQ) report, which was intended to give us direction and vision for the profession into the year 2020, said the Bachelor’s degree is currently meeting our needs, but that requirements will continue to be evaluated contingent upon the health care market.  It seems that is what we are doing, so in this way things are going according to the VQ plan.

Switching to an ELM is going to be a huge undertaking when it happens, and I believe it will happen eventually.  The NATA/CAATE/BOC have already used a significant amount of time, manpower, energy, and money to examine our entry level degree and figure out if this is the right move.  I imagine that if we decide not to make this change, the NATA will wait 3-5 years, someone else will bring it up, and we will repeat this process all over again (ahem….nomenclature), thereby using more money, manpower and energy that could be put somewhere else.  I don’t think anyone can deny this change needs to happen eventually, so unless we see some huge red flags during the research and investigation, let’s just make the right decision now and go for it.  It will be hard, but if we take our time and make sure we do it right, we will look back as those who made the decision about eliminating the internship route did and know that even through all the struggle and stress it was worth it because it was the right thing for the profession.

We have too many AT programs. If you ask me, its straight up redonkulous and I think if we lost a few programs, or 100, it would be better for the profession and better for our students. We are wide and shallow.  It is time for us to become narrower and deeper. Would cutting the number of AT Programs be hard for a lot of people? Definitely, and that is absolutely unfortunate. But ultimately it would be for the greater good and so it will be worth it, and the strong will survive which will strengthen our profession.  Additionally, a lot of AT programs have “numbers” requirements to keep them afloat which further contributes to the dilution of AT-focused students in our programs.  Decrease the number of programs and the students per program should increase, therby solving the numbers problem. I just can’t get the vision out of my head of what kind of profession we would have if we really focused on the students who want to do what we do.  Can you imagine?

Regarding the "stepping stone" concept, I believe this issue is very complex and has so many layers, that it will be hard to adequately address here.  Briefly, though, I think most students who come through our ATPs fall into one of four categories:

1.   they want to end up as a PT/PA/etc from the get go and truly are using AT as a stepping stone

2.   they go into it wanting to be ATs and then somewhere during their education decide they don’t like the idea of being overworked, underpaid, and disrespected for what might be the rest of their lives so they decide they will finish the ATP and then focus on something else for their post-graduate work

3.   they finish the ATP, maybe go to grad school for AT-related study, enter the workforce, decide they can’t or don’t want to deal with being overworked/underpaid/disrespected so they go back to school for PT/PA/etc and end up leaving the profession

4.   they finish the ATP, end up working as an AT, and stay in it for the extent of their career. 

Changing the degree to an ELM would probably all but eliminate groups 1 and 2, thus eliminating our “stepping stone” problem for the most part.  I’m not sure groups 3 and 4 will be affected directly by a change to an ELM because these individuals’ end-goal is AT.  What is the best move for the students who will be ATs for the rest of their lives?  Our focus should always be here, and all the others will find their way, and they will be okay.  We can mentor them and encourage them and help them find their way, but we can’t make our plans around them.

I also think the ECE’s point about basic courses competing with AT courses is valid. Letting the students get their GE requirements out of the way before being immersed in their clinical rotations will increase their drive, focus, and passion for athletic training. 

That’s all I have as far as a point-by-point perspective regarding the ELM degree debate. Hopefully I have adequately represented my perspective, and I hope someone will provide a thoughtful presentation of the potential drawbacks of an entry-level degree change. The fact is we don't REALLY know what this change will do to our profession. This degree evaluation document is the closest thing we have to an idea of what kind of chain reaction a degree change could set off. 

We have many other problems that need fixing (salary, ATs lacking in secondary school, only 48 states with licensure, lack of recognition and respect from others, and our identity crisis).  There is no way to know how an ELM will affect these problems, but I don’t think this is something we should expect to be able to predict.  Most of these other problems I just listed are OUR problems, and if WE don’t put our energy, time, and passion into fixing them, we will never see our dreams realized.  Our salaries, being respected, and our identity crisis are not problems the NATA, CAATE, or BOC can fix. Only we can.  So let’s let the powers that be use their wisdom and resources to make this decision, and as we stay informed and speak our minds about this, let’s daily wage war against apathy, self-loathing, and the status quo and move this profession forward.

So what do you think about the ELM degree debate?  …and please don’t comment until you’ve read the document – make sure you’re opinion is educated!

-Kim Detwiler

Involvement

I had the great pleasure of assisting with the Texas State Licensure exam this past week, and, as I passed out flyers encouraging student to get involved, I began thinking back over my career involvement.

I was fortunate enough to come from a CAATE ATEP program with instructors who pushed involvement on us at both the state and local level.  Both my clinical coordinator and program director assisted with the state licensure and national certification exams when they could.  Both attended local and national meetings.  Both were adamant that we attend the meetings to network and learn.  Their attitude towards involvement was always positive, and encouraging.  They wanted us to develop professionally, and they knew this was one of the best ways to do so.  This attitude was passed down to us- so much so that we would spend countless hours fundraising to pay our way to San Diego, St. Louis, and even Baltimore.  We wanted to be there.  We wanted to network.  We wanted to learn.  We knew the importance of it all, and that has carried over into our careers now.  Once I was out of grad school, I wanted to get involved at the local level, which is one of the biggest reasons I decided to join the Young Professional’s Committee. 

Sitting in the lobby of Ben Hogan on Sunday, I began thinking about why other athletic training students chose the same path as I did, and why others chose not to even be members of NATA at all.  What is the deciding factor that tips them to contribute back?  What aspires them to lobby at Capitol Hill?  To join a committee?  To attend annual meetings?  

It seems as though it can be traced back to their CAATE program.  If their program directors and clinical coordinators encourage them to be involved and attend annual meetings, they will.  If their student organization can raise funds to help ease the cost of the trips, then more students will opt to go.  If the location and student program appear enticing, it peaks more student interest.  If they feel as though they can have a voice on the student senate, they will pursue it.  But some schools do not have an athletic training student organization, and other’s programs are poorly managed.  Some instructors feel as though their time and money can be better put to use at an educators conference, rather than NATA and SWATA.  This feeling may trickle down to the students, who in turn chose not to participate in the annual meetings.  Whatever the reasoning is, there is a population of athletic trainers who chose not to become involved in the profession outside of their daily jobs.  

The question is, how do those of us who are involved reach out to those who are not?

-Courtney Hobbs

Professional Resolutions???

It’s a New Year; did you happen to make resolutions? If so, how is the quest to lose those extra pounds? Are you going to bed earlier yet?  How's the vow to be 10 minutes early instead of 10 minutes late? Did you book that dream vacation yet? I hope so!

Have you given any thought on what you want to achieve in your professional life in 2014?  In the past, I would of never given it one thought to write down what I want to accomplish professionally in the New Year. 

As YPs, we are familiar with the goals we are asked to set immediately after graduation.  Is it grad school or another professional degree? I know every interview asks, "where do you see yourself in five years?" I think early on we are good at professional resolutions, but once we get settled in our careers, we are less inclined to do so. And that is a very bad thing.

So I challenge you to start in 2014. It could be as simple as "I want to read more AT journal articles and devote 30 minutes a week to reading them." You could decide you want to be a be a better diagnostician and spend time each week reviewing special tests. You could take a self-study course or webinar outside of the annual symposiums. You could make a point to ask your team physician’s random questions to expand your knowledge on any topic. If your physician’s are like mine, it will turn into a fun game; they may even quiz you a little. My goals include finishing the Kinesio tape certification process, but for you it could be anything. 

Let’s help each other out this coming year and set some goals. Write it down to make yourself accountable or tell a friend so that they make you accountable. Here’s to a great 2014!

-Julie Ellena

Whole Body Cryotherapy

The new trend in cryotherapy is quickly sweeping the nation, the “Cryosauna” as it is termed, is the name of the unit that submerges the entire body in freezing cold temperature to ensure total body recovery.  The skin’s temperature is lowered to approximately 30 degrees for three minutes by exposing the naked body to temperatures between negative 133 to negative 320 degrees.  Many of the metroplex’s college, professional, and elite athletes are already jumping on board this trend, and seeing recovery results beyond the traditional cold plunge.

Sports medicine professionals have been using whole body cryotherapy in many forms, namely ice baths, for many years.  The effects seen on the body aid in both the healing and recovery process, allow for optimum performance at the highest levels.  The differences between water and air submersion are the key to the cryosauna’s success.  The biggest advantage to the cryosauna is the time the body is inside the chamber.  Three minutes is all it takes to achieve optimum results, verse an 8-10 minutes ice bath.  When gradually cooled in the ice bath, the body’s core tries to warm the blood as much as possible in order to send it out to the peripherals.  In contrast, the cryosauna allows the skin’s surface to drop to negative 30 degrees in just 30-45 seconds!  Another benefit to the cryosauna is that since the body is not submerged in a medium, it can be used on someone with an open wound without worrying about contamination and excessive cleaning procedures.  The body never touches the chamber.  This makes the treatment ideal for post-operative patients.

The biggest downfall to the cryosauna is the cost of treatment.  Single treatments can run anywhere from $75-$100.  Package deals offer better discounts, however the upfront cost can dent the pocketbook.  The silver lining lies in multiple companies popping up, which can provide a healthy dose of competitive rates. 

Whole body cryotherapy- a new twist on an old routine.  Google for more information!

The Big Debate

This past fall, I was privy to many conversations involving the issue of whether or not college athletes should be paid for their “services” to the university.  Namely, the “big money” sports i.e. football and basketball for those who are unaware.  I have heard numerous concrete and far-fetched arguments both for and against this idea, but have yet to reach a sound conclusion.  To be honest, I am torn between what seems right, and how the abuse of such a policy would render havoc on an athletic department.  

My fiancé played football for a division I college, and thankfully made it out without a serious injury or needing a surgery.  From my experience, this is not the norm.  It seems as though most of the contact athletes suffer at least one major injury in their four years, often times leading to a surgery.  Some of these injuries can lead to long-term issues such as arthritis.  In the case of concussions, we are only just now beginning to see the long-term neural damage multiple concussions can cause.  America loves its football.  As much as we cringe when we see a crushing tackle, this is part of the thrill and draw of the game- are we not praising the number of sacks the defense has per game?  This is precisely the reason the game of football is here to stay, and why I have a career in the first place.  But for the 98% of student athletes who “Go on to major in something besides professional sports” (as the NCAA so accurately puts it in their commercials) is the possibility of long-term damage to the body worth a “free” degree?  If that wasn’t enough, the gaming industry makes millions using college football player’s likenesses, and in some cases the athletes cannot even afford to buy the game themselves (see the MIZZOU article in Sports Illustrated). 

The biggest debate lies in whether or not paying student athletes could ultimately undermine the very principles of college athletics.  NCAA sports are amateur, in that they are not the highest level of competition (the NFL being the highest level with football).  Another argument is that by paying college players, it would decrease the popularity of the sport(s) altogether.  And where is the line drawn?  Only those who participate in football and basketball can get paid, because sports like tennis and swimming are non-contact and are therefore “easier on the body?”  I doubt that argument would go far with the swimmer working through their third shoulder surgery, and former collegiate tennis athlete who needs a double knee replacement. 

The fact of the matter is, however, that traditionally the average stipend check may not in fact cover all expenses for student athletes.  Many colleges, like the one I work at, cannot financially afford to take on other additional expenses like wisdom tooth removal, and year-round contacts.  What about when the student-athlete needs a suit for their first interview?  To fly home to pay their last respects to a dying family member?  To afford the $7 salad verses the $2 cheeseburger, because we tell them they need to eat better?  (Say what you want, but eating healthy is way more expensive than eating like crap… that’s a whole other blog.)  Some colleges have access to the NCAA’s special opportunity fund for things like the flight home, but not all athletes are eligible for this money, and in some cases (like oral surgery) cannot get to it quick enough.  These are the kids who fall through the cracks. 

The abuse of being paid to play college sports is the biggest hurdle for the NCAA.  With athletes being busted for a plethora of illegal and immoral activities, this may just open the checkbook for some to continue down the proverbial path of destruction.  But this statistic only accounts for a small percentage.  Many of the student athletes outside of the spotlight attend college to gasp! actually get their degree and become a productive member of society.  At the end of the day, if the college athletics support staff’s job is to prepare these students for life, can we really say that we’ve done all that we can?

-Courtney Hobbs