Tuesday, January 28, 2014

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 7th 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

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