Athletic Training Milestones MASTER DOCUMENT · 2019-02-12 · ATTRIBUTION The Athletic Training (AT) Milestones are based on the extensive work of the Accreditation Council for Graduate

THEATHLETICTRAININGMILESTONES

Authors

EricL.Sauers,PhD,ATC,FNATAR.MarkLaursen,MS,ATCForrestPecha,MS,ATC

HollieWalusz,MA,ATC,PES

Version1.1,2019©

ATTRIBUTIONTheAthleticTraining(AT)MilestonesarebasedontheextensiveworkoftheAccreditationCouncilforGraduateMedical

Education(ACGME)whodevelopedMilestonesas“competency-baseddevelopmentaloutcomes(e.g.,knowledge,skills,attitudes,andperformance)thatcanbedemonstratedprogressivelybyresidents/fellowsfromthebeginningoftheireducationthroughgraduationtotheunsupervisedpracticeoftheirspecialties”.1TheACGMErequirestheuseofspecialtyspecific

milestonesintheaccreditationoftheirmedicalresidencyandfellowshiptrainingprograms.TheACGME“…isanindependent,not-for-profit,physician-ledorganizationthatsetsandmonitorstheprofessionaleducationalstandardsessentialinpreparingphysicianstodeliversafe,high-qualitymedicalcaretoallAmericans.”2ThemissionoftheACGMEisto“improvehealthcareandpopulationhealthbyassessingandadvancingthequalityofresidentphysicians’educationthroughaccreditation”.2

TheATMilestonesProjectTeamevaluatedtheprocessandoutcomesoftheACGMEMilestones3andcarefullyconsideredthe

relationshipbetweenathletictrainingandphysicianpracticeandthesupervisoryrelationshipinherenttherein.Subsequently,

itwasdeterminedtobuildtheATMilestonesbasedontheACGMEMilestonesframework.Thevariousmedicalspecialties

liberallyadoptthestructureandlanguageintheirspecificMilestonesfrompeerspecialtieswhereefficientandeffective

languagehasbeenpreviouslyidentified.TheATMilestonesProjectTeamtookthesameapproachandsoughttoutilizethe

languagepreviouslydevelopedbythevariousACGMEandAmericanBoardofMedicalSpecialties(ABMS)specialtyboard(s)

whereverpossibletomaximizeefficiencyandalignmentwiththeeducationofourphysicianpeers.TheATMilestonesProject

TeamhasadoptedACGMEMilestoneslanguageinvariousforms,andmodifiedtheACGMEMilestonestomeetthespecific

needsoftheathletictrainingprofession,onanon-exclusivebasisforeducationalpurposesonly.Thereisnointenttoseekany

financialgainfromtheATMilestonesandtheyhavebeendevelopedsolelyforeducationalpurposes.

TheATMilestonesProjectTeamgivefullattributiontotheACGMEandtheauthorsofthespecialtyspecificMilestoneson

whichtheATMilestoneswerebased,whicharereferencedbelow.4-10

References:

1. AccreditationCouncilforGraduateMedicalEducation.MilestonesResources,MilestonesFAQsWebsite.

http://www.acgme.org/Portals/0/MilestonesFAQ.pdf?ver=2015-11-06-115640-040.AccessedApril05,2018.

2. AccreditationCouncilforGraduateMedicalEducation.AboutUsWebsite.http://www.acgme.org/About-Us/Overview.

AccessedApril05,2018.

Copyright©2018Allrightsreserved.ThecopyrightownersgrantthirdpartiestherighttousetheAthleticTrainingMilestonesonanon-exclusivebasisforeducationalpurposes. 2

3. AccreditationCouncilforGraduateMedicalEducation.MilestonesWebsite.http://www.acgme.org/What-We-

Do/Accreditation/Milestones/Overview.AccessedApril05,2018.

4. AccreditationCouncilforGraduateMedicalEducation.MilestonesBySpecialtyWebsite.

http://www.acgme.org/Portals/0/PDFs/Milestones/FamilyMedicineMilestones.pdf?ver=2017-01-20-103353-463.

AccessedMay01,2017.


http://www.acgme.org/Portals/0/PDFs/Milestones/InternalMedicineMilestones.pdf?ver=2017-07-28-090326-787.

AccessedMay01,2017.


http://www.acgme.org/Portals/0/PDFs/Milestones/EmergencyMedicineMilestones.pdf?ver=2015-11-06-120531-877.

AccessedMay01,2017.


http://www.acgme.org/Portals/0/PDFs/Milestones/PMRMilestones.pdf?ver=2015-11-06-120521-480.AccessedMay

01,2017.


http://www.acgme.org/Portals/0/PDFs/Milestones/OrthopaedicSurgeryMilestones.pdf?ver=2015-11-06-120524-887.

AccessedMay01,2017.


http://www.acgme.org/Portals/0/PDFs/Milestones/SportsMedicineMilestones.pdf?ver=2015-11-06-120519-653.

AccessedMay01,2017.


http://www.acgme.org/Portals/0/PDFs/Milestones/OrthopaedicSportsMedicineMilestones.pdf?ver=2015-11-06-

120525-030.AccessedMay01,2017.


THEATHLETICTRAININGMILESTONES

TheATMilestonesaredesignedforuseinevaluationofathletictrainersinthecontextoftheirparticipationinCommissionon

AccreditationofAthleticTrainingEducation(CAATE)accreditedprofessionaleducation,residency,andfellowshipprograms.

Theymayalsobeusedtofacilitatepeerandself-evaluationsforthepurposeofassessinganindividual’smaintenanceof

competence(MOC).TheATMilestonesprovideaframeworkfortheassessmentofthedevelopmentoftheindividualinkey

dimensionsoftheelementsofathletictrainercompetencyingeneralpractice,aswellaswithinaspecialtyareaofpractice.

TheATMilestoneshavebeendevelopedtocapturethebreadthanddepthofathletictrainingknowledge,skills,attitudesand

behaviors.Theyareorganizedtoassesssixgeneralcompetencies,adoptedfromtheAccreditationCouncilforGraduate

MedicalEducation(ACGME),andeightspecialtycompetenciesrepresentingtheeightspecialtyareasidentifiedbytheCAATE.

Foreverycompetency,therearespecificsub-competencies,eachwiththeirownsetofprogressivemilestonesformeasuring

individualperformance.

Thesixgeneralcompetenciesare:

• PatientCareandProceduralSkills

• MedicalKnowledge

• Practice-BasedLearningandImprovement

• InterpersonalandCommunicationSkills

• Professionalism

• Systems-BasedPractice

Theeightspecialtycompetenciesare:

• PreventionandWellness

• UrgentandEmergentCare

• PrimaryCare

• Orthopaedics

• Rehabilitation

• BehavioralHealth

• Pediatrics

• PerformanceEnhancement


TheATMilestonesarestructuredinaccordancewiththebeliefthateveryathletictrainerenteringgeneralpracticeshould

demonstratebehaviorsappropriateforunsupervisedpracticeacrossallofthesixgeneralcompetenciesandalloftheeight

specialtycompetencies.Thisstructureensuresappropriatedepthandbreadthofknowledgeacrossallofthecompetencies

believedtobeessentialtotheprovisionofqualityhealthcare.TheATMilestoneshaveadoptedtheInstituteofMedicine

criteriaforqualitycare,whichinvolvesthedeliveryofsafe,timely,effective,efficient,equitable,andpatient-centeredcare.

Incontrast,athletictrainerspursuingspecialtytrainingshoulddemonstrateadvancedpracticebehaviorsacrossallofthesix

generalcompetencies,plusadvancedpracticebehaviorsonlyintheirchosenareaofspecialtypractice.Itisnotreasonableto

expectthatanathletictrainerexhibitadvancedpracticebehaviorsacrossallspecialtycompetencies.Specialtycarerequires

greaterdepthineachofthesixgeneralcompetenciesandinthespecificareaofspecialtypracticeandtheATMilestonesare

developedtoprovideguidanceonhowtoprogressfromageneralisttoaspecialist.TheATMilestonesprovidealogical

progressofincreasinglycomplexandindependentclientandpatientcareservices.

ThisdocumentpresentstheATMilestonesdesignedforprogramstouseinongoingreviewofindividual(student,resident,

fellow)performance.Milestonesareknowledge,skills,attitudes,andotherattributesforeachofthesixgeneralcompetencies

(e.g.,patient-careandproceduralskills,medicalknowledge)andeightspecialtycompetencies(e.g.,PreventionandWellness,

Orthopedics)thatdescribethedevelopmentofcompetencefromanearlylearneruptoandbeyondthatexpectedfor

unsupervised,advanced,andaspirationalpractice.ProgramsshoulddeterminethefrequencywithwhichtheyusetheAT

Milestonestoassessindividualperformance.Foreachgeneralandspecialtycompetencydomain,programsshouldseekto

provideasummativeevaluationofanindividualslearningtrajectoryovertime.MoreinformationabouttheATMilestonesis

availableontheATMilestoneswebpage:www.atmilestones.com


INTEGRATEDMODELOFPROGRESSIVEATHLETICTRAININGEDUCATION

TheATMilestonesaredevelopedtomeasureanindividualsprogressiveacquisitionofincreasinglyindependentand

sophisticatedclientandpatientcarebehaviors.ThefigurebelowpresentstherelationshipsbetweentheATMilestoneslevels

(x-axis),thecorrespondinggoalfortheindividuallearner(arrow),andthefive-stagesofskillacquisitiondescribedusingthe

DreyfusModelofKnowledgeDevelopment(y-axis).1TheDreyfusModelprovidesatheoreticalframeworkfordescribingthe

movementfromadvancedbeginnerstocompetentcliniciansworkingwithoutsupervisionaftercompletionoftheireducation

programwithfurtherprogressiontowardsproficientadvancedpracticeprovidersinaspecialtyareawithaspirational

progressiontobecomeanexpert.

Figure1:Progressiveeducationandtrainingprogramsaredevelopedtobuildprogressivelyindependent

knowledge,skill,andbehaviorsthatcanbeassessedusingdifferentlevelsofmilestones.

1Paul Batalden, David Leach, Susan Swing, Hubert Dreyfus and Stuart Dreyfus. General Competencies And Accreditation In Graduate Medical Education. Health Affairs 21, no.5 (2002):103-111


AthleticTrainingMilestonesEvaluationThediagrambelowpresentsthestandardizedstructureforeachcompetency,sub-competency,andmilestonewith

interpretationsforeachofthesixlevelsofperformance.Inaddition,eachsub-competencyiscross-referencedbacktoa

specificACGMEsub-competencyinparenthesesafterthesub-competencyisstated.Foreachassessmentperiod(definedby

theend-user),anindividual’sperformanceonthemilestonesforeachsub-competencywillbeindicatedby: • selectingthelevelofmilestonesthatbestdescribestheindividual’sperformanceinrelationtothemilestonesor, • selectingthe“CriticalDeficiencies”option

GeneralCompetency(e.g.,MedicalKnowledge):Sub-CompetencyStated(ReferencetocorrespondingACGMEmilestone)CriticalDeficiencies Level1 Level2 Level3

(ReadyforUnsupervisedPractice)

Level4(ReadyforAdvancedPractice)

Level5(Aspirational)

Behaviorsarenot

withinthespectrum

ofdeveloping

competence

Significantdeficiency

inlearner

performance

Whatarethe

expectationsfora

beginninglearner?

Whatarethe

milestonesfora

learnerwhohas

advancedbeyond

beginner,butisnot

performingatalevel

sufficientfor

unsupervised

practice?

Whatshouldthe

learnerbeabletodo

wellatthispointin

theirtraining?

Whatdoesagraduate

ofaprofessional

programlooklike?

Whatadditional

knowledge,skills,and

attitudeshavethey

obtained?

AretheyreadyforBOC

certification?

Whatdoesagraduating

residentlooklike?

Whatadditional

knowledge,skills,and

attitudeshavethey

obtained?

Aretheyreadyfor

specialtycertification?

Whatdoesclinical

expertiselooklike?

Whatarestretchgoalsto

encouragecontinued

progressiontowards

mastery?

� � � � � � � � � � �Comments:

Selectingaresponseboxinthemiddleofalevelimpliesthatmilestonesinthatlevelandinlowerlevelshavebeensubstantiallydemonstrated.

Selectingaresponseboxonthelineinbetweenlevelsindicatesthatmilestonesinlowerlevelshavebeensubstantiallydemonstratedaswellas

somemilestonesinthehigherlevel(s).


TheATMilestonesarearrangedincolumnsofprogressivestagesofcompetence.Foreachassessmentperiod,determinedby

andfortheprogram,programswillneedtoreviewthemilestonesandidentifythosemilestonesthatbestdescribean

individualscurrentperformanceandultimatelyselectaboxthatbestrepresentsthesummaryperformanceforthatsub-

competency.Selectingaresponseboxinthemiddleofacolumnimpliesthattheindividualhassubstantiallydemonstrated

thosemilestones,aswellasthoseinpreviouscolumns.Selectingaresponseboxonalineinbetweencolumnsindicatesthat

milestonesinthelowercolumnshavebeensubstantiallydemonstrated,aswellassomemilestonesinthehighercolumn.

AgeneralinterpretationofeachcolumnfortheATMilestonesisasfollows:

CriticalDeficiencies:Theselearnerbehaviorsarenotwithinthespectrumofdevelopingcompetence.Insteadthey

indicatesignificantdeficienciesinanindividual’sperformance.

Level1:Describesbehaviorsofanearlylearner.

Level2:Describesbehaviorsofalearnerwhoisadvancinganddemonstratingimprovementinperformancerelatedto

milestones.

Level3(ReadyforUnsupervisedPractice):Describesbehaviorsofanindividualwhosubstantiallydemonstratesthe

milestonesidentifiedforanathletictrainerwhohascompletedaCommissiononAccreditationofAthleticTraining

Education(CAATE)accreditedprofessionalprogramandisreadyforunsupervisedpractice.Thiscolumnisdesignedas

thegraduationtargetforprofessionalprograms,butanindividualmaydisplaythesemilestonesatanypointduring

theireducation.

Level4(ReadyforAdvancedPractice):Describesbehaviorsofanindividualwhosubstantiallydemonstratesthe

milestonesidentifiedforanathletictrainerwhohascompletedaCAATEaccreditedresidencyprograminspecialtyarea

ofpracticeandexhibitsperformanceconsistentwithanadvancedpracticeclinician.Thiscolumnisdesignedasthe

graduationtargetforresidencyprograms,butanindividualmaydisplaythesemilestonesatanypointduringtheir

educationandtraining.

Level5(Aspirational):Describesbehaviorsofandindividualwhohasadvancedbeyondthosemilestonesthatdescribe

advancedpractice.Thesemilestonesreflectthecompetenceofanexpertorrolemodelandcanbeusedbyprograms,

personnelsupervisors,andindividualstofacilitatefurtherprofessionalgrowth.Itisexpectedthatonlyafew

exceptionalindividualswilldemonstratethesemilestonesbehaviors.


The“ReadyforUnsupervisedPractice”and“ReadyforAdvancedPractice”milestonesaredesignedasthegraduationtarget

foraccreditedprofessionalandresidencyprograms,respectively,butdonotrepresentagraduationrequirement.Making

decisionsaboutreadinessforgraduationisthepurviewoftheprogramfaculty.Programsareencouragedtostudytheuseof

ATMilestoneperformancedatatohelpdeterminewhetherthe“ReadyforUnsupervisedPractice”and“ReadyforAdvanced

Practice”milestones,andallothermilestones,areintheappropriatestagewithinthedevelopmentalframework,and

whethermilestonedataareofsufficientqualitytobeusedforhighstakesdecisions.


AccreditationandtheAthleticTrainingMilestonesTheATMilestonesarenotarequiredelementoftheCommissiononAccreditationofAthleticTrainingEducation(CAATE)

standardsforprofessional,post-professional,orresidencyprograms.Infact,theATMilestoneswerenotdevelopedforthe

purposeofmappingdirectlytotheeducationalcontentrequiredinCAATEaccreditededucationprograms.However,theAT

MilestonescanbeusedtohelpprovideevidenceofcompliancewithvariousstandardsacrossalllevelsofCAATE

accreditation.TheATMilestonescanbeofgreatvaluethroughoutclinicaleducationincludingcommunicationwith

preceptors,andtheassessmentofalogicalprogressionofincreasinglycomplexandindependentpatientandclient

experiences.

Mostnotably,however,theATMilestonescanbeusedtoprovideevidenceforcompliancewiththeCAATEcorecompetencies

thatarevitalcomponentsofthenew2020StandardsforProfessionalMastersProgramsandhavebeenembeddedwithinthe

post-professionalandresidencyprogramstandardsforyears.Thetablebelowprovidesageneralcross-referenceofthesix

CAATEidentified‘corecompetencies’withthecorrespondingATMilestonesgeneralcompetenciesandsub-competencies.

CAATECoreCompetencies ATMilestonesGeneralCompetencies&Sub-CompetenciesPatient-centeredcare Patient-CareandProceduralSkills(PC-1,2)

InterpersonalandCommunicationSkills(ICS-1,2)

Evidence-BasedPractice Practice-BasedLearningandImprovement(PBLI-1)

MedicalKnowledge(MK-3)

HealthCareInformatics InterpersonalandCommunicationSkills(ICS-4)

Systems-BasedPractice(SBP-6)

InterprofessionalPracticeandEducation Patient-CareandProceduralSkills(PC-7)

InterpersonalandCommunicationSkills(ICS-3)

Professionalism(PROF-2)

Systems-BasedPractice(SBP-1,2,3,4)

QualityImprovement Practice-BasedLearningandImprovement(PBLI-2,3,4)

Systems-BasedPractice(SBP-1,2,3,4)

Professionalism Professionalism(PROF-1,2,3,4)


ATHLETICTRAININGMILESTONES

GENERALCOMPETENCIES

Patient-CareandProceduralSkills

Athletictrainersmustbeabletoprovidepatientcarethatiscompassionate,appropriate,andeffectiveforthetreatmentof

healthproblemsandthepromotionofhealth.

Patient-CareandProceduralSkills(PC-1):Patient-CenteredCare:Respondstoeachpatient’suniquecharacteristics,needsandgoals.(InternalMedicinePROF-3)CriticalDeficiencies Level1 Level2 Level3



Level5Aspirational

Isinsensitiveto

differencesrelatedto

culture,ethnicity,

genderidentify,race,

age,andreligionin

thepatient/caregiver

encounter

Isunwillingtomodify

careplantoaccount

forapatient’sunique

characteristics,needs

andgoals

Issensitivetoandhas

basicawarenessof

differencesrelatedto

culture,ethnicity,gender

identify,race,age,and

religioninthe

patient/caregiver

encounter

Requiresassistanceto

modifycareplanto

accountforapatient’s

uniquecharacteristics,

needsandgoals

Seekstofullyunderstand

eachpatientsunique


andgoalsbasedupon

culture,ethnicity,gender

identify,religionand

personalpreference

Modifiescareplanto

accountforapatient’s


needsandgoalswith

partialsuccess

Recognizesand

accountsforthe

uniquecharacteristics

andneedsofthe

patient/caregiver

Appropriatelymodifies

careplantoaccount

forpatient’sunique


andgoals

Rolemodelsprofessional

interactionstonegotiate

differencesrelatedtoa

patient’sunique

characteristicsorneeds

Rolemodelsconsistent

respectforpatient’s


needsandgoals

Developsbestpractice

guidelinesfor

professional

interactionsto

negotiatedifferences

relatedtoapatient’s


needsandgoals

Developsorganizational

policiesandeducation

to supportrespectfor

patient’sunique


andgoals

� � � � � � � � � � �Comments:


Patient-CareandProceduralSkills(PC-2):Patient-CenteredCare:Demonstrateshumanismandculturalcompetency(FamilyMedicinePROF-3)CriticalDeficiencies Level1 Level2 Level3



Level5Aspirational

Failstodemonstrate

appropriate

compassion,

respect,and

empathy

Hasdifficulty

recognizingthe

impactofcultureon

healthandhealth

behaviors

Exhibitsresistance

toimproving

culturalcompetence

Consistently

demonstrates

compassion,respect,

andempathy

Recognizesimpactof

cultureonhealthand

healthbehaviors

Displaysaconsistent

attitudeandbehavior

that conveysacceptance

of diverseindividualsand

groups,including

diversity ingender,age,

culture, race,religion,

disabilities, sexual

orientation,and gender

identity

Elicitsculturalfactors

frompatientsand

familiesthat impact

healthandhealth

behaviorsinthecontext

of thebiopsychosocial

model

Identifiesowncultural

frameworkthatmay

impactpatient

interactionsand

decision-making

Incorporatespatients’

beliefs, values,and

culturalpracticesin

patientcareplans

Identifieshealthinequities

and socialdeterminantsof

health andtheirimpacton

individualandfamily

health

Anticipatesanddevelopsa

sharedunderstandingof

needsanddesireswith

patientsandfamilies;

worksinpartnershipto

meetthoseneeds

Demonstratesleadership in

culturalcompetence,

understandingofhealth

disparities,andsocial

determinantsofhealth

Advocatesfortherightsof

vulnerablepatients/

patientpopulations

Recognizesandaddresses

lackofpatient-

centerednessin

colleagues/peers

Develops

organizational

policiesand

educationto

supportthe

applicationof these

principlesinthe

practiceofathletic

training

Generatesand

disseminatesnew

knowledgein

humanismand

cultural

competence

� � � � � � � � � � �Comments:


Patient-CareandProceduralSkills(PC-3):DiagnosisandManagement:Gathersandsynthesizesessentialandaccurateinformationtodefineeachpatient’sclinicalproblem(s).(InternalMedicinePC-1)CriticalDeficiencies Level1 Level2 Level3




Doesnotcollect

accuratehistorical

data

Doesnotusephysical

examtoconfirm

history

Reliesexclusivelyon

documentationof

otherstogenerate

owndatabaseor

differentialdiagnosis

Failstorecognize

patient’scentral

clinicalproblems

Failstorecognize

potentiallylife

threatingproblems

Inconsistentlyableto

acquireaccurate

historicalinformationin

anorganizedfashion

Doesnotperforman

appropriatelythorough

physicalexamormisses

keyphysicalexam

findings

Doesnotseekoris

overlyrelianton

secondarydata

Inconsistently

recognizespatients’

centralclinicalproblem

ordifferentialdiagnoses

Consistentlyacquires

accurateandrelevant

historiesfrompatients

Seeksandobtainsdata

fromsecondarysources

whenneeded

Consistentlyperforms

accurateand

appropriatelythorough

physicalexams

Usescollecteddatato

defineapatient’scentral

clinicalproblem(s)

Acquiresaccurate

historiesfrom

patientsinan

efficient,prioritized

andhypothesis-

drivenfashion

Performsaccurate

physicalexamsthat

aretargetedtothe

patient’scomplaints

Synthesizesdatato

generatea

prioritized

differential

diagnosisand

problemlist

Effectivelyuses

historyandphysical

examinationskillsto

minimizetheneed

forfurther

diagnostictesting

Obtainsrelevant

historicalsubtleties,

includingsensitive

informationthatinforms

thedifferentialdiagnosis

Identifiessubtleor

unusualphysicalexam

findings

Efficientlyutilizesall

sourcesofsecondary

datatoinform


Rolemodelsandteaches

theeffectiveuseof

historyandphysical

examinationskillsto

minimizetheneedfor

furtherdiagnostictesting

Publishesclinicalcase

reportsonuniqueclinical

problems

Collaboratesinpractice-

basedresearcheffortsto

gather,aggregate,and

synthesizepatientdatato

enhancediagnosticand

managementefforts

Generatesand

disseminatesnew

knowledgepertainingto

diagnosesand

management

� � � � � � � � � � �Comments:


Patient-CareandProceduralSkills(PC-4):DiagnosisandManagement:PhysicalExamination(systems-basedexaminationadaptedforhealthconditionandcontextualfactors)(PhysicalMedicineandRehabilitationPC-2)CriticalDeficiencies Level1 Level2 Level3




Failstoperforma

thoroughphysical

examination

Failstoseekfeedback

orguidanceonthe

accuracyand

thoroughnessof

physicalexamination

Performsphysical

examination

proceduresthatare

contraindicatedand

createincreased

patientdiscomfortor

risk

Performsageneral

physicalexam

Requirespromptingto

performathorough

physicalexamination

includingallnecessary

elements(e.g.,

medical,neurologic)

Performaaphysical

examthatassistsin

functional

assessment(e.g.,

mayinclude

balance,gait,

cognition,

neurologic,or

musculoskeletal

assessments)

Performsexcessive

physical

examinationusing

unwarranted

techniques

Beginstoidentify

normaland

pathologicfindings

Performsarelevant,

accurate

comprehensive

disorder-specific

physicalexam

Modifiesexamto

accommodatethe

patient’simpairments

andminimize

discomfort

Efficientlyperformsa

hypothesis-drivenand

targetedphysicalexam

thatdrivesclinical

decisionmakingacross

aspectrumofages,

impairments,and

clinicalsettings

Efficientlyperformsa

hypothesis-drivenand

targetedphysicalexamthat

drivesclinicaldecision

makingforcomplexcases

Identifiesandcorrectly

interpretssubtleoratypical

physicalfindings

Rapidlyfocusesonthe

presentingproblemand

elicitskeyinformationfrom

theexaminaprioritizedand

efficientfashion

Modelsandteachesexam

skillsincomplexpatients

Efficientlyproducesa

focusedandprioritized

physicalexamination

accountingforrare

conditions

Streamlinesphysical

examinationfor

maximalcost-

effectivenessand

minimalpatientburden

� � � � � � � � � � �Comments:


Patient-CareandProceduralSkills(PC-5):DiagnosisandManagement:DiagnosticEvaluation.(PhysicalMedicineandRehabilitationPC-3)Thisincludes:

• Differentialdiagnosisofprimaryandsecondaryconditions• Appropriatestudies(e.g.,laboratory,imaging,neuropsychological)• Functionalassessments

CriticalDeficiencies Level1 Level2 Level3(ReadyforUnsupervised

Practice)



Failstodevelopan

appropriatelistof

differentialdiagnoses

Uncertainofwhich

diagnosticstudiesare

appropriatefor

commonmedical

conditions

Failstorecognizewhen

medicalreferralis

necessary

Identifiesappropriate

diagnosticstudiesfor

commonmedical

conditions

Identifiesreasonable

diagnosisforcommon

medicalconditions

Producesa

differential diagnosis

forcommonmedical

conditions

Recommends

appropriate

diagnosticstudies

for commonmedical

conditions

Inconsistently

interpretsdiagnostic

studyresults

Developsa

comprehensive

differentialdiagnosis,

includinglesscommon

conditions

Ordersappropriate

diagnosticstudiesfor

commonmedical

conditions

Appropriately

prioritizes the

sequenceandurgency

ofdiagnostic testing

Correctlyinterprets

diagnosticstudyresults

andappropriately

pursuesfurthertesting

or specialistinput

Appropriately

integrates functional

assessmentmeasures

intooverallevaluation




acrossa spectrumofages

and impairmentsandfor

complexconditions

Ordersdiagnostictesting

basedoncost

effectiveness and

likelihoodthatresultswill

influenceclinical

management




accountingforrare

conditions

Streamlinestestingfor

maximalcost-

effectivenessand

minimalpatientburden

� � � � � � � � � � �Comments:


Patient-CareandProceduralSkills(PC-6):DiagnosisandManagement:Developsandimplementscomprehensivemanagementplanforeachpatient.(InternalMedicinePC-2)CriticalDeficiencies Level1 Level2 Level3




Careplansare

consistently

inappropriateor

inaccurate

Doesnotreactto

situationsthatrequire

urgentoremergent

care

Doesnotseek

additionalguidance

whenneeded

Inconsistently

developsan

appropriatecareplan

Inconsistentlyseeks

additionalguidance

whenneeded

Recognizespatients

requiringurgentor

emergentcare

Seeksadditional

guidanceand/or

consultationas

appropriate

Consistentlydevelops

andimplements

appropriatecareplan


careplansbasedon

patient’sclinicalcourse,

additionaldata,and

patientpreferences

Recognizespatient

presentationsthat

deviatefromcommon

patternsandrequire

complexdecision-making

Managescomplexacute

andchronicpatients


complexandpatient-

centeredcare

Developscustomized,

prioritizedcareplansfor

themostcomplexpatients,

incorporatingdiagnostic

uncertaintyandcost

effectivenessprinciples

Servesasaregional

consultantforcomplex

patients

� � � � � � � � � � �Comments:


Patient-CareandProceduralSkills(PC-7):DiagnosisandManagement:Managespatientswithprogressiveresponsibilityandindependence.(InternalMedicinePC-3)CriticalDeficiencies Level1 Level2 Level3

(ReadyforUnsupervisedPractice)Level4

(ReadyforAdvancedPractice)


Cannotadvance

beyondtheneedfor

directsupervisionin

thedeliveryof

patientcare

Cannotmanage

patientswho

requireurgentor

emergentcare

Doesnotassume

responsibilityfor

patient

management

decisions

Requiresdirect

supervisiontoensure

patientsafetyand

qualitycare

Providesinconsistent

preventativecare

Inconsistently

provides

comprehensivecare

forsingleormultiple

diagnoses

Requiresindirect

supervisiontoensure

safetyandqualitycare

Providesappropriate

preventivecare

Providescomprehensive

careforsingleormultiple

diagnoses

Undersupervision,

providesappropriatecare

formedicallycomplex

patients

Initiatesmanagement

plansforurgentor

emergentcare

Independentlymanages

patientswhohaveabroad

spectrumofclinicaldisorders

includingundifferentiated

syndromes

Seeksadditionalguidance

and/orconsultationas

appropriate

Appropriatelymanages

situationsrequiringurgentor

emergentcare

Managesunusual,rare

orcomplexdisorders

Effectivelysupervises

themanagement

decisionsoftheathletic

healthcareteam

Servesasapreceptor

capableofrecognizing

andassessingmilestone

achievementinathletic

trainingstudentsand

residents

Recognizesand

promotesclinical

expertiseinpeersand

implementspolicyto

ensurepatientsareseen

byappropriatemembers

oftheteam

Servesasaclinicalcare

leadersupervising

multiplecliniciansina

coordinated,team-

basedmanner

Contributestothe

developmentand

refinementofmodelsof

educationthatpromote

progressive

responsibilityand

independence

� � � � � � � � � � �Comments:


PatientCareandProceduralSkills

Theindividualisdemonstratingsatisfactorydevelopmentoftheknowledge,skill,andattitudes/behaviorsneededto

advanceintheireducationandtraining.Thisindividualisdemonstratingalearningtrajectorythatanticipatesthe

achievementofcompetencyforunsupervisedpractice(oradvancedpracticeforresidencyprograms)thatincludesthe

deliveryofsafe,timely,effective,efficient,equitable,andpatient-centeredcare.

_____Yes_____No_____ConditionalonImprovement


MedicalKnowledge

Athletictrainersmustdemonstrateknowledgeofestablishedandevolvingbiomedical,clinical,epidemiologicalandsocial-

behavioralsciences,aswellastheapplicationofthisknowledgetopatientcare.

MedicalKnowledge(MK-1):Demonstratesmedicalknowledgeofsufficientbreadthanddepthtopracticeathletictraining.(FamilyMedicineMK-2)CriticalDeficiencies Level1 Level2 Level3




Failsto

demonstratethe

capacityfor

medicalknowledge

improvement

Failstoself-reflect

andrecognize

personallimitations

inmedical

knowledge

Demonstratesthe

capacitytoimprove

medicalknowledge

throughtargetedstudy

UsestheCommission

onAccreditationof

AthleticTraining

Education(CAATE)

curricularcontent

andBoardof

Certification(BOC)

Maintenanceof

Competence

framework

to furtherguidehisor

hereducation

Demonstrates

capacityto assess

andactonpersonal

learningneeds

Demonstrates

appropriatemedical

knowledgetocarefor

bothindividualpatients

andpatient

populations

Recognizesthe

limitationsoftheir

medicalknowledgeand

awillingnessto

continuetoadvance

theirmedical

knowledgeacrosstheir

career

PassestheBOC

examination

Successfullycompletesa

CAATEaccredited

residencyprogram

PassesaBoardofAthletic

TrainingSpecialties(BATS)

specialtyexamination

Collaboratestoproduce

clinicalpathwaysand

engageinpractice-based

researchtoinformbest

practicesforpatientcare

Demonstrateslife-long

learningthroughcontinual

self-assessmentand

continuingeducation

focusedonmaintenanceof

contemporarymedical

knowledge

Generatesand

disseminatesnewmedical

knowledge

Leadsthedevelopmentof

clinicalpathwaysforthe

deliveryofhighquality,

affordablehealthcare

Coordinatespractice-

basedresearchtoinform

bestpracticesforpatient

care

� � � � � � � � � � �

Comments:


MedicalKnowledge(MK-2):Knowledgeofdiagnostictestingandprocedures.(InternalMedicineMK-1)CriticalDeficiencies Level1 Level2 Level3




Lacksfoundational

knowledgetoapply

diagnostictestingand

procedurestopatient

care

Chooses

inappropriate

diagnostictestsor

proceduresthatplace

thepatientatriskor

poseasafetyhazard

Uncertainofwhich

diagnostictestsand

proceduresare

appropriate

Understandswhich

diagnostictestsand

procedurestoperform,

butcannotadequately

explainwhy

Doesnotunderstand

theconceptsofpre-test

probabilityandtest

performance

characteristics

Inconsistently

interpretsbasic

diagnostictest

accurately

Needsassistanceto

understandthe

conceptsofpre-test

probabilityandtest

performance

characteristics

Minimally

understandsthe

rationaleandrisks

associatedwith

common

procedures

Consistentlyinterprets

basicdiagnostictests

accurately

Understandsthe

conceptsofpre-test

probabilityandtest

performance

characteristics

Fullyunderstandthe

rationaleandrisks

associatedwith

commonprocedures

Interpretscomplex

diagnostictestsaccurately

Anticipatesandaccounts

forpitfallsandbiaseswhen

interpretingdiagnostic

testsandprocedures

Teachestherationaleand

risksassociatedwith

commonproceduresand

anticipatespotential

complicationswhen

performingprocedures

Introducesinnovationin

diagnostictestingand

proceduresinathletic

training

Pursuesknowledgeofnew

andemergingdiagnostic

testsandprocedures

� � � � � � � � � � �Comments:


MedicalKnowledge(MK-3):BasicSciencesofAthleticTraining,includingBiology,Chemistry,Physics,Psychology,Anatomy,Physiology,Statistics,ResearchDesign,Epidemiology,Pathophysiology,BiomechanicsandPathomechanics,ExercisePhysiology,Nutrition,Pharmacology(SportsMedicineMK-1)CriticalDeficiencies Level1 Level2 Level3


Level4(ReadyforAdvanced

Practice)

Level5Aspirational

Lacksappropriate

foundational

knowledgeinthebasic

sciences

Knowledgeislimitedto

traditionalathletic

populations(e.g.

collegeandsecondary

schoolaged)without

appropriate

understandingof

anatomyand

physiologyacrossthe

lifespan

Demonstratesknowledge

ofthebasicsciencesof

athletictraining


ofanatomyand

physiologyrelatedto

growth,development,

andaging

Demonstratesknowledgeof

basicsciencesappliedto

athletictrainingin patients

ofallages

Demonstratesbasicscience

knowledgefoundationalto

prevention,rehabilitation,

andmanagement

Synthesizesscientific

knowledgeinmanaging

commonmedical

conditions

Integratesbasicand

clinicalscience

knowledgeof

pathophysiology,tissue

healing,andtreatment

interventionsinreturn-

to-activitydecisions

Demonstrates

knowledgeoffactors

associatedwithriskof

injury,includingage,

gender,anddisability

Demonstratesboth

basic scienceand

clinical knowledgeof

thedetailsoftissue

healingand cellular

physiologyacrossthe

lifespaninselecting

treatmentoptions

Synthesizesand

applies scientific

knowledgeincomplex

medical conditions

Possessesthe

scientific,

socioeconomic,and

behavioralknowledge

requiredto

successfully

incorporatebasicand

clinicalscienceto

diagnoseandtreat

uncommon,

ambiguous, and

complexconditions

Generatesand

disseminatesnew

basicscience

knowledge

Introduces

innovationfromthe

basicsciencesto

advanceathletic

training

Possessesthe

scientific

socioeconomicand

behavioral

knowledgerequired

tosuccessfully

incorporatebasic

andclinicalscience

todiagnoseand

treatuncommon,

ambiguous,and

complexconditions

� � � � � � � � � � �Comments:


MedicalKnowledge


advanceintheireducationandtraining.Theindividualisdemonstratingalearningtrajectorythatanticipatesthe





Practice-BasedLearningandImprovement

Athletictrainersmustdemonstratetheabilitytoinvestigateandevaluatetheircareofpatients,toappraiseandassimilate

scientificevidence,andtocontinuouslyimprovepatientcarebasedonconstantself-evaluationandlife-longlearning.

Practice-BasedLearningandImprovement(PBLI-1):Evidence-BasedPractice:Locates,appraises,andassimilatesevidencefromscientificstudiesrelatedtothepatients’healthproblems.(FamilyMedicinePBLI-1)CriticalDeficiencies Level1 Level2 Level3




Unabletolocate

appropriateevidence

relatedtothe

patients’health

problemstohelp

directcare

Unabletocategorize

andinterpretthe

strengthofa

researchstudy

Describesbasic

conceptsinclinical

epidemiology,

biostatistics,and clinical

reasoning

Categorizesthedesign

ofaresearchstudy

Identifiesprosand

consofvariousstudy

designs, associated

typesofbias, and

patient-centered

outcomes

Formulatesa

searchable question

fromaclinical

question

Evaluatesevidence-

based point-of-care

resources

Appliesasetofcritical

appraisalcriteriato

different typesof

research,including

synopsesoforiginal

research findings,

systematicreviews and

meta-analyses,and

clinicalpractice

guidelines

Criticallyevaluates

information fromothers,

including colleagues,

experts,andsales

representatives,aswell

as patient-delivered

information

Incorporatesprinciplesof

evidence-basedcareand

informationmasteryinto

clinicalpractice

Rolesmodelsevidence-

basedpracticeand

informationmastery

techniques

Holdspeersaccountableto

practiceinanevidence-

basedmanner

Identifyimportantclinical

questionsandinformation

gaps

Engagesinimplementation

sciencetosupporttherapid

disseminationandadoption

ofevidenceintoclinical

practice

Developsand/or

implementsevidence-

basedpracticeguidelines

toimprovesystem

performance


policiesandeducationto

supportthe

implementationof

evidence-basedpractice

� � � � � � � � � � �Comments:


Practice-BasedLearningandImprovement(PBLI-2):QualityImprovement:Improvessystemsinwhichtheathletictrainerprovidescare.(FamilyMedicinePBLI-3)CriticalDeficiencies Level1 Level2 Level3




Failstorecognizethe

keySTEEEP(safe,

timely,effective,

efficient,equitable,

patient-centered)

elementsofquality

healthcare

Unabletoaccurately

describethesystemof

careinwhichtheyare

working

Unabletoidentify

qualitygapsintheir

ownhealthsystems

Understandsthekey

elementsofquality

healthcare(STEEEP)

Recognizesthe

importanceof

measuringtheend

resultsofhealthcare

inordertoadequately

assesshealthcare

quality

Beginstoidentify

potentialgapsin

qualitycare

Recognizes

inefficiencies,

inequities,

variation,and

qualitygapsin

healthcaredelivery

Identifiespotential

gapsinqualitycare

andidentifies

potential

contributingfactors

withinthesystem

Recognizesthe

importanceof

developingquality

improvementteams

Assessesavailablehealth

careoutcomesdatato

comparetheirresultsto

expectedresultswithin

thesystem

Usesasystematic

improvementmethod

(e.g., Plan-Do-Study-

Act[PDSA] cycle)to

addressanidentified

areaofimprovement

Comparescareprovided

by selfandpracticeto

internalandexternal

standards,identifies

areasforimprovement,

andimplementschange

intheirpractice.

Establishesprotocolsfor

continuousreviewand

comparisonofpractice

proceduresandoutcomes

andimplementingchanges

toaddressareasneeding

improvement

Usesanorganizedmethod,

suchasaregistry,toassess

andmanagepopulation

health

Performsmulti-cycle

qualityimprovement

initiativestoimprove

healthcarequality

Rolemodels

continuous quality

improvementof

personalpractice,as

wellaslargerhealth

systemsorcomplex

projects,using

advanced

methodologiesand

skill sets

Generatesand

disseminatesnew

knowledgetoadvance

effectivestrategiesfor

improvingsystemsin

whichathletictrainers

providecare

� � � � � � � � � � �Comments:


Practice-BasedLearningandImprovement(PBLI-3):QualityImprovement:Learnsandimprovesviaperformanceaudit.(InternalMedicinePBLI-2)CriticalDeficiencies Level1 Level2 Level3




Disregardsown

clinicalperformance

data

Demonstratesno

inclinationto

participateinoreven

considertheresults

ofquality

improvementefforts

Limitedawarenessofor

desiretoanalyzeown

clinicalperformance

data

Nominallyparticipates

inaquality

improvementprojects

Notfamiliarwiththe

principles,techniques

orimportanceofquality

improvement

Analyzesownclinical

performancedata

andidentifies

opportunitiesfor

improvement

Participatesina

qualityimprovement

project

Understands

commonprinciples

andtechniquesof

qualityimprovement

andappreciatesthe

responsibilityto

assessandimprove

care

Analyzesownclinical

performancedataand

activelyworksto

improveperformance

Activelyengagesin

qualityimprovement

initiatives

Demonstratestheability

toapplycommon

principlesandtechniques

ofqualityimprovement

toimprovecare

Activelymonitorsclinical

performancethrough

variousdatasources

Leadsquality

improvementprojects

Utilizescommonprinciples

andtechniquesofquality

improvementto

continuouslyimprovecare

Demonstrates

professionalleadershipin

promotingperformance

auditsforquality

improvementusing

clinicaldatamonitoring

Generatesand

disseminatesnew

knowledgetoadvance

performanceauditsfor

qualityimprovement

usingclinicaldata

monitoring

� � � � � � � � � � �Comments:


Practice-BasedLearningandImprovement(PBLI-4):QualityImprovement:Monitorspracticewithagoalforimprovement.(InternalMedicinePBLI-1)CriticalDeficiencies Level1 Level2 Level3




Unwillingtoself-reflect

uponone’spracticeor

performance

Notconcernedwith

opportunitiesfor

learningandself-

improvement

Inconsistentlyself-

reflectsuponone’s

practiceor

performanceand

inconsistentlyacts

uponthosereflections

Missesopportunities

forlearningandself-

improvement

Regularlyself-reflects

uponone’spractice

orperformanceand

identifiesareasto

improvepractice

Inconsistentlyacts

uponopportunities

forlearningandself-

improvement

Recognizesthevalue

ofcriticalreviewsand

morbidityand

mortalityconferences

(MandMs)for

learningandself-

improvement

Regularlyself-reflects

uponone’spracticeor

performanceand

maximizespractice

improvement

Recognizessub-optimal

practiceorperformance

asanopportunityfor

learningandself-

improvement

Activelyengagesin

criticalreviewsand

morbidityandmortality

conferences(MandMs)

tosupportlearningand

improvementinselfand

others

Rolesmodelsself-

reflectivepracticeand

monitoringpractice

improvement

Holdspeersaccountable

forfailurestorecognize

opportunitiesfor

improvement

Leadscriticalreviewsand

morbidityandmortality

conferences(MandMs)

tosupportlearningand

self-improvementin

others

Demonstrates

professionalleadership

regardingself-reflective

practiceandmonitoring

practiceperformance

Generatesand

disseminatesnew

knowledgetoadvance

self-reflectivepractice

andmonitoringpractice

performance

� � � � � � � � � � �Comments:


Practice-BasedLearningandImprovement







InterpersonalandCommunicationSkills

Athletictrainersmustdemonstrateinterpersonalandcommunicationskillsthatresultintheeffectiveexchangeof

informationandcollaborationwithpatients,theirfamilies,andhealthprofessionals.

InterpersonalandCommunicationSkills(ICS-1):Communicateseffectivelywithpatientsandcaregivers.(InternalMedicineICS-1)CriticalDeficiencies Level1 Level2 Level3




Ignorespatient

preferencesforplan

ofcare

Makesnoattemptto

engagepatientin

shareddecision-

making

Routinelyengagesin

antagonisticor

counter-therapeutic

relationshipswith

patientsand

caregivers

Engagespatientsin

discussionsofcare

plansandrespects

patientpreferences

whenofferedbythe

patient,butdoesnot

activelysolicit

preferences

Attemptstodevelop

therapeutic

relationshipswith

patientsand

caregiversbutis

oftenunsuccessful

Defersdifficultor

ambiguous

conversationsto

others

Engagespatientsin

shareddecisionmaking

inuncomplicated

conversations

Requiresassistance

facilitatingdiscussionsin

difficultorambiguous

conversations

Requiresguidanceor

assistancetoengagein

communicationwith

personsofdifferent

socioeconomicand

culturalbackgrounds

Identifiesand

incorporatespatient

preferenceinshared

decisionmakingacross

awidevarietyofpatient

careconversations

Quicklyestablishesa

therapeuticrelationship

withpatientsand

caregivers,including

personsofdifferent

socioeconomicand

culturalbackgrounds

Incorporatespatient-

specificpreferencesinto

planofcare

Rolemodelseffective

communicationand

developmentof

therapeuticrelationships

inbothroutineand

challengingsituations

Modelsculturally

competent

communicationand

establishestherapeutic

relationshipswithpersons

ofdiversesocioeconomic

backgrounds

Demonstrates


promotingeffective

communicationwith

patientsandcaregivers

Generatesand

disseminatesnew

knowledgetoadvance

effectivecommunication

withpatientsand

caregivers

� � � � � � � � � � �Comments:


InterpersonalandCommunicationSkills(ICS-2):Communicateseffectivelywithpatients,families,stakeholders,andthepublic.(FamilyMedicineC-2)CriticalDeficiencies Level1 Level2 Level3




Demonstrates

disrespectful

communicationwith

patients,families,

stakeholders,orthe

public

Failstorecognize

physical,cultural,

psychological, and

socialbarriersto

communication

Unabletoestablish

rapportandfacilitate

patient-centered

informationexchange

Recognizesthat

respectful

communicationis

importanttoquality

care

Identifiesphysical,

cultural,psychological,

andsocialbarriersto

communication

Usesthemedical

interviewtoestablish

rapportandfacilitate

patient-centered

informationexchange

Matchesmodalityof

communicationto

patientneeds,

healthliteracy,and

context

Organizesinformation

tobe sharedwith

patientsand families

Participatesinlife-

alteringdiscussions

anddeliveryofbad

news

Negotiatesavisit

agendawith the

patient,anduses

activeand reflective

listeningtoguidethe

visit

Educatesandcounsels

patientsandfamiliesin

diseasemanagement

andhealthpromotion

skills

Engagespatients’

perspectives inshared

decisionmaking

Recognizesnon-verbal

cues andusesnon-

verbalcommunication

skillsinpatient

encounters

Effectively

communicates difficult

information,such as

life-alteringdiscussions,

deliveryofbadnews,

acknowledgementof

errors,andduring

episodesofcrisis

Rolemodelspatient-

centerednessand

integratesallaspectsof

patientcaretomeet

patients’needs

Rolemodelseffective

communicationwith

patients,families,

stakeholders,andthe

public

Engagescommunity

partnerstoeducatethe

public

Demonstrates


inpromotingeffective

communicationwith

patients,families,

stakeholders,andthe

public

Generatesand

disseminatesnew

knowledgetoadvance

effectivecommunication

withpatients,families,

stakeholders,andthe

public

� � � � � � � � � � �Comments:


InterpersonalandCommunicationSkills(ICS-3):Communicateseffectivelyininterprofessionalteams.(InternalMedicineICS-2)CriticalDeficiencies Level1 Level2 Level3




Utilizes

communication

strategiesthat

hampercollaboration

andteamwork

Verbaland/ornon-

verbalbehaviors

disrupteffective

collaborationwith

teammembers

Usesunidirectional

communicationthat

failstoutilizethe

wisdomoftheteam

Resistsoffersof

collaborativeinput

Exhibitsdefensive

behaviorswithinthe

healthcareteam

Inconsistentlyengages

incollaborative

communicationwith

appropriatemembers

oftheteam

Inconsistentlyemploys

verbal,non-verbal,and

writtencommunication

strategiesthatfacilitate

collaborativecare

Consistentlyand

activelyengagesin

collaborative

communicationwithall

membersoftheteam

Verbal,non-verbaland

writtencommunication

consistentlyactsto

facilitatecollaboration

withtheteamto

enhancepatientcare


collaborative

communicationwiththe

healthcareteamto

enhancepatientcare,

eveninchallenging

settingsandwith

conflictingteammember

options

Demonstrates


inpromotingeffective

communicationin

interprofessionalteams

Generatesand

disseminatesnew

knowledgetoadvance

effectivecommunicationin

interprofessionalteams

� � � � � � � � � � �Comments:


InterpersonalandCommunicationSkills(ICS-4):HealthInformationTechnology:Appropriateutilizationandcompletionofhealthrecords.(InternalMedicineICS-3)CriticalDeficiencies Level1 Level2 Level3




Healthrecordsare

absentormissing

significantportions of

importantclinicaldata Healthrecordsare

disorganizedand

inaccurate Healthrecordsarenot

completedinatimely

manner Privacyofhealth

recordsisnot

adequatelymaintained

Failstorecognizethe

criticalityof

appropriateutilization

andcompletionof

healthrecords

Healthrecordsare

organized and

accuratebutare

superficialandmiss

keydataorfailto

communicateclinical

reasoning

Healthrecordsare

completedinatimely

manner

Privacyofhealth

recordsisofprime

importance

Healthrecordsare

organized,

accurate,

comprehensive,

and effectively

communicate

clinical reasoning

Healthrecordsare

succinct, relevant,

andpatientspecific

Healthrecordsare

organizedandcomplete

frompatientintaketo

discharge,documenting

allpatientinteractions,a

thoroughhistoryand

physicalexamination,

dailytreatmentnotes,

referrals,anddischarge

summary

Healthrecordscapture

patient-ratedoutcomes

Healthrecordsadhereto

allstateandfederal

guidelines

Healthrecordsserveas

aprimarymeansof

datacollectionand

aggregationforthe

ongoingassessmentof

qualityofcare


importanceoforganized,

accurateand

comprehensivehealth

recordsthatare succinct

andpatientspecific

Demonstrates


inpromotingthe


andcompletionof

healthrecords

Generatesand

disseminatesnew

knowledgetoadvance


andcompletionofhealth

records

� � � � � � � � � � �Comments:


InterpersonalandCommunicationSkills







Professionalism

Athletictrainersmustdemonstrateacommitmenttocarryingoutprofessionalresponsibilitiesandanadherencetoethical

principles.

Professionalism(PROF-1):Completesaprocessofprofessionalization.(FamilyMedicinePROF-1)CriticalDeficiencies Level1 Level2 Level3




Demonstrateslack

ofprofessionalism

Placespersonal

valuesaheadof

professionalvalues

Failstoexhibit

appropriate

honesty,integrity,

andrespectto

patientsandteam

members

Definesprofessionalism

Knowsthebasicprinciples

ofmedicalethics

Recognizesthatconflicting

personalandprofessional

valuesexist

Demonstrateshonesty,

integrity,andrespectto

patientsandteam

members

Recognizesown

conflictingpersonal

andprofessionalvalues

Knowsinstitutionaland

governmental

regulationsforthe

practiceofathletic

training

Recognizesthat

athletictrainershave

anobligationtoself-

disciplineandtoself-

regulate

Engagesinself-

initiatedpursuitof

excellence

Embracesthe

professional

responsibilitiesof

beinganathletic

trainer

Practicestothefull

scopeofeducation

andtrainingand

formalprivileging

withinahealthsystem

Demonstratesleadership

andmentorshipinapplying

sharedstandardsand

ethicalprinciples,including

thepriorityof

responsivenesstopatient

needsaboveself-interest

acrossthehealthcareteam

Developsinstitutionaland

organizationalstrategiesto

protectandmaintainthese

principles

Demonstrates


inpromoting

professionalismwith


Generatesand

disseminatesnew

knowledgetoadvance


instilling

professionalizationin

others

� � � � � � � � � � �Comments:


Professionalism(PROF-2):Hasprofessionalandrespectfulinteractionswithpatients,caregivers,membersoftheinterprofessionalteam,andstakeholders.(InternalMedicinePROF-1)CriticalDeficiencies Level1 Level2 Level3




Lacksempathyand

compassionfor

patientsand

caregivers

Disrespectfulin

interactionswith

patients,caregivers,

membersofthe

interprofessional

team,and

stakeholders

Sacrificespatient

needsinfavorofown

self-interest

Blatantlydisregards

respectforpatient

privacyand

autonomy

Inconsistently

demonstrates

empathy,compassion

andrespectfor

patientsand

caregivers

Inconsistently

demonstrates

responsivenessto

patients’and

caregivers’needsin

anappropriate

fashion

Inconsistently

considerspatient

privacyandautonomy

Consistently

respectfulin

interactionswith

patients,caregivers

andmembersofthe

interprofessional

team,evenin

challengingsituations

Isavailableand

responsivetoneeds

andconcernsof

patients,caregivers

andmembersofthe

interprofessional

teamtoensuresafe

andeffectivecare

Emphasizespatient

privacyandautonomy

inallinteractions

Demonstrates

empathy,compassion

andrespecttopatients

andcaregiversinall

situations

Anticipates,advocates

for,andproactively

workstomeetthe

needsofpatientsand

caregivers

Demonstratesa

responsivenessto

patientneedsthat

supersedesself-

interest

Positively

acknowledgesinputof

membersofthe

interprofessionalteam

andincorporatesthat

inputintoplanofcare

asappropriate

Rolemodelscompassion,

empathyandrespectfor


Rolemodelsappropriate

anticipationandadvocacyfor

patientandcaregiverneeds

Fosterscollegialitythat

promotesahigh-functioning


Teachesothersregarding

maintainingpatientprivacy

andrespectingpatient

autonomy

Demonstrates


inpromoting

professionalismwith


membersofthe

interprofessionalteam,

andstakeholders

Generatesand

disseminatesnew

knowledgetoadvance


professionalismwith


membersofthe

interprofessionalteam,

andstakeholders

� � � � � � � � � � �Comments:


Professionalism(PROF-3):Demonstratesprofessionalconductandaccountability.(InternalMedicinePROF-2andFamilyMedicinePROF-2)CriticalDeficiencies Level1 Level2 Level3




Isunreliablein

completingpatient

careresponsibilities

orassigned

administrative

tasks

Shuns

responsibilities

expectedofan

athletictraining

professional

Completesmost

assignedtasksina

timelymannerbutmay

needmultiplereminders

orothersupport

Acceptsprofessional

responsibilityonlywhen

assignedormandatory

Documentsandreports

clinicaland

administrative

informationtruthfully

Maintainspatient

confidentiality

Attendsto

responsibilitiesand

completesdutiesas

required

Identifiesappropriate

channelstoreport

unprofessional

behavior

Recognizes

professionalismlapses

inselfandothers

Completesassigned

professional

responsibilities

withouttheneedfor

reminders

Consistently

recognizeslimitsof

knowledgeandasks

forassistance

Presentsthemselvesina

respectfuland

professionalmanner

Completes

administrativeand

patientcaretasksina

timelymannerin

accordancewithlocal

practiceand/orpolicy

Reportsprofessionalism

lapsesusingappropriate

reportingprocedures

Willingnesstoassume

professional

responsibilityregardless

ofthesituationor

consequences

Prioritizesmultiple

competingdemandsin

ordertocompletetasks

andresponsibilitiesina

timelyandeffective

manner

Rolemodelsprioritizing

multiplecompeting

demandsinorderto

completetasksand

responsibilitiesinatimely

andeffectivemanner

Assistsotherstoimprove

theirabilitytoprioritize

multiple,competingtasks

Negotiatesprofessional

lapsesoftheathletichealth

careteam

Exhibitsself-awareness,

self-management,social

awareness,and

relationshipmanagement

Helpsimplement

organizationalpoliciesto

sustainathletictrainingasa

profession

Modelsprofessional

conductplacingthe

needsofeachpatient

aboveself-interest

Demonstratesthe

highestdegreeof

professionalconductand

accountabilitythat

othersseektoemulate

� � � � � � � � � � �Comments:


Professionalism(PROF-4):Exhibitsintegrityandethicalbehaviorinprofessionalconduct.(InternalMedicinePROF-4-Modified)CriticalDeficiencies Level1 Level2 Level3




Dishonestinclinical

interactions,

documentation,

research,or

scholarlyactivity

Refusestobe

accountablefor

personalactions

Doesnotadhereto

basicethical

principles

Blatantlydisregards

formalpoliciesor

procedures

Honestinclinical

interactions,

documentation,

research,andscholarly

activity.

Requiresoversightfor

professionalactions

Hasabasic

understandingof

ethicalprinciples,

formalpoliciesand

procedures,anddoes

notintentionally

disregardthem

Demonstrates

accountabilityforthe

careofpatients

Adherestoethical

principlesfor

documentation,follows

formalpoliciesand

procedures,

acknowledgesand

limitsconflictof

interest,andupholds

ethicalexpectationsof

researchandscholarly

activity

Beginstoreflecton

personalprofessional

conduct

Honestandforthrightin

clinicalinteractions,

documentation,

research,andscholarly

activity

Demonstratesintegrity,

honesty,and

accountabilityto

patients,societyand

theprofession

Identifiesandresponds

appropriatelytolapses

ofprofessionalconduct

amongpeergroup

Activelymanages

challengingethicaldilemmas

andconflictsofinterest

Regularlyreflectson

personalprofessional

conduct

Assistsothersinadheringto

ethicalprinciplesand

behaviorsincludingintegrity,

honesty,andprofessional

responsibility

Rolemodelsintegrity,

honesty,accountability

andprofessional

conductinallaspectsof

professionallife

Demonstrates


inpromotingintegrity

andethicalbehaviorin

professionalconduct

Generatesand

disseminatesnew

knowledgetoadvance

integrityandethical

behaviorinprofessional

conduct

� � � � � � � � � � �Comments:


Professionalism







Systems-BasedPractice

Athletictrainersmustdemonstrateanawarenessofandresponsivenesstothelargercontextandsystemofhealthcare,as

wellastheabilitytocalleffectivelyonotherresourcesinthesystemtoprovideoptimalhealthcare.

Systems-BasedPractice(SBP-1):PatientSafety:Recognizessystemerrorandadvocatesforsystemimprovement.(InternalMedicineSPB-2)CriticalDeficiencies Level1 Level2 Level3




Ignoresariskfor

errorwithinthe

systemthatmay

impactthecareofa

patient

Ignoresfeedbackand

isunwillingtochange

behaviorinorderto

reducetheriskfor

error

Doesnotrecognizethe

potentialforsystem

error

Makesdecisionsthat

couldleadtoerror

whichareotherwise

correctedbythesystem

orsupervision

Resistanttofeedback

aboutdecisionsthat

mayleadtoerroror

otherwisecauseharm

Recognizesthe

potentialforerror

withinthesystem

Identifiesobviousor

criticalcausesoferror

andnotifies

supervisor

accordingly

Recognizesthe

potentialriskfor

errorinthe

immediatesystem

andtakesnecessary

stepstomitigatethat

risk

Willingtoreceive

feedbackabout

decisionsthatmay

leadtoerroror

otherwisecauseharm

Identifiessystemic

causesofmedicalerror

andnavigatesthemto

providesafepatient

care

Activatesformalsystem

resourcestoinvestigate

andmitigaterealor

potentialmedicalerror

Reflectsuponand

learnsfromowncritical

incidentsthatmaylead

tomedicalerror

Advocatesforsystem

leadershiptoformally

engageinquality

assuranceandquality

improvementactivities

Advocatesforsafepatient

careandoptimalpatient

caresystems

Teachesothersregarding

theimportanceof

recognizingandmitigating

systemerror

Demonstrates


promotingpatientsafety

Generatesand

disseminatesnew

knowledgetoadvance


promotingpatientsafety

Viewedasaleaderin

identifyingandadvocating

forthepreventionof

medicalerror

� � � � � � � � � � �Comments:


Systems-BasedPractice(SBP-2):PatientSafety:Emphasizespatientsafety.(FamilyMedicineSPB-2)CriticalDeficiencies Level1 Level2 Level3




Ignoresmedical

errors

Failstounderstand

thatmedicalerrors

varywidelyacross

settingsandbetween

providers

Ignoresthe

importanceofteam-

basedcarein

ensuringpatient

safety

Understandsthat

medicalerrorsaffect

patienthealthand

safety,andthattheir

occurrencevaries

acrosssettingsand

betweenproviders

Understandsthat

effectiveteam-based

careplaysarolein

patientsafety

Recognizesmedical

errorswhentheyoccur,

includingthosethatdo

nothaveadverse

outcomes

Understandsthe

mechanismsthatcause

medicalerrors

Understandsand

followsprotocolsto

promotepatientsafety

andpreventmedical

error

Participatesineffective

andsafehand-offsand

transitionsofcare

Usescurrentmethodsof

analysistoidentify

individualandsystem

causesofmedicalerrors

commontoathletic

training

Developsindividual

improvementplanand

participatesinsystem

improvementplansthat

promotepatientsafety

andpreventmedical

errors

Performseffectiveand

safehand-offsand

transitionsofcare

Consistentlyengagesin

self-directedandpractice

improvementactivities

thatseektoidentifyand

addressmedicalerrors

andpatientsafetyindaily

practice

Fostersadherenceto

patientcareprotocols

amongstteammembers

thatenhancepatient

safetyandprevent

medicalerrors

Leadsself-directedand

systemimprovement

activitiesthatseekto

continuously

anticipate,identifyand

preventmedicalerrors

toimprovepatient

safetyinallpractice

settings,includingthe

development,use,and

promotionofpatient

careprotocolsand

othertools

� � � � � � � � � � �Comments:


Systems-BasedPractice(SBP-3):Cost-Effectiveness:Identifiesforcesthatimpactthecostofhealthcare,andadvocatesfor,andpracticescost-effectivecare.(InternalMedicineSBP-3)CriticalDeficiencies Level1 Level2 Level3




Ignorescostissues

intheprovisionof

care

Demonstratesno

efforttoovercome

barrierstocost-

effectivecare

Lacksawarenessof

externalfactors(e.g.

socio-economic,cultural,

literacy,insurance

status)thatimpactthe

costofhealthcareand

therolethatexternal

stakeholders(e.g.

providers,suppliers,

financers,purchasers)

haveonthecostofcare

Recognizesthecosts

associatedwiththe

provisionofathletic

trainingservices,even

whentheyaren’tbeing

billedfor/reimbursed

Recognizesthat

externalfactors

influenceapatient’s

utilizationofhealth

careandmayactas

barrierstocost-

effectivecare

Possessesan

incomplete

understandingofcost-

awarenessprinciples

forapopulationof

patients(e.g.screening

tests)

Doesnotconsider

limitedhealthcare

resourcesregarding

diagnosticor

therapeutic

interventions

Consistentlyworksto

addresspatientspecific

barrierstocost-effective

care

Advocatesforcost-

consciousutilizationof

resources

Incorporatescost-

awarenessprinciples

intostandardclinical

judgmentsanddecision-

making,including

screeningtests

Minimizescosts

associatedwith

unnecessarydiagnostic

andtherapeutictests

Teachespatientsand

healthcareteammembers

torecognizeandaddress

commonbarrierstocost-

effectivecareand

appropriateutilizationof

resources

Activelyparticipatesin

initiativesandcare

deliverymodelsdesigned

toovercomeormitigate

barrierstocost-effective

highqualitycare

Demonstrates


inpromotingcost-

effectiveathletic

trainingservices

Generatesand

disseminatesnew

knowledgetoadvance

cost-effectiveathletic

trainingservices


guidelinesforthe

provisionofcost-

effectivecare


policiesandeducation

to supportcost-

effectivecare

� � � � � � � � � � �Comments:


Systems-BasedPractice(SBP-4):InterprofessionalTeams:Workseffectivelywithinaninterprofessionalteam.(InternalMedicineSBP-1;Level1fromFamilyMedicineSBP-4)CriticalDeficiencies Level1 Level2 Level3




Refusestorecognize

thecontributionsof

other

interprofessional

teammembers

Frustratesteam

memberswith

inefficiencyand

errors

Disregardsneedfor

communicationat

timeoftransition

Doesnotrespondto

requestof

caregiversinother

deliverysystems

Understandsthatquality

patientcarerequires

coordinationand

teamwork,and

participatesasa

respectfulandeffective

teammember

Identifiesrolesofother

teammembersbutdoes

notrecognizehow/when

toutilizethemas

resources

Frequentlyrequires

remindersfromteamto

completeathletic

trainingresponsibilities

Inefficienttransitionsof

careleadtounnecessary

expenseorrisktoa

patient(e.g.duplication

oftests,reinjury)

Understandstheroles

andresponsibilitiesofall

teammembersbutuses

themineffectively

Participatesinteam

discussionswhen

requiredbutdoesnot

activelyseekinputfrom

otherteammembers

Communicationwith

futurecaregiversis

presentbutwithlapses

inpertinentortimely

information

Understandstheroles

andresponsibilitiesof

andeffectively

partnerswith,all

membersoftheteam

Activelyengagesin

teammeetingsand

collaborativedecision-

making

Proactively

communicateswith

pastandfuturecare

giverstoensure

continuityofcare

Integratesallmembersof

theteamintothecareof

patients,suchthateach

isabletomaximizetheir

skillsinthecareofthe

patient

Viewedbyotherteam

membersasaleaderin

thedeliveryofhigh

qualitycare

Coordinatescarewithin

andacrosshealth

deliverysystemsto

optimizepatientsafety,

increaseefficiencyand

ensurehighquality

patientoutcomes

Anticipatesneedsof

patient,caregiversand

futurecareprovidersand

takesappropriatesteps

toaddressthoseneeds

Demonstrates


inpromotingsafeand

effectivetransitionsof

carewithinandacross

healthdeliverysystems

aspartan


Generatesand

disseminatesnew

knowledgetoadvance

interprofessionalteam-

basedcare

� � � � � � � � � � �Comments:


Systems-BasedPractice(SBP-5):Advocatesforindividualandcommunityhealth.(FamilyMedicineSBP-3)

CriticalDeficiencies

Level1 Level2 Level3(ReadyforUnsupervised

Practice)



Refusesto

recognizesocial

contextand

environmental

impacton

individualand

communityhealth

Ignoreshowa

community’s

publicpolicy

decisionsaffect

individualand

communityhealth

Recognizessocialcontext

andenvironment,and

howacommunity’s

publicpolicydecisions

affectindividualand

communityhealth

Recognizesthat

athletictrainerscan

impactcommunity

health

Listswaysinwhich

community

characteristicsand

resourcesaffectthe

healthofpatientsand

communities

Identifiesspecific

communitycharacteristic

thatimpactspecific

patients’health

Understandstheprocess

ofconductinga

communitystrengthsand

needsassessment

Collaborateswithother

athletictraining

practices/systems,public

health,andcommunity-

basedorganizationsto

educatethepublic,guide

policies,andimplement

andevaluatecommunity

initiatives

Rolemodelsactive

involvementincommunity

educationandpolicy

changetoimprovehealth

ofpatientandcommunities

Demonstrates


incommunityeducation

andpolicychangeto

improvehealthof

patientand

communities

Generatesand

disseminatesnew

knowledgein

communityeducation

andpolicychangeto

improvehealthof

patientand

communities

� � � � � � � � � � �Comments:


Systems-BasedPractice(SBP-6):HealthInformationTechnology:Utilizestechnologytooptimizecommunication.(FamilyMedicineC-4)CriticalDeficiencies Level1 Level2 Level3




Failstorecognize

theeffectsof

technologyon

information

exchangeandthe

athletic

trainer/patient

relationship

Ignorestheethical

andlegal

implicationsofusing

technologyto

communicatein

healthcare

Recognizeseffectsof

technologyon

informationexchange

andtheathletic

trainer/patient

relationship

Recognizestheethical

andlegalimplicationsof

usingtechnologyto

communicateinhealth

care

Ensuresthatclinical

andadministrative

documentationis

timely,complete,and

accurate

Maintainskeypatient-

specificdatabases,

suchasproblemlists,

medications,health

maintenance,chronic

diseaseregistries

Effectivelyandethically

usestechnologyina

mannerwhichenhances

communicationand

doesnotinterferewith

theappropriate

interactionwiththe

patient

Ensurestransitionsof

careareaccurately

documented,and

optimizes

communicationacross

systemsandcontinuums

ofcare

Stayscurrentwith

technologytoimprove

communicationwith

patients,other

providers,andsystems

Usescomprehensive

multi-media

communicationstrategies

toenhancepatientcare

Usestechnologyto

optimizecontinuitycare

ofpatientsandtransitions

ofcare

Usestechnologytoadapt

systemsforimproving

communicationwith

patients,otherproviders,

andsystems

Demonstrates


inutilizingtechnologyto

optimizecommunication

Generatesand

disseminatesnew

knowledgeinutilizing

technologytooptimize

communication

� � � � � � � � � � �Comments:


Systems-BasedPractice







ATHLETICTRAININGMILESTONES

SPECIALTYCOMPETENCIES

Thespecialtycompetencies,sub-competencies,andmilestonesarebeingdevelopedbasedupontheeight‘areasoffocus’

(specialtyareas)developedbytheCAATE(https://caate.net/caate-establishes-residency-focus-areas/).Theseareasrepresent

coreareasofathletictrainingpractice,butpresentopportunityforathletictrainerstodevelopadvancedpracticebehaviors

consistentwithspecialtypractice.BecausetheATMilestonesoriginallydevelopedbasedonaneedwithinthespecialtyof

orthopaedics,thiswasthefirstspecialtyareathatwasdeveloped.Workisunderwaytodevelopeachofthesubsequent

specialtycompetencies,sub-competencies,andmilestones,andthisdocumentwillbeupdatedregularlytoreflectthese

additions.Thedevelopmentofcompetencies,sub-competencies,andmilestonesforadditionalfuturespecialtyandsub-

specialtyareas(e.g.,geriatrics,sportneurology)arecurrentlybeingconsidered.

PreventionandWellness–INDEVELOPMENT

UrgentandEmergentCare–INDEVELOPMENT

PrimaryCare–INDEVELOPMENT

Orthopaedics–SEEBELOW

Rehabilitation–INDEVELOPMENT

BehavioralHealth–SEEBELOW

Pediatrics–SEEBELOW

PerformanceEnhancement–INDEVELOPMENT


Orthopaedics

Athletictrainersmustdemonstratetheabilitytoconductanappropriatediagnosticevaluationtodefineeachpatient’sclinical

problemandtoeffectivelymanageincreasinglycomplexpatientproblems.

Orthopaedics(Ortho-1):DiagnosticEvaluation:Gathersandsynthesizesessentialandaccurateinformation(history,physicalexam,labwork,imagingstudies,neuropsychologicaltesting,functionalassessmentmeasures,etc.)todefineeachpatient’sclinicalproblem(s).


Practices)



Failstoidentify

appropriate

diagnostictests

Failstoaccurately

identifyappropriate


Failstoidentify

deviationsfromthe

normalcourseof

orthopaedic

conditions

Performarelevant

patienthistory

Performsabasic

physicalexamination

Recognizesnormal

movementpatterns

Demonstrates

knowledgeof

commonorthopaedic

conditions

Demonstratesboth

basicscienceand

clinicalknowledgeof

thedetailsoftissue

healingandcellular

physiologyacrossthe

lifespan

Performsaregional

orthopaedicexam

withappropriate

diagnosticselective

tissuetests

Recognizesourceof

abnormalmovement

patternsand

structures

Appliesclinicalrules

fordiagnostics(such

asOttawaAnkle,

CanadianC-spine)

Demonstrates

knowledgeoffactors

associatedwithrisk

ofinjury,including,

age,genderand

disability

Accuratelyand

efficientlydiagnoses

common,non-

complex,

orthopaedic

conditions

Recognizestheneed

forandrecommends

appropriateplain

films/radiographs

Accuratelyinterprets

plain

films/radiographs

Appropriatelyprioritizesthe

urgencyandsequencingof

diagnostictesting

Utilizesclustersofdiagnostic

testsandevaluatescomplex

conditionswithorwithoutco-

morbidities,andrecognizes

atypicalpresentations

Recognizesappropriate

differentialsthatincludenon-

orthopaedicconditionsthat

presentasorthopaedic

conditions

Recommendsandinterprets

advancedorthopaedicimaging,

suchasMSUS,MRI,andCT

Educatesotherstoimprove

theirorthopaedicdiagnostic

evaluationknowledgeand

skills



orthopaedicexamination

accountingforrare

conditions

Servesasaconsultant

forrareand/orcomplex

orthopaedicpatients

Demonstrates


inorthopaedicdiagnostic

evaluation

Generatesand

disseminatesnew

knowledgetoadvance

orthopaedicdiagnostic

evaluation

� � � � � � � � � � �

Comments:


Orthopaedics(Ortho-2):Management:Effectivelymanagespatientswithincreasinglycomplexorthopaedicconditions.CriticalDeficiencies Level1 Level2 Level3

(ReadyforUnsupervisedPractices)



Inappropriate

managementplaces

patientatrisk

Careplansare

consistently

inappropriateor

inaccurate

Failstoreferwhen

appropriate

Failstomeasurethe

end-resultsofcare

Failstoinformpatient

oflong-termhealth

consequences

Participatesin

patientmanagement

beingconductedby

otherappropriately

qualifiedproviders

Demonstrates

knowledgeofbasic

careplansfor

commonorthopaedic

conditions

Inconsistently

developsan

appropriatecareplan

Participatesin

patienteducation

regardingthenature

oftheircondition

andcorresponding

careplan

Synthesizes

informationgathered

toguidepatientcare


appropriatecareplan

Protectspatientfrom

furtherinjuryand

understandsthe

implicationsofactivity

onrecoverytime

Performspatient

educationregarding

theirconditionand

correspondingcare

plan

Initiatesmanagement

plansforurgentor

emergentcare

Demonstrates

knowledgeof

treatmentoptionsof

operativeandnon-

operative

managementof

orthopaedic

conditions

Effectivelymanages

common,non-complex

orthopaedicconditions


careplansbasedon

patient’sclinicalcourse,

additionaldata,and

patientpreferences

Performspatient

educationregarding

long-termconsequences

oforthopaedic

conditions

Appropriatelyapplies

criteriaforsafereturnto

activityandparticipation


situationsrequiring

urgentoremergentcare

Recognizes

complicationsin

operativeandnon-

operativemanagement

oforthopaedic

conditions

Effectivelymanages

complexorthopaedic

conditionswithorwithout

co-morbidities

Developscustomized,

prioritizedcareplansfor

themostcomplexpatients,


uncertaintyandcost


Patientadvocatefor

maximizinglong-term

health-relatedqualityof

life(HRQOL)

Careplanextendsbeyond

returntosafeactivityto

maximizeparticipation


theirorthopaedic

managementknowledge

andskills


ofcontroversiesin

operativeandnon-

operativemanagementof

orthopaedicconditions

Effectivelymanagesrare

conditions

Servesasaconsultantfor

rareand/orcomplex

orthopaedicpatients

Demonstrates


orthopaedic

management

Generatesand

disseminatesnew

knowledgetoadvance

orthopaedic

management


guidelinesfordeveloping

orthopaediccareplans

� � � � � � � � � � �

Comments:


Orthopaedics







BehavioralHealth

Athletictrainersmustdemonstratetheabilitytoappropriatelyassessandrecognizeeachpatient’sclinicalproblemandto

effectivelymanagebehavioralhealthproblems.

BehavioralHealth(BH-1):Assessmentandrecognitionofconditions,thatinclude,butarenotlimitedto,suicidalideation,depression,anxietydisorder,psychosis,mania,eatingdisorders,andattentiondeficitdisorders.CriticalDeficiencies Level1 Level2 Level3




Failstorecognize

behavioralhealth

concernsinpatients

Failstorecognizean

at-riskorincrisis

patient

Failstointerveneon

behalfofanat-riskor

incrisispatient

Failstoidentify

appropriate

assessmentmeasures

Failstoidentify

deviationsfromthe

normalcourseof

behavioralhealth

conditions

Demonstrates

knowledgeof

commonbehavioral

healthconditions

Performsarelevant

patienthistory

Identifiescommon

characteristicsofat

riskorincrisis

patients

Inconsistentlyseeks

additionalguidance

whenneeded

Identifiescommon

behavioralhealth

conditions

Identifiesatrisk

patientsand

populations

Recognizes

appropriate

behavioralresponses

tolifeevents

Recognizestheneed

tointerveneonbehalf

ofanat-riskorincrisis

patient

Seeksadditional

guidance,consultation

and/orreferralas

appropriate

Recognizestheneedfor

andrecommends

appropriatebehavioral

healthassessments

Demonstratesboth

basicscienceand

clinicalknowledgeof

behavioralhealth

conditions

Accuratelyinterprets

behavioralhealth

assessments

Accuratelyidentifies

common,non-complex,

behavioralhealth

conditions

Establishesanetworkof

behavioralhealth

professionals

Recognizescomplex

conditionswithorwithout

co-morbidities,andatypical

presentations

Accuratelyidentifiesat-risk

populationsandisableto

interveneearlyinthe

process

Recognizesdifferent

presentations,sequelae,

andprognosesof

behavioralhealth

conditionsacrossthe

lifespan

Appropriatelyprioritizes

theurgencyand

sequencingofbehavioral

healthassessments


theirbehavioralhealth

knowledgeandskills


complexbehavioralhealth

patients

Demonstrates


behavioralhealth

Generatesand

disseminatesnew

knowledgetoadvance

behavioralhealth

� � � � � � � � � � �Comments:


BehavioralHealth(BH-2):Management:Effectivelymanagespatientswithbehavioralhealthconditions.CriticalDeficiencies Level1 Level2 Level3




Failstorecognize

needforreferral

Failstoreferwhen

appropriate

Inappropriate

managementplaces

patientatfurtherrisk

orincrisis

Activatesemergency

actionplanina

suspectedbehavioral

healthcrisis

Participatesin

patientmanagement

beingconductedby

otherappropriately

qualifiedproviders

Adherestoall

institutional/facility

behavioralhealth

policies

Demonstrates

knowledgeofbasic

careplansfor

commonbehavioral

healthconditions

Recognizeswhen

referralisneededand

whenasituationis

emergent/non-

emergent

Understandswhenan

individualized

behavioralhealthcare

teamneedstobe

developed

Performspatient

educationregarding

behavioralhealth

conditions

Initiatesand

recommends

appropriate

managementplansfor

urgentoremergent

careofbehavioral

healthconditions

Isanactivememberof

thebehavioralhealth

careteam

Synthesizesinformation

gatheredtoguide

patientcare

Effectivelymanages

common,non-complex

behavioralhealth

conditions

Communicateswith

careteamand

participatesinthe

implementationofthe

careplan


situationsrequiring

urgentoremergentcare

Recognizescommon

complicationsin

behavioralhealth

conditions

Abletoeducatepatients

andstakeholdersofat

riskpopulationson

preventionandlong

termconsequencesof

behavioralhealth


oftheuseofpsychotropic

medicationsandtheir

interactionsandside

effects

Managesday-to-day

considerationsfor

behavioralhealthpatients

Patientadvocatefor

maximizinglong-term

health-relatedqualityoflife

(HRQOL)


theirknowledgeandskills

inmanagingbehavioral

healthconditions

Withinapatient

population,identify

individualandgroup

behavioralhealthneeds

anddevelopsmore

advancedbehavioralhealth

policies(e.g.teampolicy,

individualcontracts)


managementof

behavioralhealth

conditions

Demonstrates


managementof

behavioralhealth

conditions

Generatesand

disseminatesnew

knowledgetoadvancethe

managementof

behavioralhealth

conditions


guidelinesforthe

managementof

behavioralhealth

conditions


conditions

Developsand

implementsbehavioral

healthEAPandother

policiesgoverning

behavioralhealth

conditions

� � � � � � � � � � �Comments:

BehavioralHealth


advanceintraining.He/sheisdemonstratingalearningtrajectorythatanticipatestheachievementofcompetencyfor

unsupervisedpractice(oradvancedpracticeforresidencyprograms)thatincludesthedeliveryofsafe,timely,effective,

efficient,equitable,andpatient-centeredcare.



Pediatrics

Athletictrainersmustdemonstratetheabilitytoconductanappropriatediagnosticevaluationtodefineeachpediatric

patient’sclinicalproblemandtoeffectivelymanageincreasinglycomplexpediatricpatientproblems.

Pediatrics(Peds-1):DiagnosticEvaluation:Gathersandsynthesizesessentialandaccurateinformation(history,physicalexam,labwork,imagingstudies,neuropsychologicaltesting,andfunctionalassessments)todefineeachpediatricpatient’sclinicalproblem(s).


Practice)



Failstoidentify

conditionsuniquetothe

pediatricpatient

Failstoidentify

appropriatepediatric

diagnostictests

Failstoaccurately

identifyappropriate


forthepediatricpatient

Failstoidentify

deviationsfromthe

normalcourseof

pediatricconditions

Performarelevant

patienthistory

includinggrowthand

developmental

milestones

Performsabasic

physicalexamination

Demonstrates

knowledgeofcommon

pediatricconditions

Demonstrates

clinicalknowledge

ofpediatricgrowth

anddevelopment

Demonstrates

knowledgeofbasic

scienceoftissue

healing,cellular

physiology,and

physisphysiologyin

pediatrics

Appliesclinicalrules

fordiagnostics(such

asPediatricOttawa

Ankle,PECARNHead

TraumaRules,

CanadianC-spine)


factorsassociatedwithriskof

injury,including,age,gender

anddisability

Performsaregionalpediatric

orthopaedicexamwith

knowledgeofthegrowthplate

locationsandappropriate

diagnostictests

Accuratelydiagnosescommon,

non-complex,pediatric

conditions

Accuratelyrecommendsand

interpretsappropriateplain

films/radiographs,recognizing

theimportanceofcomparison

viewstoevaluatephysisinjury


pediatricdifferentialsthat

includeasthma,Diabetes(Type

1and2),anaphylaxis,syncope,

congenitalandacquiredheart

disease,exercise,dehydration,

supplements,andmedication

sideeffects

Appropriatelyprioritizesthe

urgencyandsequencingof

diagnostictesting

Utilizesclustersofdiagnostic

testsandevaluatescomplex

conditionswithorwithoutco-

morbidities,andrecognizes

atypicalpresentations


differentialsthatincludenon-

orthopaedicconditionsthat

presentasorthopaedic

conditionsinthepediatric

patient

Respectscumulativeradiation

effectsinpediatricpatients

andrecommendsand

interpretsadvancedpediatric

orthopaedicimaging,suchas

MSKUS,MRI,andCT


theirpediatricdiagnostic

evaluationknowledgeand

skills



ped ia t r i c examination

accountingforrare

conditions


rareand/orcomplex

pediatricpatients

Demonstratesprofessional

leadershipinpediatric

diagnosticevaluation

Generatesanddisseminates

newknowledgetoadvance

pediatricdiagnostic

evaluation

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Comments:


Pediatrics(Peds-2):Management:Effectivelymanagespediatricpatientswithincreasinglycomplexconditions.CriticalDeficiencies Level1 Level2 Level3




Inappropriate

managementplaces

patientatrisk

Careplansare

consistently

inappropriateor

inaccurate

Failstoreferwhen

appropriate

Failstomeasurethe

end-resultsofcare

Failstoinformpatient

andfamily/caregiverof

long-termhealth

consequences

Participatesin

pediatricpatient

managementbeing

conductedbyother

appropriatelyqualified

providers

Demonstrates

knowledgeofbasic

careplansforcommon

pediatricconditions

Inconsistently

developsan

appropriatecareplan

Participatesin

pediatricpatientand

family/caregiver

educationregarding

thenatureoftheir

conditionand

correspondingcare

plan

Synthesizesinformation

gatheredtoguide

pediatricpatientcare


appropriatecareplan

Protectspediatricpatient

fromfurtherinjuryand

understandsthe

implicationsofactivity,

overuseinjury,andphysis

injuryonrecoverytime

Performspediatric

patientand

family/caregiver

educationregardingtheir

conditionand

correspondingcareplan


oftreatmentoptionsof

operativeandnon-

operativemanagement

ofpediatricconditions

Effectivelymanages

common,non-complex

pediatricconditions

Appropriatelymodifiescare

plansbasedonpatient’s

clinicalcourse,additional

data,andpatientand

family/caregiver

preferences

Educatesfamilyandpatient

regardinglong-term

consequencesofpediatric

conditions

Appropriatelyapplies

criteriaforsafereturnto

activityandparticipation


situationsrequiringurgent

oremergentcare

Recognizescomplicationsin

operativeandnon-

operativemanagementof

pediatricconditions

Educatespatientandfamily

regardingmedicationside

effects(prescribed,OTC,

andsupplements).

Effectivelymanagescomplex

pediatricconditionswithor

withoutco-morbiditiessuch

asasthma,allergy,diabetes,

heartdisease,seizuresetc

Developscustomized,

prioritizedcareplansforthe

mostcomplexpatients,


uncertaintyandcost


Careplanextendsbeyond

returntosafeactivityto

maximizeparticipationand

longtermhealth


theirpediatricpatient

managementknowledgeand

skills


controversiesinoperativeand

non-operativemanagement

ofpediatricconditions

Effectivelymanagesrare

conditions


rareand/orcomplex

pediatricpatients

Demonstratesprofessional

leadershipinpediatric

conditionmanagement

Generatesand

disseminatesnew

knowledgetoadvance

pediatriccondition

management


guidelinesfordeveloping

pediatricconditioncare

plans

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Comments:


Pediatrics





