Perceptions and Attitudes of Athletic Training Students toward a Course Addressing Psychological Issues in Rehabilitation

Article excerpt

In 1999, athletic training adopted new educational competencies and clinical proficiencies addressing the following domains: (1) risk management, (2) assessment and evaluation, (3) acute care, (4) general medical conditions and disabilities, (5) pathology of illness and injury, (6) pharmacologic aspects of injury and illness, (7) nutritional aspects of injury and illness, (8) therapeutic exercise, (9) therapeutic modalities, (10) health care administration, (11) professional development and responsibilities, and (12) psychosocial development and responsibilities. These newly adopted competencies and proficiencies have improved the academic preparation of future certified athletic trainers. However, the addition of the 12th domain, psychosocial development and responsibilities, still may not provide athletic training students with a thorough understanding of the complex issues surrounding psychological adjustment to injury. This research study examined athletic training students' perceptions and attitudes before and after completing a new course addressing psychological issues of injury. J Allied Health 2005; 34:101-109.

PAIN, limited range of motion, and decreased strength are effects and symptoms that are commonly experienced following injury. However, denial, depression, anger, anxiety, and fear can also occur as a result of injury. Although allied health professionals who perform orthopedic assessments are academically well prepared to care for the physical ailments associated with injury, some are much less adept at designing rehabilitation and treatment programs aimed at addressing psychological reactions.1 The potential for helping allied health professionals such as certified athletic trainers (ATCs) and physical therapists recognize both the physical and the psychological ramifications of injury should begin with academic preparation.

Currently, undergraduate athletic training students (ATSs) are expected to receive formal instruction in 20 different subject matter areas, and transitional clinical doctorate physical therapy (TDPT) students are expected to demonstrate competency in 20 areas.2,3 One of the revised subject matter areas in athletic training has been changed from "psychology" to "psychosocial intervention and referral."2'4 This requires that ATSs not only learn to recognize the range of psychological reactions experienced following injury and illness but also how to intervene and recognize the need for referral. For TDPT students, psychology is less specific. Competencies such as communication, individual and cultural differences, and screening indirectly incorporate psychosocial interventions.3 Yet, in order to meet the Commission on Accreditation of Allied Health Education Programs (CAAHEP) standards and guidelines for athletic training and the Commission on Accreditation in Physical Therapy Education (CAPTE) competencies for physical therapy, psychosocial subject matter could be covered in one lecture within an established course or addressed for an entire academic quarter or semester. A course specifically designed to address the psychological problems encountered throughout the rehabilitation process is not required; therefore, to include such a course would be a decision by a college or university to address the standards as established by CAAHEP or CAPTE. Such a course may increase awareness by preparing the ATS or TDPT students to meet and effectively manage the many cognitive, emotional, and behavioral challenges that arise from the grief response.5 This study was designed to provide one large midwestern National Collegiate Athletic Association (NCAA) Division I university with summative data regarding changes ATSs experienced in perception and attitude following such a course. Hence, this study attempts to answer the following questions.

1. Does an ATS's perception of an injured student-athlete's psychological response to injury change following the completion of a college course on the psychological impact of injury? …