Patient Perceptions of Athletic Trainers and Orthopaedic Medical Residents as Primary Clinical Support Staff in Sports Medicine Practice: A Randomized, Double-Blinded Prospective Survey

By Pecha, Forrest Q.; Nicolello, Timothy S. et al. | Journal of Allied Health, Winter 2015 | Go to article overview

Patient Perceptions of Athletic Trainers and Orthopaedic Medical Residents as Primary Clinical Support Staff in Sports Medicine Practice: A Randomized, Double-Blinded Prospective Survey


Pecha, Forrest Q., Nicolello, Timothy S., Xerogeanes, John W., Karas, Spero, Labib, Sameh A., Journal of Allied Health


BACKGROUND: Orthopaedic sports medicine practices utilize a variety of healthcare professionals to assist physicians in the clinic. The purpose of this study was to investigate patients' perception of orthopaedic knowledge and clinical care provided by orthopaedic medical residents and athletic trainers (ATs). HYPOTHESIS: ATs will be perceived similarly to orthopaedic medical residents in overall patient care and perceived education level. STUDY DESIGN: Randomized, double-blind survey. LEVEL OF EVIDENCE: 2. METHODS: New patients were randomly selected to receive the survey to complete during an office visit. The survey included 8 questions which rated the patient's perceived level of orthopaedic knowledge and level of patient care provided by the AT and orthopaedic medical residents. A total of 110 surveys were collected during the 2-year study period. The data were analyzed using a multivariate analysis of variance (MANOVA). RESULTS: The multivariate effect (Pillai's trace) was not significant between clinicians, F(8,111)=0.122, p=0.695, partial η2=0.106. Univariate tests showed a significance between patient perceived level of clinician education, F(1,118)=5.361, p=0.632, partial η2=0.043. Univariate test showed no significant differences on any other dependent variables. CONCLUSION: There is no evidence that patients' perception is different when comparing ATs and orthopaedic medical residents in orthopaedic knowledge and clinical care. Although a statistically significant difference was found in the perceived highest level of education attained, orthopaedic medical residents and ATs were each perceived to have a master's degree level of education. Physicians should continue to use ATs in their practices. J Allied Health 2015; 44(4):225-228.

IN THE ORTHOPAEDIC sports medicine clinic, clinicians, such as physician assistants (PA), nurses (RN), and medical assistants (MA), have traditionally been utilized by physicians in various capacities. It is important to note that these clinicians maintain the title or credential of their profession (i.e., nurse practitioner, orthopaedic medical resident, or physician assistant) while providing services in the clinic.

The practice of athletic training encompasses the prevention, examination and diagnosis, treatment, and rehabilitation of emergent, acute, subacute, and chronic neuromusculoskeletal conditions and certain medical conditions in order to minimize subsequent impairments, functional limitations, disability, and societal limitations.7,10,14 An athletic trainer's (AT) credential is dependent upon the completion of an athletic training program accredited by the Commission on Accreditation of Athletic Training Education (CAATE) and passing a National Board of Certification exam. More than 70% of ATs who receive a bachelor's degree in athletic training also go onto obtain a master's degree.3,11,12 In order to practice as a physician, students can go on to medical residency programs. These programs include 3 to 7 years of professional training under the supervision of senior physician educators in a specific field, such as orthopaedics.1

Several studies have reported patients' perception of medical residents involved in their care. Malcolm et al. investigated patient perception of medical residents in a family practice clinic, reporting an overall satisfaction of care and comfort in having medical residents involved in their care, ranking from good to excellent in 91% of patients.9 Dalia et al. investigated patient per- ception of who the "main physician" was between firstyear medical residents and attending physicians. Most patients (59%) viewed the first-year medical resident as their "main physician." It was suggested that the perception towards the medical resident was related to the amount of time spent with the patient in comparison.4 Huynh et al. investigated patient perception of medical residents in a dermatology clinic in which residents were measured on a scale of 1 to 10 and averaged a score of 9. …

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