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CERT UPDATE A PUBLICATION FROM THE BOARD OF CERTIFICATION SUMMER 2023 Breaking Down Barriers Through IDEAS SUMMER 2023 BOCATC.ORG 3 2023 BOARD OFFICERS President/Athletic Trainer Director René Revis Shingles, PhD, AT, ATC Vice President/Athletic Trainer Director Michael Carroll, MEd, LAT, ATC Treasurer/Athletic Trainer Director Mary Kirkland, MS, LAT, ATC Athletic Trainer Director Chris Ashton, MS, LAT, ATC Athletic Trainer Director Christina Chapski, EdD, AT, ATC Athletic Trainer Director Neil Curtis, EdD, LAT, ATC Physician Director Katherine Dec, MD, FAAPMR, FAMSSM Public Director Robin Jenkins, MSW, DCSW, CPM, ICE-CCP, CAE Athletic Trainer Director Appointee Jeremy Marra, MS, ATC, CSCS, CES Athletic Trainer Director Appointee Lynne-Marie Young, M.Ed, LAT, ATC Chief Executive Officer Anne Minton, MBA, ICE-CCP INSIDE BOARD OF DIRECTORS 2023 BOC Board Officers 3 Letter from the President 4 The BOC Seeks Candidates for its Board of Directors 5 BOC CONNECTION 2023 is a Reporting Year for Athletic Trainers 5 Cover Article: Breaking Down Barriers Through IDEAS 6 Applying Cultural Congruence in Patient Care 8 International Arrangement: Extending Reach on a Global Scale 10 BOC Orthopedic Specialty: Is it for you? 13 Orthopedic Specialty - 2023 Exam Deadlines 13 Featured BOC Approved Provider 18 New BOC Approved Providers 19 INDUSTRY NEWS In-Depth Look: NFL Athletic Trainers Breaking Barriers and Making History 14 Parenting and the Profession: Strategies to Make it Work 16 PROFESSIONAL PRACTICE AND STATE REGULATION ECC Requirements Helping ATs Maintain Life-Saving Skills 12 Legislative News 21 BOC CORNER Meet the BOC Volunteers 9 BOC Advocates for ATs During Capitol Hill Visit 20 The BOC Mourns the Passing of Steve Bair 22 NATA NEWS Latest News and Updates from NATA 19 CANDIDATES Athletic Trainer Certification - 2023 Exam Deadlines 23 BOC Holiday Closures 23Athletic Trainers (ATs) are in demand! While there may be murmurs of doom and gloom in the athletic training profession, I would like to spread some sunlight on this situation to demonstrate the level of opportunity which exists for all of us to enjoy successful, thriving and rewarding careers. According to data from the U.S. Bureau of Labor Statistics, job growth for ATs is projected at 17% over the next 10 years - higher than average occupational growth projections. Advances in practice domains and ongoing professional development have positioned ATs as incredibly versatile health care professionals and demand continues to grow. We now provide care within 40+ settings and are expanding our reach internationally. There are definitely employment situations facing the constraints of understaffing, coupled with high patient levels. The changing aspects seem to be stirring rumors of ATs facing challenging work situations and encountering low salaries and negative work dynamics. The good news is this is not the norm. ATs are in demand by employers who understand the value of an AT’s unique and comprehensive skill set and focus on patient-centered care. Because our worth as health care professionals is becoming more evident, employers understand they need to assess several factors within their organizational cultures to help attract and retain ATs. Employers are addressing issues related to compensation, work/life balance and professional development through the following actions: • Assessing and updating salary reviews • Assessing overall benefits packages to promote work/life balance • Assessing job descriptions to reflect best practices • Assessing culture and identifying opportunities for improvement The BOC works to support and help advance the role of the AT evidenced by growth trends. Currently, there are nearly 57,000 certified ATs. The BOC projects by the close of 2023, our numbers will rise to the highest level to date. The BOC plays a key role in bringing the athletic training profession to elevated heights. Working with state regulators, the BOC is consistently advocating for improved legislation to support practice acts and licensing, as well as growth of the athletic training profession. In addition, expanded promotion of the value of BOC credentials and communication directly to employers will continue to elevate awareness of and demand for ATs. As the organization which develops the exam, maintains standards and certification guidelines, the BOC works to keep credential holders at a level needed to provide quality care. The certification maintenance process helps ATs to gain required continuing education credits and expand their knowledge and professional development. With 2023 being a certification maintenance reporting year, the BOC has resources to help support ATs in their daily work to provide appropriate and quality patient- centered care. The Cultural Literacy Competence Assessment Model (CAM) is one such BOC tool which is focused on improving an AT’s ability to individualize patient care based on background and needs. Find additional options to meet your continuing education needs through the BOC’s Program Directory. With deep appreciation, René Revis Shingles LETTER FROM THE PRESIDENT René Revis Shingles, PhD, AT, ATC 4 BOCATC.ORG SUMMER 20232023 is a Reporting Year for Athletic Trainers Complete Your Requirements Early The BOC Seeks Candidates for its Board of Directors The BOC is accepting applications for a new Athletic Trainer director to serve on the BOC Board of Directors beginning in 2025, following a year of mentorship. All application materials are due by June 30. If you are interested in submitting your name as a potential candidate, please visit the BOC website for the application and appointment guidelines. If you have any questions about the process, please contact the BOC at BOC@bocatc.org. SUMMER 2023 BOCATC.ORG 5 Are you on track to complete your BOC certification maintenance requirements by Dec. 31, 2023? Check your “My To Do List” in your BOC profile to pay your 2023 certification maintenance fee and any past due fee. In addition, you can access your continuing education reporting form. Category A Programs Learn more about programs that qualify for Category A. Program Directory Find BOC Approved Provider programs. Competence Assessment Modules (CAMs) Increase clinical expertise through professional article review and assessment. Two topic choices: • Cultural Literacy - 3.5 Category A CEUs • Mental Health - 7.5 Category A CEUs Quality Improvement (QI) Projects Apply quality improvement projects to enhance your patient- centered care and outcomes. Two topic choices: • Facility Principles - 10 Category A CEUs • Hand Hygiene - 10 Category A CEUs CATEGORY B, C AND D REQUIREMENTS ATs must complete a defined number of CEUs during each certification maintenance period. Options are also available within Categories B, C and D to fulfill requirements. A current breakdown of options by category can be found in the Continuing Education section of the BOC website. EMERGENCY CARDIAC CARE REQUIREMENTS ATs are required to upload a current Emergency Cardiac Care (ECC) card/certificate or confirm current ECC certification. Check the clickable “My To Do List” on your BOC profile dashboard to complete these action items. CATEGORY A REQUIREMENTS AND OPTIONS For the 2022-2023 certification maintenance period, Category A specific requirements include a minimum of 10 CEUs (if 50 CEUs due) or 5 CEUs (if 25 CEUs due). As a reminder, the previous Evidence-Based Practice designation has been removed as a separate category and has been integrated into Category A for the 2022-2023 certification maintenance period. Listed below are options for earning Category A CEUs. ANNUAL CERTIFICATION MAINTENANCE FEES AND ATTESTATION OF COMPLIANCE WITH “BOC STANDARDS OF PROFESSIONAL PRACTICE” There are ANNUAL requirements due at the end of each year, including payment of maintenance fees and completing an attestation of compliance with “BOC Standards of Professional Practice.” Check the clickable “My To Do List” on your BOC profile dashboard to complete these action items.BREAKING DOWN BARRIERS 6 BOCATC.ORG SUMMER 2023 When the Inclusion, Diversity, Equity and Advocacy Strategies (IDEAS) Committee was formed, it was done with a deliberate eye towards developing BOC-specific initiatives and collaborations with other organizations within the athletic training profession. The goal is to foster advances in support of Athletic Trainers (ATs) within their work environments and maximize their ability to provide optimum patient care. The increasing diversity of patient populations brings the necessity for health care providers to change the way we practice. In recent years, health care organizations have put improving outcomes and patient satisfaction at the forefront of their diversity, equity and inclusion efforts. One such mechanism to reduce health disparities, and ultimately improve outcomes for diverse patients, is to adapt how we provide care. The IDEAS Committee’s work is focused on helping do just that. The strategic priorities of the IDEAS Committee are centered around four key areas of the BOC: exam, continuing education, athletic training profession and operations/administration. There are several projects ongoing in these areas to ensure that work product, programs and activities of the BOC are IDEAS reflective. DEMOGRAPHICS To gather a broader perspective and be able to better serve the individualized needs of ATs, the IDEAS Committee expanded demographic fields within BOC profiles for ATs. This more refined data enables the BOC to assess issues around diversity within the athletic training profession, related to everything from exam administration to certification renewal with a clearer view of the characteristics that impact ATs, allowing us to better meet their needs. In addition, the IDEAS Committee reviewed the demographics of BOC’s volunteer population and found it very closely mirrors and is representative of the AT population. Based on data collected during 2020-2021 certification renewal, updated demographics were pulled to create a current profile summary of ATs. The IDEAS Committee analyzed this expanded scope of data to assess demographics related to ethnicity and gender information, as well as other background details. Going forward, data will be continually assessed to identify shifts in demographics that may impact programs and processes at the BOC, and within the athletic training profession. TRAINING AND EDUCATION A focus of the IDEAS Committee is to incorporate IDEAS knowledge into training for BOC staff and volunteers to make sure IDEAS reflective concepts are instilled in all areas of work throughout the organization. BOC volunteers will have training that incorporates IDEAS knowledge and concepts. The BOC team is working with the IDEAS Committee to collaborate and create a volunteer training program that effectively meets volunteer needs and instills a knowledge base and healthy understanding of diversity, equity and inclusion topics. One area of the highest importance in the IDEAS Committee’s plan is exam delivery, considering the exam is a critical touch point for each AT candidate. It seemed foundational to ensure that IDEAS reflective knowledge was provided and experienced by BOC exam item writer volunteers and ultimately integrated, as appropriate, into the exam. To facilitate this, exam item writers will complete the Cultural Literacy Competence Assessment Module (CAM) as part of their training.The Cultural Literacy CAM, which is available to all ATs as a continuing education option focuses on applied use of IDEAS concepts such as: • Social determinants of health and their influence on patient-centered care • Importance of cultural sensitivity in establishing and empowering the patient- clinician relationship • Identifying perceptions on cultural competence, health disparities and bias • Techniques to deliver culturally competent clinical practice According to Jeremy Marra MS, ATC, CSCS, CES (he/him), IDEAS Committee member as well as BOC Board of Directors Athletic Trainer Director Appointee, the Cultural Literacy CAM can support every AT, no matter their background or practice setting. “This assessment tool allows the AT to take a step back and consider concepts they may otherwise not incorporate into daily practice. Each of us brings our own background and biases to the table. These biases are not inherently negative but need to be evaluated to promote both competent and patient centered care.” CLIMATE SURVEY The IDEAS Committee is coordinating a climate survey to be implemented in 2023 with the intention of gaining a view of where ATs currently are in relation to inclusion, diversity, equity and advocacy. The survey will address the workplace environment, patient care, barriers ATs face, as well as input on educational needs based on this information. Results of the climate survey will help to shape some of the IDEAS Committee’s future strategic priorities and provide an outline for educational needs. THROUGH IDEAS STRATEGIC PRIORITIES The IDEAS Committee’s strategic priorities are focused in four areas. THE EXAM The IDEAS Committee regards the BOC exam as the gateway to the athletic training profession and respects the constant need for exam security and validity and recognizes that there is additional room for review and evaluation to affirm the BOC’s strategic priority of diversity, equity and inclusion. These tasks are to be completed with guidance from the exam development department and will position the BOC as a leader in culturally aware exam development and maintenance. CONTINUING EDUCATION Athletic Trainers (ATs) need to be able to provide culturally competent care to any patient they may encounter. Research and best practices will continue to evolve over the course of an AT’s career. IDEAS goal is that ATs will have the resources available to stay up to date on best practices, while also providing continuing education self-assessments for ATs to better help them identify knowledge gaps. OPERATIONS AND ADMINISTRATION The BOC prides itself on our forward-thinking policies and procedures. The administrative tasks will affirm that the BOC is the leader in considering all in its practices. Operationally, the IDEAS Committee will collaborate with the BOC staff to support initiatives for recruitment of future volunteers and staff. ATHLETIC TRAINING PROFESSION Understanding that growth into the profession is not directly in the BOC’s domain, the IDEAS Committee is determined to work with the strategic partners and their Diversity, Equity and Inclusion groups to aid and collaborate on this task when able. The IDEAS Committee has implemented a more robust demographics collection in BOC360 and are confident that this additional data will aid in understanding who ATs are and their certification paths. SUMMER 2023 BOCATC.ORG 7By Emma Nye, DAT, LAC, ATC The increasing diversity of patient populations brings the necessity for health care providers to change the way we practice. In recent years, health care organizations have put improving outcomes and patient satisfaction at the forefront of their diversity, equity and inclusion efforts. One such mechanism to reduce health disparities, and ultimately improve outcomes for diverse patients, is to adapt how we provide care and to become more culturally congruent. The concept of “culturally congruent practice” has been circulating among health care professionals for decades. Many definitions of culturally congruent practice, or culturally congruent care, exist in the health care space. One such definition used among the nursing profession is “the process through which providers and clients create an appropriate fit between professional practice and what patients and families need and want in the context of relevant cultural domains.” The processes of culturally congruent care aim to push health care professions forward by recognizing that it is within a “dynamic interaction between clients and providers that care occurs, and that both client patient, family and provider attitudes, perceptions and behaviors influence outcomes.” The profession of athletic training has largely focused on “cultural competence” as a means to ensure practicing Athletic Trainers work to consider the patient’s beliefs, values and preferences into care plans. Cultural competence, while it’s a clear advancement from simply culture awareness, can oftentimes come up short when it comes to making a clear connection to actual health care outcomes. Other health professions have used cultural competence to represent the process by which practitioners demonstrated culturally congruent care, rather than a standalone skill. Additionally, it is difficult to align cultural competence directly with improved health outcomes if we fail to include the patient, as we know that “care offered is not always equal to care received.” The concepts of culturally congruent practice aim to close this gap. One first step to becoming more culturally congruent in your health care practices is to ask the right questions that take into consideration the patient’s values, needs and beliefs. Cultural assessment tools have been used as a means to best collect information from the patient’s perspective, to ultimately address cross-cultural differences in health care planning and plan culturally appropriate interventions. Many cultural assessment tools may be used by health care providers. We have included a document with a good starting point here. The goal with these tools is to not only reflect that the provider is culturally competent but to take it one step further to involve the patient to compromise interventions through shared, culturally congruent, decision-making. In addition to exploring cultural assessment tools for implementation into their practice, providers can also seek out professional development to learn about culturally congruent care and ways to eliminate disparities and develop skills to become more self-aware of how to best respond to patients’ cultural differences, and how to integrate them into care planning. As our profession continues to evolve with the needs of the patients within our care, so does the need to reevaluate the expectations of our current and future clinicians. References Schim, S. M., & Doorenbos, A. Z. (2010). A three-dimensional model of cultural congruence: Framework for intervention. Journal of social work in end-of-life & palliative care, 6(3-4), 256-270. Marion, L., Douglas, M., Lavin, M. A., Barr, N., Gazaway, S., Thomas, E., & Bickford, C. (2016). Implementing the new ANA standard 8: Culturally congruent practice. Online Journal of Issues in Nursing, 22(1). Narayan MC. Cultural Assessment and Care Planning. Home Healthcare Nurse: The Journal of the Home Care and Hospice Professional. 2003; 21(9):611-8. APPLYING CULTURAL CONGRUENCE IN PATIENT CARE 8 BOCATC.ORG SUMMER 2023Corey A. Oshikoya, Ed.D., LAT, ATC Corey A. Oshikoya, Ed.D., LAT, ATC is currently the committee chair of the Professional Practice and Discipline Committee. Oshikoya is currently assistant clinical professor at Northern Arizona University. Name the group(s) you participate in as a BOC volunteer and how long you’ve participated. I have been a continuing education home study reviewer and a member of the Nominating Committee from 2013-2016. I was an outside reviewer for the BOC exam from 2015 to present. I have also served as both committee member and current chair of the Professional Practice and Discipline Committee from 2017 to present. What is the best or most rewarding part about volunteering with the BOC? I believe being a part of and volunteering for the organization that stewards and maintains the integrity of the ATC ® credential is a part of my professional service. I enjoy the conversations and friendships I have made with colleagues and new friends who are passionate about athletic training. And honestly, the BOC staff is great to work with! How has your experience volunteering at the BOC influenced you? I see the BOC’s contribution to athletic training as more than the organization that I took the test through and the folks who collect continuing education units. The BOC is a group of special people who seek to protect the public and preserve the honor of our certification. This protection creates a legal and moral standard for which those who aspire to be Athletic Trainers (ATs) and for those who wish to remain a member of the athletic training profession. Because of the BOC, I value my certification and the efforts it takes to maintain it. What advice would you give to an AT looking to get involved as a BOC volunteer? Volunteering with the BOC has been a valuable and informative experience. I would tell other ATs that they will not regret investing their time (large or small) with the BOC. The mission of protecting the public and the ATC ® credential are paramount, and I have enjoyed every minute of it. It is worth investing in athletic training. MEET THE BOC VOLUNTEERS The BOC would like to take this opportunity to thank all BOC volunteers who serve as BOC board members, committee, task force, work group members and exam item writers. The BOC welcomes volunteers from a variety of backgrounds. Visit the BOC website, to learn more about volunteer opportunities with the BOC. SUMMER 2023 BOCATC.ORG 9Next >