第1章:
健康照護者
運動傷害防護員(AT)
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Chapter 1: The Athletic
Trainer as a Health Care
Provider
© 2014 The McGraw-Hill Companies, Inc. All rights reserved.
• Athletic trainers specialize in preventing,
recognizing, managing and rehabilitating
injuries
• (專門：預防、辨識、管理和復健傷害)
• Function as a member of a health care
team which also incorporates and
involves a number of medical specialties
(運作：以健康照護團隊模式含醫事人員）
• Provide a critical link between the medical
community and physically active
individuals
• （提供：社區醫療與個人運動間連結）
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1-3
Historical Perspective
• Early History
– Evidence suggests that coaches,
physicians & therapists existed in Greek
and Roman civilizations（希臘和羅馬）
• Assisted athletes in reaching top performance
– Athletic trainers came into existence in the
late 19th century in intercollegiate &
interscholastic sports（大學間和校際間）
– Early treatments involved rubs, counterirritants, home remedies and poultices
– （摩擦、對抗刺激劑、家庭偏方、糊藥）
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1-4
Evolution of Contemporary
Athletic Trainer
（當代AT的發展）
• Traditional setting of practice included
colleges and secondary schools（9-12年級）
– Dealing exclusively
（獨有）
with an athletic population
• Today certified athletic trainers (ATC) work
in a variety of settings and with a variety of
patient populations
– Professional sports, hospitals, clinics, industrial
settings, the military, equipment sales,
physician extenders（內科醫師的延伸）
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1-5
• Rapid evolution of the profession following
WW I
– Athletic trainers became specialists in
preventing and managing injuries
– Dr. S.E. Bilik wrote, The Trainer’s Bible (1917)
– The Cramer brothers developed a line of
liniments to treat ankle sprains (1920’s) and
followed the publication The First Aider (1932)
– In the 1930’s the NATA started to come into
existence but then disappeared during WW II
– In 1950 the NATA was reorganized and it has
continued to flourish and expand
（塗藥）
（繁榮）
（擴張）
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1-6
• With the evolution of the profession a
number of milestones
have been
achieved
（里程碑）
– Recognition of Acts as healthcare
providers
– Increased diversity
of practice settings
– Passage of practice acts
– Third party reimbursement
for athletic
trainers
– Constant revision and reform of
athletic training education
（多樣性）
（管道）
（第三方賠償）
（修正）
（重訂）
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1-7
Changing Face of Athletic
Training Profession
• Role of the athletic trainer is more in line（
在內部）, today, as a health care provider
– 40% of athletic trainers are employed in
clinics（診所）, hospitals（醫院）, industrial（工業
的） and occupational （職業的）settings
– Also involved in NASCAR, performing arts,
military, NASA, medical equipment & sales,
law enforcement, and the US government
• Has resulted in changes in athletic training
education
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1-8
• Athletic trainers do not just provide
medical care to athletes or those just
injured during physical activity
• Becoming more aligned（對齊） as a
clinical health care profession
– Requires terminology（術語） changes
• Patients and clients vs. athletes
• Athletic clinic or facility vs. athletic training room
• Athletic trainers – NOT TRAINERS!!
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1-9
Sports Medicine and Athletic
Training
• Broad field （主要的範圍） of medical
practices related to physical activity and
sport（身體活動與運動）
• Involves a number of specialties
involving active populations
• Typically classified（典型分類） as
relating to performance enhancement
（增進運動表現）or injury care and
management（傷害照護與管理）
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1-10
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1-11
運動醫學
Sports Medicine
促進運動表現
傷害照護與管理
• 運動生理學
• 生物力學
• 運動力學
• 運動營養學
• 肌力訓練與調整
• 教練學
• 個人適能訓練
•
•
醫療實務操作
運動保健
運動治療
運動按摩治療
運動牙科
骨科醫學
矯正與修補
運動整脊
運動腳病學
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1-12
Growth of Professional Sports
Medicine Organizations
•
•
•
•
•
•
•
•
•
•
International Federation of Sports Medicine (1928)
American Academy of Family Physicians (1947)
National Athletic Trainers Association (1950)
American College of Sports Medicine (1954)
American Orthopaedic Society for Sports Medicine (1972) （美
國整形外科的運動醫協會）
National Strength and Conditioning Association (1978)
American Academy（學會） of Pediatrics（小兒科）, Sports
Committee（委員會）(1979)
Sports Physical Therapy Section of APTA (1981)
NCAA Committee on Competitive Safeguards and Medical
Aspects of Sports (1985)
National Academy of Sports Medicine (1987)
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1-13
International Federation of
Sports Medicine
• Federation （聯盟）Internationale de
Medecine Sportive (FIMS) （國際運動醫學聯
盟）
• Principal purpose to promote the study and
development of sports medicine throughout
the world
• Made up of national sports medicine
associations of over 100 countries
• Organization includes many disciplines （章
程）that are concerned with physically active
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1-14
American Academy of Family
Physicians（美國家庭醫師學會）
• To promote and maintain high quality
standards for family doctors who are
providing continuing comprehensive（
綜合的） health care to the public
• It is a medical association of more than
93,000 members
• Many team physicians （隊醫）are
members of this organization
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1-15
National Athletic Trainers’
Association（國家運動傷害防護員協會）
• To enhance the quality of health care for
athletes and those engaged in physical
activity, and to advance the profession of
athletic training through education and
research in the prevention, evaluation,
management and rehabilitation of injuries
• The NATA now has 32,000 members
© 2014 The McGraw-Hill Companies, Inc. All rights reserved.
1-16
Figure 1-1
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1-17
American College of Sports
Medicine （美國運動醫學會）
• Patterned（仿）after FIMS (Umbrella
Organization)
• Interested in the study of all aspects of sports
• Membership composed of medical doctors,
doctors of philosophy, physical educators,
athletic trainers, coaches, exercise
physiologists, biomechanists, and others
interested in sports
• （成員有：醫師、博士生、體育老師、運動傷害護員、教練、運
動生理學家、生物力學家和其他對運動有興趣之人士）
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1-18
American Orthopaedic Society
for Sports Medicine
（美國整形外科運動醫學協會）
• To encourage and support scientific research
in orthopaedic sports medicine and to
develop methods for safer, more productive
and enjoyable fitness programs and sports
participation
• Members receive specialized training in
sports medicine, surgical procedures, injury
prevention and rehabilitation
• 1,200 members are orthopaedic surgeons（
整形外科醫師） and allied（結盟） health
professionals
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National Strength and
Conditioning Association
• To facilitate （促進）a professional exchange of ideas
in strength development as it relates to the
improvement of athletic performance and fitness and to
enhance, enlighten, and advance the field of strength
and conditioning（肌肉適能和身體狀況調節）
• 30,000 strength and conditioning coaches（教練）,
personal trainers（個人健身指導員）, exercise physiologists
（運動生理學家）, athletic trainers（運動保健員）,
researchers（研究者）, educators（教師）, sport coaches（
運動教練）, physical therapists（物理治療師）, business
owners（業者）, exercise instructors（運動講師） and
fitness directors（體適能指導員）
• Accredited certification programs
– Certified ©Strength
and Conditioning Specialist（專家）,
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1-20
American Academy of
Pediatrics, Sports Committee
• Dedicated to providing the general
pediatrician and pediatric sub-specialist with
an understanding of the basic principles of
sports medicine and fitness and providing a
forum（論壇） for the discussion of related
issues
• To educate all physicians, especially
pediatricians, about the special needs of
children who participate in sports （目的在教育所
有醫師，尤其是小兒科醫師。以增進對孩童在參與運動活動中的
特殊需求的認識）
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1-21
American Physical Therapy
Association, Sports Physical Therapy
Section
• To provide a forum to establish collegial relations
between physical therapists, physical therapist
assistants, and physical therapy students interested
in sports physical therapy
• Promotes prevention, recognition, treatment and
rehabilitation of injuries in an athletic and physically
active population
• Provides educational opportunities through
sponsorship of continuing education programs and
publications
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1-22
NCAA Committee on Competitive
Safeguards and Medical Aspects of
Sports
• Collects and develops（蒐集與發展）
pertinent（相關） information regarding
desirable training methods, prevention and
treatment of sports injuries, and utilization（
運用） of sound safety measures
• Disseminates（傳播） information and
adopts（調整） recommended policies and
guidelines designed to further the above
objectives
• Supervises（監督）
drug-education and
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1-23
National Academy of Sports
Medicine
• Founded by physicians, physical therapists
and fitness professionals
• Focuses on the development, refinement （
細化，精緻）and implementation（履行） of
educational programs for fitness,
performance and sports medicine
professionals
• Offer a variety of certifications (fitness and
performance)
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1-24
Other Health Related
Organizations
• Various aspects of health related
professions have also become involved
– Dentistry, podiatry, chiropractic medicine
• National, state and local organizations
have also emerged
– Focus on athletic health and safety
• All bodies have worked towards the
reduction of injury and illness in sport
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Sports Medicine Journals
• A variety of publications exist, providing excellent
resources to the sports medicine community
–
–
–
–
–
–
–
–
–
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Journal of Athletic Training（運動保健期刊）
Journal of Sports Rehabilitation（運動復健期刊）
International Journal of Sports Medicine（國際運動醫學期刊）
Physician and Sports Medicine（內科與運動醫學）
Clinics in Sports Medicine（臨床運動醫學）
American Journal of Sports Medicine（美國運動醫學期刊）
Sports Health（運動健康）
Athletic Therapy & Training（運動治療與訓練）
Training & Conditioning（訓練與調節）
Athletic Training & Sports Health Care（運動保健與健康照護）
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1-26
Employment Settings for the
Athletic Trainer
• Employment opportunities are becoming
increasingly diverse（不一樣）
– Dramatic transformation since 1950
– Due largely to the efforts of the NATA
• Started out primarily in the collegiate
setting, progressed to high schools and
now 40% are found primarily in hospital
and clinic settings（大學→高中→40%醫院和診所）
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1-27
• Settings include:
–
–
–
–
–
–
–
–
–
–
–
–
Clinics and hospitals（診所與醫院）
Physician extenders（
Industrial/Occupational settings（工廠）
Corporate settings（公司企業）
Colleges or Universities（大學）
Secondary schools（中學）
School districts（學校）
Professional sports（專業運動項目）
Amateur/Recreational/Youth sports（業餘/娛樂/青少年運動項目）
Performing arts（表演藝術）
Military & Law enforcement（軍/警務單位）
Health & fitness clubs（健康管理中心＆體適能中心）
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1-28
Treating Physically Active
Populations 運動的意涵
• Consists of athletic, recreational or
competitive activities（運動的、娛樂性、競爭性）
• Requires physical skills and utilizes
strength, power, endurance, speed,
flexibility, range of motion and agility
（利用）
（敏捷性）
• （要求運動技巧、運用肌耐力、爆發力、速度、柔軟度、
關節活動度和敏捷性）
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1-29
• The Adolescent Athlete（青少年運動員）
– Focuses on organized competition（有組織的競爭）
– A number of sociological issues are
involved（社會議題）
• How old or when should a child begin training?
– Skeletal maturity（骨骼成長） presents
some challenges with respect to healthcare
– Physically （身）and emotional （心）
adolescents can not be managed the same
way as adults
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1-30
• The Aging Athlete（老人運動）
– Physiological and performance capability （能力）
changes overtime（隨者時間，生理和運動能力會改變）
• Function will increase and decrease depending on
point in lifecycle（生命週期）
• May be the result of both biological and sociological
effects（生物和社會影響）
– High levels of physiological function can be
maintained through an active lifestyle（動態生活）
• The impact on long-term health benefits have been
documented（動態生活長期下來有助健康）
– Beginning an exercise program（運動計畫）
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1-31
– Exercise program should be gradual and
progressive as long as no unusual signs or
symptoms develop（分級和漸進式進行）
– Individuals over age 40 should have a
physical and exercise testing before
engaging in an exercise program（超過40
歲者，運動前要先做運動評估）
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1-32
• Occupational Athlete 職業運動員
– Occupational, industrial or worker “athlete”
are involved in strenuous, demanding or
repetitive physical activity
• May result in accidents（意外）and injury（傷害）
– Involves
• Instruction on ergonomic（人體力學）
techniques to avoid injury associated with
physical demand of job responsibilities
• Intervention when injuries arise
– Correcting mechanics（矯正機械）, faulty postures,
（錯誤姿勢） strength deficits（肌力不夠）, lack of
flexibility（柔軟度差）
• Injury prevention is still critical（傷害預防是關鍵）
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1-33
Roles & Responsibilities of the
Athletic Trainer
AT的角色和責任
• Charged with injury prevention and health
care provision（準備） for an injured patient
– Often requires a cadre of sports medicine
professionals（要求對動醫學的專業）
• Athletic trainer deals with the patient and
injury from its inception （起初）until the
athlete returns to full competition
• （從起初受傷，照顧到恢復能在運動競技場比賽)
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1-34
Roles and Responsibilities:
Board of Certification Domains
認證的領域
• Injury/illness prevention & wellness protection
傷害預防與保健
• Clinical evaluation and diagnosis 臨床評估與
診斷
• Immediate & emergency care 急救
• Treatment & rehabilitation 治療與復健
• Organizational and professional health and
well-being 全人健康組織與專業
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1-35
• Prevention(預防)
– Ensure safe environment(環境安全)
– Conduct pre-participation physicals(引導)
– Develop training and conditioning programs
(訓練計畫設計)
– Select and fit protective equipment properly
(護具)
– Explaining important diet and lifestyle
choices(營養與規律生活)
– Ensure appropriate medication use while
discouraging substance abuse(避免藥物濫用)
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1-36
• Clinical Evaluation & Diagnosis
(臨床評估與診斷)
– Recognize nature and extent of injury(辨識)
– Involves both on and off-field evaluation
skills and techniques(評估技巧與技術)
– Understand pathology of injuries and
illnesses(病理學)
– Referring to medical care(轉介醫療照護)
– Referring to supportive services(轉介支持)
• Immediate & Emergency Care(急救)
– Administration of appropriate first aid and
emergency medical care (CPR, AED)
– Activation of emergency action plans (EAP)
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1-37
• Treatment and Rehabilitation
–
–
–
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Design preventative training systems 系統
Rehabilitation program design 復健
Supervising rehabilitation programs 督導
Incorporation of therapeutic modalities治療方式
and exercise 整合
– Offering psychosocial intervention 社會心理
• Organizational & Professional Health and
Well-being 有組織的&專業性的
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–
–
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Record keeping 紀錄保持
Ordering supplies and equipment 支援與器材
Establishing policies and procedures 制度與流程
Supervising personnel 監督人員
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1-38
• Professional Responsibilities
– Athletic trainer as educator 教師角色
– Athletic trainer and continuing education
持續進修
– Athletic trainers as counselor 諮商者角色
– Athletic trainers as researcher 研究角色
• Incorporation of evidence based medicine 醫學
• Participating and acquiring evidence for 證據
efficacious patient care
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1-39
Importance of Engaging
Evidence Based Practice
• Evidence driving patient
care
– Failure to engage in
evidenced based care
could jeopardize patient
care 缺證據恐危急病患照顧
– EVB Steps
–
–
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–
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Develop clinical question
Search literature 研究
Appraise evidence 估量
Apply evidence 提供
Assess outcomes 評估
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1-40
• Developing a clinical question
– Utilizes the PICO format (Patient, Intervention,
Comparison, Outcome)
• Searching the literature
– Using key words to assemble 招集 a comprehensive
廣泛的assessment of available literature
• Evaluating the strength of the evidence
– Type of study vs. quality of evidence
– Must critically嚴格地 evaluate and rate估價 the evidence
• Applying the evidence
– Integrating evidence with patient needs and values
– Bridging barriers between research evidence and
clinical decisions to ensure optimal care
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1-41
• Assessing Treatment Outcomes
– Determining effectiveness
– Outcomes assessment measures
• Condition-oriented evidence 以調整狀況為主的證據
• Patient-oriented evidence 以患者本身為主的證據
– Patient perceptions, experience, patient-centered goals
• Disablement model 表示”無能”的方式
– Evaluates functional loss due to impairment and impact on
quality of life 判斷功能喪失，是以損害患者生活品質為考量
– Comprehensive assessment 廣泛性評估
– Patient reported outcomes 患者報告結果
– Global ratings of change 總體的變化分級
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1-42
Personal Qualities of the
Athletic Trainer
• Stamina and the ability to adapt
(精力和適應能力)
• Empathy(心情轉換)
• Sense of humor(幽默)
• Communication(溝通)
• Intellectual curiosity (理性的好奇心)
• Ethical practice(道德感)
• Professional memberships(專業)
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1-43
Athletic Trainer and
the Athlete
• Major concern on the part of the ATC
should be the injured patient 關心
• All decisions impact the patient 衝擊
• The injured patient must always be
informed (報告，告知)
– Be made aware of the how, when and why
that dictates the course of injury
rehabilitation 支配
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1-44
• The patient must be educated about
injury prevention and management
(患者需被教育：有關傷害的預防和管理)
• Instructions should be provided
regarding training and conditioning
(教學:提供對訓練和調整情況的關心)
• Inform the patient to listen to his/her
body in order to prevent injuries(傾聽身
體訊號，預防運動傷害)
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1-45
Athletic Trainer and Parents
• Athletic trainers must keep parents
informed, particularly in the secondary
school setting
– Injury management and prevention
• The parents decision regarding關心
healthcare must be a primary
consideration
• Insurance 保險plans may dictate care
– Selection of physician (保險支配照護資源)
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1-46
• The athletic trainer, physician and
coaches must be aware and inform
parents of Health Insurance Portability
and Accountability Act (HIPAA)
• 健康保險便携性與責任法案(HIPAA)
– Regulates dissemination宣傳 of health
information
– Protects patient’s privacy and limits the
people who could gain access 進入的權利
to medical records
– (保護和限制獲得病人的醫療紀錄)
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1-47
The Athletic Trainer and
the Team Physician 隊醫
• Athletic trainer works under direct
supervision of physician (AT是在隊醫的督導下工作)
• Physician assumes a number of roles
– Serves to advise and supervise ATC
• Physician and the athletic trainer must be
able to work together
– Have similar philosophical 達觀的，理性的
opinions regarding 關心injury management
• Helps to minimize discrepancies 不一致 and
inconsistencies 不協調
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1-48
• The physician醫師 is responsible for
compiling 編輯 medical histories and
conducting 主導physical exams
– Pre-participation screening 運動前的評估
• Diagnosing injury 診斷傷害
• Deciding on disqualifications 取消資格
– Decisions regarding athlete’s ability to
participate based on medical knowledge
and psychophysiological demands of sport
• Attending practice and games出席練習或比賽
• Commitment to sports and athlete
對運動本身與運動員有責任義務
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1-49
• Potentially serve as the academic
program medical director(醫學學術指導)
– Coordinates and guides medical aspects of
program (在醫學方面計畫的協調與指導)
– Provides input into educational content and
provides programmatic instruction(提供教育內
容與具綱領性的研究架構)
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1-50
The Athletic Trainer and
the Coach
• Must understand specific role of all
individuals involved with the team
• 教練須了解隊員們的個別差異
• Coach must clearly understand the
limits of their ability to function as a
health care provider in their respective
state 教練需了解AT並非無所不能。
• Directly responsible for injury prevention
– Athlete must go through appropriate
conditioning program 運動員需經歷適度的調整計畫
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1-51
• Coach must be aware of risks
associated with sport
• Provide appropriate training and
equipment
• Should be certified in CPR and first aid
• Must have thorough knowledge of
skills, techniques and environmental
factors associated with sport
• Develop good working relationships with
staff, including athletic trainers
– Must be a cooperative relationship
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Referring the Patient to
Other Personnel
• The athletic trainer must be aware of
available medical and non-medical personnel
– Patient may require special treatment outside
of the “traditional” sports medicine team
• Must be aware of community based services
and various insurance plans
– Typically the athletic trainer and team
physician will consult 商量 on the particular
matter and refer accordingly 相對應地
– 就案例做討論，再依個別狀況做相對應的處理
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Support Health Services &
Personnel
•
•
•
•
•
•
•
•
•
•
•
Physicians
Dentist
Podiatrist
Nurse
Physicians Assistant
Physical Therapist
Occupational Therapist
Massage Therapist
Ophthalmologist
Dermatologist
Gynecologist
•
•
•
•
•
•
•
•
•
•
Exercise Physiologist
Biomechanist
Nutritionist
Sport Psychologist
Coaches
Strength & Conditioning
Specialist
Social Worker
Neurologist
Emergency Medical
Technician
Osteopath
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Support Health Services & Personnel
健康服務支援與人員
•
•
•
•
•
•
•
•
•
•
•
Physicians 醫師
Dentist 牙醫
Podiatrist 足科醫師
Nurse 護士
Physicians Assistant 醫師助理
Physical Therapist 物理治療師
Occupational Therapist 職能治療
Massage Therapist 按摩治療師
Ophthalmologist 眼科醫師
Dermatologist 皮膚科醫師
Gynecologist 婦科醫師
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Support Health Services & Personnel
健康服務支援與人員
•
•
•
•
•
•
•
•
•
•
Exercise Physiologist 運動生理學家
Biomechanist 生物力學家
Nutritionist 營養師
Sport Psychologist 運動心理學家
Coaches 教練
Strength & Conditioning Specialist 運動指導員
Social Worker 社工
Neurologist 神經科專業醫師
Emergency Medical Technician 醫療急救人員
Osteopath 整骨醫師
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Recognition and Accreditation of the
Athletic Trainer as an Allied
Healthcare Professional
(AT 被認定與任命健康照護專業人員)
• June 1990- AMA officially recognized athletic
training as an allied health profession
• Committee on Allied Health Education and
Accreditation (CAHEA) was charged with
responsibility of developing essentials and
guidelines for academic programs to use in
preparation of individuals for entry into
profession through the Joint Review Committee
on Athletic Training (JRC-AT)
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• June 1994-CAHEA dissolved and replaced
immediately by Commission on Accreditation
of Allied Health Education Programs
(CAAHEP)
– Recognized as an accreditation agency for
allied health education programs by the
U.S. Department of Education
• Entry level college and university athletic
training education programs at both
undergraduate and graduate levels were
accredited by CAAHEP through 2005
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• In 2003, JRC-AT became an independent
accrediting agency
– JRC-AT would accredit athletic training
education programs without involvement of
CAAHEP
– JRC-AT officially became the Committee for
Accreditation of Athletic Training Education
(CAATE) in 2006
– CAATE was officially recognized by CHEA in
2007
• CHEA is a private nonprofit national organization that
coordinates accreditation activity in the United States
• Recognition by CHEA puts CAATE on the same level as
other national accreditors, such as CAAHEP
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• Effects of CAATE accreditation are not
limited to educational aspects
• In the future, this recognition may
potentially affect regulatory legislation, the
practice of athletic training in nontraditional
settings, and insurance considerations
• Recognition will continue to be a positive
step in the development of the athletic
training profession
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Accredited Athletic Training
Education Programs
• Entry-level athletic training education
programs
– In 2012, 333 undergraduate programs, 19
entry-level master’s programs
• Advanced graduate athletic training
education programs
– Designed for individuals that are already
certified ATs
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Education Council
教育協調會
• In 1997 the Education Council was
established to dictate 支配 the course of the
educational preparation for the athletic
training student
• Focus has shifted to competency based
education at the entry level
• Education Council has significantly expanded
and reorganized the clinical competencies 核
心能力 and proficiencies 精熟
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Athletic Training Education
Competencies 核心能力
• Eight Content Areas
(AT教育養成八大領
域)
– Evidence based practice 實務證明
– Prevention & health promotion 預防與健康促進
– Clinical examination & diagnosis 臨床檢查與診斷
– Acute care of injury & illness 疾病傷害急性處理
– Therapeutic interventions 治療介入
– Psychosocial strategies & referrals 社會心理策略與參
考
– Healthcare administration 健康管理
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• Foundational Behaviors of Professional
Practice
– “People” components of the profession
• Recognizing the primary focus of practice
should be the patient (以患者為主)
• Understanding that competent health care
requires a team approach (團隊照護模式)
• Being aware of legal elements of practice(合法)
• Practicing ethically(道德)
• Advancing the knowledge base in athletic
training (精益求精)
• Appreciate cultural diversity (尊重多元文化)
• Being an advocate and model for the AT
profession (致力專業)
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Post-Professional Athletic
Training Education Programs
• 15 programs are certified by the NATA
Graduate Education Committee
• Designed to enhance academic and
clinical preparation of already certified
athletic trainers
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Specialty Certifications
• NATA is in the process of developing
specialty certifications
– Further enhance professional development
– Aid in expanding scope of practice
• Specialty certifications build on entry
level knowledge
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• Purpose
– To provide the athletic trainer with
advanced clinical practice credential 證書
that demonstrates 證明attainment of
knowledge and skills that will enhance
patient care, enhance health-related
patient quality of life, and optimize clinical
outcomes in specialized areas of athletic
training practice
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Requirements for Certification
as an Athletic Trainer
• Must have extensive 廣泛的background
in formal academic preparation and
supervised practical experience
• Guidelines are set by the Board of
Certification (BOC)
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• Upon meeting the educational guidelines
applicants are eligible有資格當上 to sit for
the examination
• Examination is computer based
• Exam assesses 5 domains
– Injury/illness prevention and wellness
protection
– Clinical evaluation and diagnosis
– Immediate & emergency care
– Treatment and rehabilitation
– Organizational and professional health and
well-being
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• Upon passing the certification
examination = BOC certified as an
athletic trainer
– Credential of ATC
• BOC certification is a prerequisite 必修
的for licensure in most states
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Continuing Education
Requirements
• Ensure ongoing professional growth
and involvement 牽連
• Requirements that must be met to
remain certified
– 75 CEUs over the course of three years
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• Purpose:
– To encourage athletic trainers to obtain
current professional development information
– To explore new knowledge in specific areas
– To master new athletic training related skills
and techniques
– To expand approaches to effective athletic
training
– To further develop professional judgment
– To conduct professional practice in an ethical
and appropriate manner
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• CEUs are awarded for:
– Attending symposiums討論會, workshops,
seminars
– Serving as a speaker or panelist
專題討論小組參加者
– Certification exam writer
– Authoring a research article;
authoring/editing a textbook
– Completing post-graduate work
• All certified athletic trainers must
demonstrate proof of current CPR/AED
certification
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State Regulation of the
Athletic Trainer
• During the early-1970s NATA realized
the necessity of obtaining some type of
official recognition by other medical
allied health organizations of the athletic
trainer as a health care professional
• Laws and statutes specifically governing
管理 the practice of athletic training
were nonexistent in virtually 實際上
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every state
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• Athletic trainers in many individual states
organized efforts to secure recognition by
seeking some type of regulation of the
athletic trainer by state licensing
agencies
• To date 48 of the 50 states have enacted
some type of regulatory statute
governing the practice of athletic training
• Rules and regulations governing the
practice of athletic training vary
tremendously極端地from state to state
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• Regulation may be in the form of:
– Licensure
• Limits practice of athletic training to those who
have met minimal requirements established by
a state licensing board
• Limits the number of individuals who can
perform functions related to athletic training as
dictated by the practice act
• Most restrictive 限制的; of all forms of
regulation
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– Certification
• Does not restrict using the title of athletic trainer
to those certified by the state
• Can restrict performance of athletic training
functions to only those individuals who are
certified
– Registration
• Before an individual can practice athletic
training he or she must register in that state
• Individual has paid a fee for being placed on an
existing list of practitioners but says nothing
about competency 核心能力
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– Exemption(義務等的)免除
• State recognizes that an athletic trainer
performs similar functions to other licensed
professions (e.g. physical therapy), yet still
allows them to practice athletic training despite
the fact that they do not comply 遵從 with the
practice acts of other regulated professions
• Legislation 立法 regulating the practice of
athletic training has been positive and to
some extent protects the athletic trainer
from litigation訴訟
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Future Directions for the
Athletic Trainer
• Will be determined by the efforts of the
NATA and its membership
– Ongoing re-evaluation, revision and reform of
athletic training education
– Further recognition of CAATE by CHEA will
further enhance credibility
– Athletic trainers must continue to actively seek
third party reimbursement 償還 for athletic
training services
– Standardization of state practice acts
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– Athletic trainers will seek specialty
certifications
• Expanding breadth 寬度 and scope of practice
– Increase in secondary school employment of
athletic trainers
– Increase in recognition of athletic trainers as
physician extender
– Potential for expansion in the military, industry,
and fitness/wellness settings
– With general population aging = increased
opportunity to work with aging physically
active individuals
– Continue to enhance visibility 能見度 through
research and scholarly 學者的 publication
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– Continue to be available for local and
community meetings to discuss health care
of the athlete
– Increase recognition and presence出席
internationally
– Most importantly, continue to focus efforts
on injury prevention and to provide high
quality health care to physically active
individuals regardless不關心的 of the
setting in which the injury occurs
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