Clinical Expertise is a combination of one's education and clinical experience. To me, an expert is not just someone who is "really good" at something. An expert has the base education that the rest of the profession has, as well as thousands of hours and patient encounters in that particular field or topic. Additionally and expert needs to be up to date on all the most recent research and standards of practice. All too often we have individuals who claim to be experts, because they've been in the profession for years and they've "seen it all". Clinical expertise in actuality involves 3 main domains: taking into account current evidence, base education on the topic or skill, actively sought out and documented clinical experience.
For example, Doctors have to go through undergraduate school, medical school, residencies and then fellowships to become specialized in one field of medicine. The result is the array of different doctors we have now (orthopedic, internal medicine, family practitioner etc.) and further specialized doctors in those fields (i.e. at Prisma orthopedics we have a knee specialist, shoulder specialist etc.)
In athletic training we don't yet have a specified course or certification yet for individuals to call themselves an expert or specialist. You don’t hear of athletic trainers who identify as a specialist in general medicine or rehabilitation or whatever it may be. There may be those who say "oh yeah shoulders are my thing, I love evaluating and treating shoulders." But confidence in a topic does not equate to expertise.
We spoke in class about the progress that athletic training has made towards clinical expertise programs, which they hope to implement In a few years time. The idea is not to try and encourage all athletic trainers to obtain clinical expertise in an area after their schooling, but instead to provide a structured and clearly defined expectation for what clinical expertise is and how to obtain it. The proposed structure in order to obtain this title, is to complete a residency designed to educate and give the AT experience in the field they are trying to specialize in. By doing this they obtain that base education necessary and easily accumulate the patient encounters and hours needed in that specific field. Finally, there will be a certification exam, similar to the BOC, specific to that field of expertise.
Personally, I have no intention of gaining expertise in a field, but I can still see the merit in having a regulated program like this in place. My only concern is the lack of understanding of the process and value of clinical experts. We currently struggle to identify to employers the differences between assistantships, internships, residencies, fellowships and the PM and PPM programs. It sometimes feels like athletic trainers get lost in their letters and certifications, because they feel like they won't be selected for jobs or stand out in the hiring pool if they don't have all the extra credentials and certifications that are available. I think before this is implemented we need to focus on our foundation and ensure that current practicing clinicians and those that hire them fully understand the current roles and responsibilities of athletic trainers and the pathways to become an athletic trainer. If we already struggle to show the value in the certifications and training we already have, adding new certifications and expertise will only add to the confusion.
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