Collaboration is a key area that athletic trainers have plenty of room for improvement. Athletic trainers are notoriously bad at shouldering all the responsibilities of a patient's care themselves. This lack of interprofessional practice not only adds additional strain to the athletic trainer, but it creates a further divide between other health care professionals and athletic trainers. Interprofessional practice also leads to overall better care of the patient and prevents miscommunication of information and patients being "lost to the system." Interprofessional practice is defined as the provision of health care by providers from different professions in a coordinated manner that addresses the needs of the patient(s). Providers share mutual goals, resources and responsibility for patient care. (2) Interprofessional education (IPE) is defined as an educational process whereby professions learn about, from, and with each other to improve collaboration and the quality of care. (2) So if IPP is commonplace in other health care professions, why does athletic training often struggle with incorporating this into their profession? In my opinion, there are 2 key components that contribute to this IPP struggle.
1. Perceived Lack of Respect/Understanding of the Athletic Training Profession and Its allowances
The professional preparation of athletic trainers has grown dramatically from its previous apprenticeship roots in physical education. Now athletic trainign is a professional masters degree program accredited by the Commission on Accreditation of Athletic training Education (CAATE). (2) This transition into a health care profession is a main source of confusion about the profession by the public and other health care professionals. Despite these major changes and the professions desire to be universally recognized as health care providers, many in the medical community remain ignorant to the professions evolution and educational standards. (2) This lack of understanding needs to be addressed as much of the literature on interprofessional teams identifies role confusion and medical dominance among professions as a key barrier to team functioning. (2) When there is confusion, tension, conflict or lack of respect among the professions, professional stereotyping may arise, further preventing successful team functioning. In fact, investigations into IPE and IPP in athletic training have identified that many concepts were misunderstood by athletic training educators due to a lack of appreciation for their role in the future of health care. It is further defined as a vehicle by which students in health profession programs learn about the diverse roles and contributions of all health professionals in the health care system. (2) This is a concept that athletic trainers seem to be fairly familiar with. Based on our class discussion on the topic, it seems almost everyone has had an issue getting in touch with members of their interdisciplinary team or being an integral part of the team. At my clinical site last year, I never saw my team doctor outside of our "welcome to the team" dinner.
2. Lack of reaching out on both ends
Athletic trainers agree that IPP concepts are beneficial to care, but they also admit to not consistently practicing this manner. (1) 47.33% of individuals indicated that their patient care occurred in an interprofessional manner. (3) That's less than half. Clearly, there is room for improvement on the athletic training side. If we understand IPP is important, and we know we aren't consistently practicing IPCP, then why are we not making changes in our practice? A lot of it boils down to context and setting.
More and more orthopedic physicians have begun to employ athletic trainers a physician extenders. By doing this practice efficiency, revenue and productivity increase while patient education and satisfaction increase as well.(2) There is structured interprofessional practice built into hospital systems that utilize health care professionals this way. It Is much easier to practice interprofessionally when you see each other consistently and have a first hand understanding of how each person in the team provides benefit to patient care. Similarly, good consistent interprofessional practice is much harder if a team doctor is assigned to several teams, or based far away For example: at my last job the team doctor was 45 minutes away and assigned to 2 other high schools and a college sport. It may be worth consideration of a medical model structure, wherein more regular interaction with other health care professionals occurs, increasing the frequency of IPCP. (1) (some examples could be, hosting Grand Rounds sessions, monthly meetings etc.)
Overall, we can't expect change to happen without doing something ourselves. "Athletic trainers should conduct a self-assessment of their work environment to determine how best to improve their role in a collaborative practice team." (3) Even if other members of the interdisciplinary team don't do everything they can, we should still do everything we can on our part.
(1) Hankemeier D, Manspeaker SA. Perceptions of interprofessional and collaborative practice in collegiate athletic trainers. Journal of athletic training. 2018;53(7):703-708.
(2) Breitbach AP, Richardson R. Interprofessional education and practice in athletic training. Athletic Training Education Journal. 2015;10(2):170-182.
(3) Hankemeier DA, Manspeaker SA. Athletic trainers' perceptions of interprofessional and collaborative practice. Athletic Training and Sports Health Care. 2017;9(5):203-216.
Comentarios