













































MANUSCRIPT TYPE


CLINICAL MENTORSHIP CASE STUDY  

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 6 – Issue 2 – September 2023 

Prioritizing Patient-Centered Care when Integrating Athletic Training 
Students into Clinical Practice  
Amber Kingsley, MS, ATC*; Amy L. Fraley, PhD, SCAT, ATC; Krista M. Richards, MS, SCAT, ATC; Matthew J. Drescher, PhD, LAT, 
ATC†; Zachary K. Winkelmann, PhD, SCAT, ATC, CHSE* 
*University of South Carolina, Columbia, SC; †North Dakota State University, Fargo, ND 
 

 
ABSTRACT 
Athletic trainers are responsible for the patient care of student-athletes but also can be responsible for the education and mentorship 
of athletic training (AT) students through the role of preceptor. ATSs require extensive first-hand clinical experiences to prepare them 
for autonomous practice but must first feel comfortable with the skills they have learned to apply them in clinical practice. The unique 
clinical experience these ATSs experienced was the combined experience of a graduate assistant athletic trainer preceptor who 
also assisted as a teaching assistant in the classroom. This allowed the preceptor to help the ATSs expand on the information provided 
in the classroom and apply it directly to clinical experiences. The ATSs also used standardized patient encounters to practice clinical 
skills in a moderated environment to improve patient care before directly treating patients. The ATSs at this clinical education site 
each had the opportunity to practice autonomously in the treatment of patients. The preceptors taught by example and allowed 
each student to progress independently, making clinical decisions autonomously. Mock scenarios and standardized patients provided 
real-life clinical scenarios to the ATSs. These experiences helped determine the skills and knowledge that lacked proficiency and 
needed to be practiced before treating patients. To maximize patient-centered care, ATSs should be allowed to assist in daily 
decision-making and patient encounters until they feel ready to work more autonomously. Each AT student has a different learning 
style; early and frequent communication with ATSs will allow for a more beneficial clinical education experience.  
Content Focus: Health Professions Education   
 
Correspondence 
Dr. Zachary Winkelmann, 1300 Wheat Street, Columbia, SC 29208. 
E-mail: winkelz@mailbox.sc.edu   
Twitter: @zachwinkelmann 
 
Full Citation 
Kingsley A, Fraley AL, Richards KM, Drescher MJ, Winkelmann ZK. Prioritizing patient-centered care when integrating athletic 
training students into clinical practice. Clin Pract Athl Train. 2023;6(2): 58-64. https://doi.org/10.31622/2023/0006.02.10.  
 

 
INTRODUCTION 

Athletic trainers work with various patient populations to deliver patient-centered care at the highest 
standard. Patient-centered care is a shared decision-making process that considers patients' needs while 
treating them.1  This can be achieved through cultural competency, using personal pronouns, setting short 
and long-term goals with the patient, and using patient-reported reported outcome measures. Athletic 
trainers typically work with patients daily and gain their trust through patient interactions. For many 
athletes, athletic trainers are the main point of contact when it comes to their healthcare needs. According 
to collegiate student-athletes, the two main strengths of athletic trainers regarding patient-centered care 
were providing culturally competent care and care that was respectful to what they wanted.2 These 
athletes also responded that they wanted the care provided to them to be individualized and for them to 
be treated as a priority.2  

One of the six core competencies required for accredited professional athletic training programs is 
patient-centered care.3 The athletic training students (ATS) are taught the principles of patient-centered 
care in the classroom and expected to implement these concepts into clinical education experiences under 
the guidance of the supervising athletic trainer, otherwise referred to as the preceptor. Athletic trainers 
who serve as preceptors are tasked with the role of providing ATSs with mentorship and feedback in their 
clinical education. ATSs need direct clinical education experiences to improve their skills and confidence 
when treating patients, but the patient preference about their preferred provide must be considered when 

mailto:winkelz@mailbox.sc.edu
https://doi.org/10.31622/2023/0006.02.10


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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 6 – Issue 2 – September 2023 

being treated by an ATS or their supervising athletic trainer. It is the job of this preceptor, along with the 
athletic training program, to determine if the AT student is prepared to provide patient care and to ensure 
that the care they are providing is patient-centered and appropriate. 

Research has been conducted analyzing patient satisfaction and patient-centered care of the services 
provided by athletic trainers. However, limited research is available on the athlete’s perception of patient-
centered care provided by ATSs because the patient care provided falls under the preceptor's 
responsibility. ATSs need to gain experience and confidence in preparation for certification, which occurs 
through direct patient care. This paper aims to provide a case study on a unique clinical experience to 
achieve the goal of proficiency in patient-centered care by ATSs. 

ATHLETIC TRAINING STUDENT CHARACTERISTICS 

Throughout the academic year, four professional-level ATSs were assigned to two preceptors who 
provided care to University of South Carolina swim and dive student-athletes. The ATSs were all enrolled 
in the same post-baccalaureate athletic training program. During the fall semester, a second-year AT 
student was present for the entirety of the semester and acted as a mentor to two different first-year ATSs 
assigned to the clinical education site. The second-year student had completed all classes for evaluation 
and therapeutic intervention and was able to perform injury evaluations and assist with designing 
treatment and rehabilitation plans. The two first-year ATSs were enrolled in evaluation and therapeutic 
intervention of lower extremity injuries and could implement evaluation and treatment skills learned in the 
classroom directly into clinical practice. During the spring semester, one first-year ATS had completed the 
lower extremity orthopedic evaluation class and was learning evaluation skills for head, neck, spine, and 
abdominal injuries. The program curriculum is detailed in Table 1 below.  

CLINICAL MENTOR CHARACTERISTICS 

Two athletic trainers were employed at this clinical education site and both served as preceptors for the 
students throughout the year. The patient population consisted of NCAA Division 1 collegiate men’s and 
women’s swim and dive student-athletes aged 18 to 24 years old. The head athletic trainer was in their 
third year as the athletic trainer for swim and dive and has been certified for six years with previous 
experience working with patients in the NCAA Division I, high school, and orthopedic clinic settings. The 
head athletic trainer had four years of previous preceptor experience. The graduate assistant athletic 
trainer worked with the swim and dive team for the entirety of the academic year. The graduate assistant 
was in their second year as an athletic trainer and had previous experience working with secondary school 
patients between 10 and18 years old. This was the first year of preceptor experience for the graduate 
assistant. In addition to their duties with the swim and dive team, the graduate assistant athletic trainer was 
also a teaching assistant for the first-year students in both the fall and spring semesters, assisting in the 
evaluation and therapeutic intervention courses while providing additional help in the lab portion of the 
class, proctoring exams, and grading assignments.  

EXPERIENCE 

The goals of this clinical experience for the ATSs were to implement skills learned in the classroom and to 
improve autonomous clinical decision-making under the supervision of assigned preceptors. The ATSs 
assigned to this clinical site both in the fall and the spring semesters experienced unique clinical  

 



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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 6 – Issue 2 – September 2023 

Table 1. Professional Athletic Training Education Program Curriculum 
Year 1 Classes 

Summer 
Human Anatomy for Health Sciences 
Introduction to Therapeutic Interventions in Athletic Training 
Principles of Evidence-Based Medicine 
Principles of Athletic Training Lab 

Fall 
Evaluation & Therapeutic Intervention of Lower Extremity Injuries (+Lab) 
Behavioral Health & Wellness 
Clinical Experiences in Athletic Training I 

Spring 
Evaluation & Therapeutic Intervention of Head, Neck, Spine, and Abdomen Injuries (+Lab) 
Clinical Pathology & Pharmacology in Athletic Training (+Lab) 
Transforming Health Care for the Future 
Clinical Experiences in Athletic Training II 

Year 2 Classes 
Summer 

Evaluation & Therapeutic Intervention of Upper Extremity Injuries (+Lab) 
Emergency Management Practices in Athletic Training 
Clinical Experiences in Athletic Training III 

Fall 
Athletic Training Administration 
Advanced Clinical Skills in Athletic Training 
Clinical Experiences in Athletic Training IV 

  

teaching by having a preceptor (the graduate assistant athletic trainer) who was also a teaching assistant 
and helped educate ATSs in both the classroom and clinical setting. The two preceptors were able to work 
together to provide educational examples and different views on patient care. In the fall semester, the 
second-year ATS mentored both first-year ATSs and took autonomy when writing rehabilitation programs 
for lower extremity injuries. The first-year ATSs, with the assistance of the graduate assistant athletic 
trainer, took the information they had just learned in class regarding lower extremity injuries and 
transferred that information into sport-specific demands required of the patients by designing 
rehabilitation plans that conformed to the needs of the sport. In the spring semester, the first-year ATSs 
had the opportunity to evaluate any lower extremity injury as they had completed that class in the fall and 
any spine, neck, or abdomen injuries once they learned about them in class that spring. 

The graduate assistant athletic trainer was able to observe in the classroom exactly how the ATSs were 
being taught and assist during additional, structured practice lab sessions to ensure the students were 
performing all skills correctly. The practice lab was a time for ATSs to review class material, including skills 
learned in their orthopedic evaluation and clinical pathology courses. While some ATSs practiced their 
skills and signoffs in practice lab only, the ATSs at this clinical site practiced evaluation and patient care 
skills weekly with the preceptors because the graduate assistant athletic trainer was aware of the material 
they were practicing in class. The graduate assistant athletic trainer would portray a patient and have the 
ATSs perform clinical skills and practice patient-centered care in a mock scenario first to offer corrections 
and advice before allowing the ATSs to work with patients.  

Because the graduate assistant athletic trainer was present one day a week in the evaluation classes for 
the first-year ATSs, they could also implement material the ATSs were learning directly into clinical practice 



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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 6 – Issue 2 – September 2023 

that same day. This included implementing new rehabilitation exercises, documentation, range of motion 
and special tests, and conversations reviewing classroom material and applying it to real-life experiences 
and patients. By observing the ATSs working one-on-one with a patient, even in a mock scenario, the 
graduate assistant athletic trainer was able to find ways to improve the ATSs’ patient care and help 
implement these improvements directly into clinical practice. As the ATSs became more proficient in their 
clinical skills, as graded on a 0-2 point scale (0 being could not complete, 1 being able to complete skill 
but not proficiently, and 2 being proficient application of clinical skill), the preceptors allowed the ATSs to 
become more involved in the decision-making process of patient care instead of directing the ATSs with 
what to do.  

The professional master’s athletic training program also uses a standardized patient (SP) encounter as a 
part of the evaluation and treatment education courses. A SP is a layperson evaluated by the ATS and 
pretends to have a certain injury/illness.4 These encounters can be observed via webcam, so the simulation 
is realistic for the student, providing additional training and practice in real-life scenarios in a moderated 
environment. The role of the graduate assistant athletic trainer was to watch the live recording of the SP 
encounters and provide feedback and grading to the ATSs as part of the teaching assistant duties.  

RESULTS AND DISCUSSION 

Outside of providing patient care, another potential part of an athletic trainer’s job is to educate ATSs 
about the profession by working as a preceptor. ATSs work with their preceptors to gain confidence in 
patient care by implementing core competencies required for certification. ATSs have shown that they do 
implement core competencies in their patient encounters.5 In a study examining ATSs, as the number of 
patient encounters for each ATS increased, the total number of core competencies students used in clinical 
practice also increased.5 It was also found that patient-centered care was the most likely core competency 
implemented into the clinical practice of these students.5 The ATSs had many opportunities to use patient-
centered care throughout their time with the swim and dive clinical experience as they became more 
comfortable performing clinical skills practiced with the preceptors. The ATSs were tasked with leading 
rehabilitation sessions with patients and performing evaluations on areas of the body they had already 
learned once they demonstrated competence in these areas. The ATS in the spring semester was 
apprehensive when taking the initiative and working autonomously and relied on the guidance of the 
preceptors when making all clinical decisions. This ATS was limited to gaining firsthand experience as they 
were in class four days a week during open treatment/clinic hours at the clinical site. In addition, this ATS 
had fewer real-life evaluations because the teams were in their off-season for most of the clinical rotation. 
To supplement the ATS’s learning, the preceptors implemented mock clinical scenarios throughout the week 
to allow the ATS to practice evaluation and treatment skills. 

The preceptors at this clinical site allowed both the first- and second-year students as much autonomy while 
treating patients as the ATSs were comfortable with. According to a survey of approved clinical instructors 
(former term to describe preceptor), most reported that the professional athletic training program required 
students to be evaluated on clinical proficiencies in a controlled classroom setting before allowing them to 
practice on actual patients.6 As the ATSs develop their clinical skills through the classroom, they also 
practice those skills on patients at assigned clinical sites once the preceptor determines the professional 
students are ready. There is a balance in allowing ATSs to gain direct clinical experience while also putting 
the patient’s needs and safety first when students do not have enough experience to provide a practical 
evaluation. The roles of the preceptors at this clinical education site were to determine when the ATSs were 
ready to provide autonomous patient care, determined by competence in clinical skills and ability to 
determine clinical decisions. In the second semester, the ATS struggled to take initiative with patient care, 



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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 6 – Issue 2 – September 2023 

and the preceptors were flexible when allowing more time and resources and better address that 
individual AT student’s needs through additional mock scenarios before they were ready to provide 
patient care to student-athletes. Although the ATS was less involved with direct patient care, the preceptors 
ensured the involvement of the ATS when designing rehabilitation and treatment plans, using concepts 
taught in the classroom and explaining how they correlated to clinical practice.  

From the ATS’s perspective, preceptors who allow students to grow in their clinical practice of critical 
thinking, decision-making, and independent thought help with their transition to autonomous clinical 
practice.7 It was found that ATSs benefited the most from and implemented the most core competencies 
when they assisted their preceptor during a patient encounter versus just observing or working 
independently.5 By assisting their preceptors, the ATSs were corrected and followed the lead of their 
preceptors when providing patient-centered care. Allowing ATSs to be part of the decision-making process 
allows them to develop these skills. In a study examining patient outcomes after treatment performed by 
ATSs, there was no difference in the functional improvement of the patient when comparing treatment 
performed by ATSs in their first clinical internship versus those in their second.8 ATSs can provide patient 
care regardless of whether they are in the first or second year of their athletic training program and will 
benefit from gaining hands-on experience early in their education. Being able to apply skills they learn in 
the classroom to “real-world athletic training learning experiences” is important to the ATS’s education and 
development of confidence in themselves and their skills.9 Each ATS at this clinical education site learned 
best in different ways. The second-year student was proficient in most of their clinical skills and abilities but 
lacked confidence when making clinical decisions and looked to the preceptors for answers to specific 
treatment and exercises to do with patients. Toward the end of the semester, the second-year ATS was 
performing full evaluations, writing rehabilitation and treatment plans for patients, and conversing with 
coaches. This ATS learned best through experience and was pushed to work outside their comfort zone to 
make clinical decisions autonomously. All three first-year ATSs learned best through collaborative practice, 
working with a preceptor to provide treatment and make clinical decisions. However, they all progressed 
throughout the clinical rotation to become more confident in their patient care choices. They became 
competent in clinical skills practiced at this clinical education site.  

Other healthcare professions recognize the importance of teaching patient-centered care to their students 
and residents. In a survey among pharmacy residents, the program used interviews with veterans to 
improve patient-centered care.10 The residents reported that through the interview process, they helped 
create positive relationships with patients and improved upon their personal skills as a clinician.10 For 
medical school students, those in their clinical years of education had a more positive perspective towards 
empathy and, in turn, had better support toward patient-centered care.11 The results of this study show 
that as ATSS increase time in clinical education with patient interaction, they can incorporate more 
components of patient-centered care into their clinical practice and improve relationships with patients. 
However, medical students spend a great deal longer immersed in a clinical experience than ATSs do, 
forcing ATSs to develop communication and clinical skills much quicker. There is a lack of time and real-life 
opportunities for these ATSs to provide evaluations for various medical conditions and injuries.6 Medical 
students participating in their clerkship rotation with clinical experience ranging from zero to 10+ previous 
clinical rotations recognized the impact of patient-centered care on patients and medical professionals.12 
These students were aware that care that is individualized to the patient creates shared responsibility and 
decision-making between the patient and the health care provider.12 ATSs benefit from assisting their 
preceptor during patient encounters, meaning that the preceptor and ATS can work as a team to evaluate 
athletes to ensure that the care provided is appropriate while allowing the ATS firsthand experience.5 



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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 6 – Issue 2 – September 2023 

There has been an increased use of SP encounters as part of the clinical education of healthcare 
professionals. In a study on nursing students regarding the use of a SP encounter, it was found that those 
nursing students who participated found it to be more realistic when compared with using a simulated 
patient or mannequin.13 These nursing students also reported increased self-confidence after participating 
in the SP encounter.13 The ATSs are individually evaluated on their clinical skills using SP encounters several 
times throughout their two years in the education program. Usiing the information gained from observing 
the ATSs in the SP encounters, the graduate assistant athletic trainer could implement specific skills or 
focuses that the ATSs struggled with during weekly practice sessions and daily encounters with patients. The 
SP encounter allows the ATS to fully evaluate a patient, determine a diagnosis and treatment plan, and 
practice patient-centered care without the assistance of a preceptor. The use of SP encounters can help 
increase confidence in healthcare students by allowing them to perform a full evaluation autonomously and 
in a safe environment before clinical practice.  

CLINICAL TEACHING BOTTOM LINE 

Patient-centered care can be improved among ATSs by implementing the core competencies during clinical 
education. This can be achieved by observing and working with preceptors in clinical practice. The safety 
and well-being of the patient are the priority of the healthcare provider; to prepare ATSs for autonomous 
clinical practice, they must be introduced to clinical situations and decision-making regarding patient care. 
It is always important to put the best interests of the patient first, and before any patient encounters, the 
athletic trainer should confirm with the patient that they are comfortable with ATSs assisting and providing 
patient care. Being able to provide continuity of learning from the classroom to the clinical site can help 
improve ATSs’ retention and implementation of clinical skills and practice. Still, as clinical educators, 
preceptors should strive to include ATSs in the patient care and decision-making process rather than relying 
solely on observation. 

Each ATS will learn best in different ways, and good communication and flexibility are required on the 
preceptor’s part to be an effective teacher. The recommendations for clinical practice based on the 
research to maximize patient-centered care and the ATS’s experience are to allow ATSs to assist in daily 
decision-making, and patient encounters until they feel ready to work more autonomously. The professional 
athletic training educational program can also utilize SP encounters in didactic education to help create 
scenarios that ATSs might not see in clinical practice to give them a variety of experiences and practice in 
a controlled environment. Further, athletic training programs should encourage the integration of 
preceptors into didactic education to enhance the connection between classroom and clinical education. The 
most important aspects of being a preceptor are good communication with the ATS, instilling confidence in 
these students by providing constructive feedback, and allowing them to successfully practice their skills 
with proper guidance to prepare them for autonomous practice. ATSs are the profession's future and must 
obtain the skills to provide patient-centered care.  

REFERENCES 

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All rights reserved. ISSN Online 2577-8188                                                                     Volume 6 – Issue 2 – September 2023 

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https://doi.org/10.4085%2F1062-6050-314-16
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https://doi.org/10.1177/2377960820930153

	ABSTRACT

