






































MANUSCRIPT TYPE


CLINICIAN EXPERTISE COMMENTARY 

 

5 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                                  Volume 7 – Issue 2 July 2024 
 

The Development, Implementation, and Value of the Athletic Training 
Milestones for Assessing Progressive Clinical Behaviors 
 
Hollie Walusz, MA, ATC *; Eric Sauers, PhD, ATC, FNATA†; Mark Laursen, MS, ATC *; Forrest Pecha, MS, ATC‡ 
*Boston University, Boston, MA; †A.T. Still University, Meza, AZ; ‡Steamboat Orthopaedic and Spine Institute, Steamboat Spring, 
CO 

 
Content Focus 
Vitality of The Profession, Health Professions Education 
 
Correspondence 
235 N Billerica Rd, Tewksbury, MA 01876 
E-mail: hjwalusz@bu.edu 
 
Reference 
Walusz H, Sauers E, Larsen M, Pecha F. The development, implementation, and value of the athletic training 
milestones for assessing progressive clinical behaviors. Clin Pract Athl Train. 2024;7(2): 5-11. 
https://doi.org/10.31622/2024/0007.02.2.  
 
Author Characteristics 
Hollie Walusz currently serves as a Head Athletic Trainer for Boston University and has served as the Residency Program Director 
since 2016. She has been a preceptor for professional programs, faculty in a baccalaureate program and professional program, 
is affiliate faculty in a DAT program, affiliate faculty in a Neurology fellowship program, and is core faculty and program director 
for a Commission on Accreditation of Athletic Training Education (CAATE)-accredited Orthopedic residency program. She has seen 
the impact of the AT Milestones first-hand across all levels of AT education as well as use for professional growth. Hollie speaks 
nationally regarding the use of the AT Milestones in athletic training. Additionally, Hollie speaks nationally regarding residency and 
fellowship training as a catalyst to advance the profession. She serves as the Chair of the Residency and Fellowship Council for the 
CAATE and was previously the Chair of the Residency and Fellowship Standards Committee for the CAATE. 
 
Dr. Eric L. Sauers is a tenured Full Professor and Dean of the College for Healthy Communities at A. T. Still University in Santa Maria, 
California. He served the CAATE for 11 years in numerous roles, including as President, Vice President, and Commissioner. Dr. Sauers 
has published numerous peer-reviewed scientific articles and given numerous state, regional, national, and international presentations 
related to his research and scholarship. 

Mark Laursen currently serves as the Residency and Fellowship Director for the CAATE and as an Adjunct Clinical Associate Professor 
at Boston University. From 2008 until 2022, Mark served Boston University as the Director of Athletic Training Services and as a 
Clinical Associate Professor in Boston University's Sargent College of Health and Rehabilitation Sciences. 

Forrest Pecha serves as the Clinical Outreach Director at Steamboat Orthopaedic and Spine Institute in Steamboat Springs, Colorado, 
and Medical Coordinator for Steamboat Springs Winter Sports Club. Previously, he was the Program Director for the Athletic Training 
Residency at both St. Luke's Sports Medicine in Boise, ID and at Emory Sports Medicine in Atlanta, GA. Forrest has served the 
profession through the CAATE, BOC, and NATA for over 20 years. He was one of the founders of Athletic Trainers in the Physician 
Practice Society (ATPPS), past President of the ATPPS Board of Directors, and past commissioner for the CAATE. 

 
COMMENTARY 

Background 

The development of the Athletic Training Milestones (AT Milestones) ©1 (Appendix 1) began as an effort to 
enhance and facilitate the assessment of learners in athletic training residency programs. However, during 
the development process, it became apparent that they could have much greater utility for the profession if 
they were developed to assess progressive clinical behaviors of learners, throughout the continuum of 
learning, from professional-level training through specialist and subspecialist training. The AT Milestones 
were developed to facilitate the observation and assessment of clinical behaviors across the six general core 
competencies adapted from the Accreditation Council for Graduate Medical Education (ACGME)2,3 and the 

https://doi.org/10.31622/2024/0007.02.2


The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

6 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                                  Volume 7 – Issue 2 July 2024 

eight specialty areas identified by the Commission on Accreditation of Athletic Training Education (CAATE).4  

The authors designed the AT Milestones based closely upon the ACGME Milestones to provide a mechanism 
to allow mentors, peers, and other healthcare providers to assess an individual’s clinical behavior in one, 
more, or all of the competency areas. To date, the authors have completed the AT Milestones for all six 
ACGME core competencies and five of the eight specialty areas. The specialty areas were developed in 
collaboration with clinicians who have specialty content expertise in one or more of the respective specialty 
areas.  

Development 

The AT Milestones levels of progression were derived from the Dreyfus model of skill acquisition. The Dreyfus 
model is a five-stage model of skill acquisition frequently cited in the healthcare education literature that 
plots one’s progression through a series of five levels: novice, advanced beginner, competent, proficient, and 
expert.5 Specifically, the model suggests that learners progress from rigid adherence to rules and procedures 
(novice) to a largely intuitive mode of operation that relies heavily on deep, implicit knowledge (expert). 
The ACGME recommends this model for curriculum planning for residency training programs.6 The AT 
Milestones have adopted the Institute of Medicine criteria for quality care, which involves delivering safe, 
timely, effective, efficient, equitable, and patient-centered care (STEEP).7 The authors utilized the theoretical 
framework outlined by Dreyfus and the ACGME general competencies model, in which specific milestones 
have been developed for all medical specialties. In completing this work, the authors looked specifically at 
milestones from Family Medicine, Internal Medicine, Physical Medicine and Rehabilitation, Orthopaedic 
Surgery, Emergency Medicine, and both Orthopaedic Sports and Sports Medicine specialties to develop 
and adapt specific milestone narratives for athletic training practice.8-14  

This framework, in combination with the vision towards competency-based education (CBE) in medicine and 
competency-based developmental outcomes, led to the completion of the AT Milestones. CBE is a 
fundamentally flexible and outcome-centric educational framework that removes time-based constraints and 
focuses on the learner.15,16 CBE is an innovative advance in higher education that organizes content or 
delivery according to competencies, what a learner knows and can manage, and allows one to use 
experiences, skills, and knowledge to complete the training needed to pursue their goals.13 CBE in medical 
education, was an approach to designed to prepare physicians for practice that is fundamentally oriented 
to graduate outcome abilities and organized around competencies derived from an analysis of societal and 
patient needs.16 

The AT Milestones expand on these efforts to identify and achieve outcomes for teaching and learning in 
athletic training. Competency-based assessment is formative, aiming to monitor how one is learning, thinking, 
and applying knowledge.15 It is important to remember that competence is not fixed, and anyone can move 
forward or slide backward on the continuum based on how intentional the learner is in integrating the 
competencies into practice. One intentional addition to the AT Milestones was the inclusion of ‘Critical 
Deficiencies.’ Not all medical specialties include this anchor in their Milestones, but Internal Medicine does, 
and the authors considered their inclusion important for communicating to a learner what behaviors may 
negatively impact patient safety or represent unacceptable practice.17 

Perhaps one of the most valuable and unique features of the AT Milestones, compared to those developed 
in medicine and other healthcare professions, is the inclusion of milestones (observed behaviors) consistent 
with an early learner (Levels 1 and 2), someone ready for unsupervised practice (Level 3), someone who has 
completed specialty training (Level 4), and aspirational behaviors emblematic of a clinical expert (Level 5), 
which should represent the continuum of an athletic trainer’s career (Table 1). Significant time was spent 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                                  Volume 7 – Issue 2 July 2024 

discussing what observed patient care behaviors were necessary for someone to complete a professional 
program and practice athletic training unsupervised (Level 3). Similarly, significant time was spent discussing 
the progression from generalist to specialist and how those behaviors should change with additional 
education and training (Level 4). These discussions were not based on formal documents such as the CAATE 
Standards or the BOC Practice Analysis, but rather on the author's significant combined expertise in athletic 
training, healthcare, and education to represent a ‘preferred state.’ Instead, they are independent of other 
prescribed expectations and seek to articulate a shared vision for highly competent athletic training practice 
to which we hope all educators and clinicians aspire. Each competency and sub-competency, along with 
every milestone at every one of the five levels, is subject to scrutiny. Over time, we hope that researchers 
and clinical specialists in each area may debate and challenge the assumptions within the AT Milestones and 
they will be iteratively enhanced through ongoing analysis.  

Implementation 

Formative and summative assessment alongside clear and constructive feedback are essential to a learner’s 
growth and development. Traditional exams and checklists often miss the integral behaviors and assessment 
of skills encompassed within a comprehensive competency-based tool. Kak, et al. found that written tests are 
probably the furthest from, and the weakest predictor of, actual job performance, whereas job samples are 
among the best predictors of job performance in healthcare.18 Job samples, with periodic appraisals by 
supervisors, peers, and self, require both observation and evaluation and are used to infer competence.18  

The goal of a formative assessment is to monitor learning and provide feedback that can be used to improve 
performance. Studies have shown that programs that deeply invest in training, simulation, supervision, and 
frequent feedback may result in a marked shortening of training.19,20 The AT Milestones can be used in this 
manner via multiple established time points throughout a program and, subsequently, the clinical 
performance across the span of the clinician’s education or training, encompassing the entire continuum of 
learning. In our own use, we have found more meaningful assessments and subsequent debriefing sessions 
open a dialogue for forward progression and opportunities for the individual user. Through the 
programmatic quality improvement process, feedback from faculty and learners alike have denoted the AT 
Milestones improve in the quality of formative feedback, establish transparent criteria that limits bias or 
confusion in scores because of established benchmarks, and provide a more accurate way to capture the 
totality of the learner’s transfer of knowledge, skills, and abilities to patient care and working within a 
healthcare system. In our experience, the AT Milestones have offered the faculty and learners easily 
identifiable criteria and thresholds for a given score, allowing for consistency of grading amongst users, and 
allows the program to tailor teaching and learning to the needs of each learner. Leach described the 
treatment of the patient as an art, denoting the importance of finding harmony between biomedical 
knowledge, technology, and a patient-facing approach to healthcare to improve patient care.21 The AT 
Milestones allow for the assessment of clinical behaviors in an ongoing and consistent basis and allow for the 
development of individualized learner plans with specific examples of what one does well and areas of 
opportunity for growth as it relates to patient care across a broad spectrum of healthcare competencies. 

It is essential to use a summative assessment mechanism to evaluate learning so the program can feel 
confident that the learner has met the threshold expectation for the type of program they are progressing 
through (professional, residency, fellowship, doctoral) or for the time and space they are in relative to 
continuing professional development. By tying together foundational knowledge both scientifically and in the 
practice of athletic training, the AT Milestones allow for evaluation of one’s ability to apply all they have 
learned to the patient, quantify readiness to practice, and ultimately produce highly competent/proficient 
clinicians to meet the healthcare needs of the public. In addition, the capacity of the AT Milestones to facilitate 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

8 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                                  Volume 7 – Issue 2 July 2024 

this summative assessment in athletic training education further implicates their use in both professional and 
post-professional athletic training education. We have also found that the AT Milestones can be used as a 
summative evaluation, providing both the learner and the program (or other relevant parties) clarity in 
expectations upon program completion. Additionally, evidence supports the tool as having excellent content 
validity for the general competency milestones, indicating the AT Milestones can be used to assess an athletic 
trainer’s or athletic training student’s progression of independent knowledge, skill, and behavior acquisition.22  

When implementing the AT Milestones, consideration should be given to how to best analyze, synthesize, 
and deliver information garnered from the tool in addition to training on how to use the tool, frequency of 
use, and selection of individuals performing the assessment. In physician education, Milestones are typically 
used every 3-6 months,2,3 so it is important to use the tool in conjunction with other measures to supplement 
multisource feedback. The orthopedic residency and neurology fellowship programs at Boston University use 
the tool in multiple ways across four time points. It first serves as a training tool on expectations of 
foundational core competencies and specialty competencies within the residency and fellowship programs 
upon hire. It is then used for self-assessment as a mode of exposure to and training of the tool early in the 
program for formative discussions. This is followed by self-assessment, peer assessment, and clinical faculty 
assessment at both mid-experience (for formative feedback) and end of the experience as a summative 
assessment tool. The final element is to determine who is doing the assessment. It is important to develop a 
Clinical Competency Committee (CCC) made up of those who mentor and observe the learner’s practice and 
behaviors in a clinical capacity on an ongoing and consistent basis.23 Depending on the size of the learner 
groups being assessed, the literature suggests the CCC be a minimum of 3 individuals, but ideally made up 
of 5 to 7 people.23 The role of the members of the CCC is to create accountability that graduates will 
provide safe, high-quality care to patients and maintain the standards of the healthcare system.  

Value 

Detailed and immediate feedback to healthcare providers about their competence helps them learn and 
improve performance.18 The primary authors of the AT Milestones believe that they are a valuable tool to 
assess and provide feedback about progressive clinical behaviors to ensure competence at graduation from 
a professional program and upon completion of specialty or subspecialty training. Regardless of where an 
individual is within their professional development, the AT Milestones provide explicit examples of clinical 
competence at increasing levels, including aspirational milestones, for every competency area. In this way, 
the authors have also found that the AT Milestones are useful to practicing athletic trainers for self-assessment 
and reflection on one’s growth and continued professional development.  

The AT Milestones have been found to have content validity22 and serve as a feasible assessment24 across a 
broad spectrum of education. The AT Milestones have also recently been used to assess didactic components 
of a Doctor of Athletic Training (DAT) program, for learning activities such as quality improvement projects 
and case presentations. There is also preliminary evidence of the use of the AT Milestones in professional 
education.24 Future work examining the value of the AT Milestones in different types of programs and for 
various purposes is warranted. However, a significant benefit of the AT Milestones is that they are based on 
the same theoretical model as the medical milestones, which have a rich and growing research base to 
support their use.25  

Perhaps more importantly, the AT Milestones serve as a reflective tool that can help capture where the 
athletic trainer has started and identify their current depth and breadth of knowledge, skills, attitudes, and 
behaviors in each of the respective competencies and sub-competencies. In this sense, the tool can 
subsequently provide a map of what the learner needs to continue to grow and develop in a particular 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

9 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                                  Volume 7 – Issue 2 July 2024 

area. The narrative descriptors within each performance level outline a framework of observable behaviors 
and other attributes required to build individualized professional growth plans. These narratives can help 
guide planning and continuing development along the continuum and progression of learning throughout 
one’s career. Multiple studies cite the importance of self-reflection,26-28 so using that in conjunction with valid 
feedback is a sound approach to building a plan for continued professional growth and to amplify learning. 

By providing a tool for assessing progress and defining global athletic training competencies within the 
healthcare system, we believe that educators can be aided in producing competent and proficient clinicians 
who can better treat the public and subsequently advance the athletic training profession. We, as clinical 
educators, should all strive to be lifelong learners who are able to ensure we, too, are continually developing 
our clinical expertise. The AT Milestones provide added value to the profession in the form of a valid 
instrument to assess competence and growth both within athletic training education and across the continuum 
of professional practice, ultimately advancing and promoting growth and change in the profession. 

 

REFERENCES 

1. Athletic Training Milestones Project. AT Milestones Website. https://www.atmilestones.com. 2018 © 
2. Accreditation Council for Graduate Medical Education. Milestones Resources. 

https://www.acgme.org/milestones/resources  
3. Accreditation Council for Graduate Medical Education. The Milestones Guidebook. 

https://www.acgme.org/globalassets/milestonesguidebook.pdf 
4. CAATE Approved Residency Specialty Areas. CAATE Website. https://caate.net/Programs/Residency-

Fellowship 
5. Dreyfus and Dreyfus. A five-stage model of the mental activities involved in directed skill acquisition. 

Unpublished Report, University of California, Berkely, 1980. 
6. Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. General competencies and accreditation in 

graduate medical education. Health Aff. 2002;21(5):103-111. doi:10.1377/hlthaff.21.5.103 
7. Six Domains of Healthcare Quality. Agency for Healthcare Research and Quality. 

https://www.ahrq.gov/talkingquality/measures/six-domains.html 
8. Accreditation Council for Graduate Medical Education. Milestones Resources. Family Medicine 

Milestones. https://www.acgme.org/globalassets/PDFs/Milestones/FamilyMedicineMilestones.pdf 
9. Accreditation Council for Graduate Medical Education. Milestones Resources. Internal Medicine 

Milestones. https://www.acgme.org/globalassets/PDFs/Milestones/InternalMedicineMilestones.pdf 
10. Accreditation Council for Graduate Medical Education. Milestones Resources. Orthopaedic Sports 

Medicine Milestones. 
https://www.acgme.org/globalassets/PDFs/Milestones/OrthopaedicSportsMedicineMilestones.pdf 

11. Accreditation Council for Graduate Medical Education. Milestones Resources. Sports Medicine 
Milestones. https://www.acgme.org/globalassets/PDFs/Milestones/SportsMedicineMilestones.pdf 

12. Accreditation Council for Graduate Medical Education. Milestones Resources. Physical Medicine and 
Rehabilitation Milestones. https://www.acgme.org/globalassets/pdfs/milestones/pmrmilestones.pdf 

13. Accreditation Council for Graduate Medical Education. Milestones Resources. Emergency Medicine 
Milestones. https://www.acgme.org/globalassets/PDFs/Milestones/EmergencyMedicineMilestones.pdf 

14. Accreditation Council for Graduate Medical Education. Milestones Resources. Orthopaedic Surgery 
Milestones. 
https://www.acgme.org/globalassets/PDFs/Milestones/OrthopaedicSurgeryMilestones.pdf 

https://www.atmilestones.com/
https://www.acgme.org/milestones/resources
https://www.acgme.org/globalassets/milestonesguidebook.pdf
https://caate.net/Programs/Residency-Fellowship
https://caate.net/Programs/Residency-Fellowship
https://www.ahrq.gov/talkingquality/measures/six-domains.html
https://www.acgme.org/globalassets/PDFs/Milestones/FamilyMedicineMilestones.pdf
https://www.acgme.org/globalassets/PDFs/Milestones/InternalMedicineMilestones.pdf
https://www.acgme.org/globalassets/PDFs/Milestones/OrthopaedicSportsMedicineMilestones.pdf
https://www.acgme.org/globalassets/PDFs/Milestones/SportsMedicineMilestones.pdf
https://www.acgme.org/globalassets/pdfs/milestones/pmrmilestones.pdf
https://www.acgme.org/globalassets/PDFs/Milestones/EmergencyMedicineMilestones.pdf
https://www.acgme.org/globalassets/PDFs/Milestones/OrthopaedicSurgeryMilestones.pdf


The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                                  Volume 7 – Issue 2 July 2024 

15. Mace KL, Bacon CEW. The Future of Health Professions Education: Considerations for Competency-
Based Education in Athletic Training. Athl Train Educ J. 2019;14(3):215-222. doi:10.4085/1403215 

16. Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-
based education in medicine: a systematic review of published definitions. Med Teach. 
2010;32(8):631-637. doi:10.3109/0142159X.2010.500898 

17. Kinnear B, Bensman R, Held J, O’Toole J, Schauer D, Warm E. Critical Deficiency Ratings in Milestone 
Assessment: A Review and Case Study. Acad Med. 2017;92(6):820. 
doi:10.1097/ACM.0000000000001383 

18. Kak N, Burkhalter B, Cooper MA. Measuring the competence of healthcare providers. Oper Res Issue 
Pap. 2001;2(1):1-28. 

19. Ten Cate O, Hart D, Ankel F, et al. Entrustment Decision Making in Clinical Training. Acad Med. 
2016;91(2):191. doi:10.1097/ACM.0000000000001044 

20. Ten Cate O. A primer on entrustable professional activities. Korean J Med Educ. 2018;30(1):1-10. 
doi:10.3946/kjme.2018.76 

21. Leach DC. Changing education to improve patient care. Postgrad Med J. 2008;84(994):437-441. 
doi:10.1136/qhc.100054 

22. Welch Bacon CE, Anderson BE, Cavallario JM, Van Lunen BL, Eberman LE. Content Validation of the 
Athletic Training Milestones: A Report from the Association for Athletic Training Education Research 
Network. J Athl Train. 2023;58(5):483-487. doi:10.4085/1062-6050-0332.22 

23. Accreditation Council for Graduate Medical Education. Clinical Competency Committee Guidebook. 
https://www.acgme.org/globalassets/acgmeclinicalcompetencycommitteeguidebook.pdf 

24. Welch Bacon CE, Anderson BE, Cavallario JM, Van Lunen BL, Eberman LE. 
Perceptions and use of the athletic training milestones in education: A report from 
the AATE research network. Clin Pract Athl Train. 2024;7(2): 11-26. 
https://doi.org/10.31622/2024/0007.02.3.  

25. Accreditation Council for Graduate Medical Education. Research and Reports. 
https://www.acgme.org/milestones/research/ 

26. Koshy K, Limb C, Gundogan B, Whitehurst K, Jafree DJ. Reflective practice in health care and how to 
reflect effectively. IJS Oncol. 2017;2(6):e20. doi:10.1097/IJ9.0000000000000020 

27. Winkel AF, Yingling S, Jones AA, Nicholson J. Reflection as a Learning Tool in Graduate Medical 
Education: A Systematic Review. J Grad Med Educ. 2017;9(4):430-439. doi:10.4300/JGME-D-16-
00500.1 

28. Carraccio C, Englander R, Gilhooly J, et al. Building a Framework of Entrustable Professional Activities, 
Supported by Competencies and Milestones, to Bridge the Educational Continuum. Acad Med. 
2017;92(3):324. doi:10.1097/ACM.0000000000001141 

29. Carraccio CL, Benson BJ, Nixon LJ, Derstine PL. From the Educational Bench to the Clinical Bedside: 
Translating the Dreyfus Developmental Model to the Learning of Clinical Skills. Acad Med. 
2008;83(8):761. doi:10.1097/ACM.0b013e31817eb632 

30. Meier AH, Gruessner A, Cooney RN. Using the ACGME Milestones for Resident Self-Evaluation and 
Faculty Engagement. J Surg Educ. 2016;73(6):e150-e157. doi:10.1016/j.jsurg.2016.09.001 

31. Nodine T r. How did we get here? A brief history of competency-based higher education in the United 
States. J Competency-Based Educ. 2016;1(1):5-11. doi:10.1002/cbe2.1004 

32. Park YS, Zar FA, Norcini JJ, Tekian A. Competency Evaluations in the Next Accreditation System: 
Contributing to Guidelines and Implications. Teach Learn Med. 2016;28(2):135-145. 
doi:10.1080/10401334.2016.1146607 

https://www.acgme.org/globalassets/acgmeclinicalcompetencycommitteeguidebook.pdf
https://doi.org/10.31622/2024/0007.02.3


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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                                  Volume 7 – Issue 2 July 2024 

33. Potts JR. Assessment of Competence: The Accreditation Council for Graduate Medical 
Education/Residency Review Committee Perspective. Surg Clin. 2016;96(1):15-24. 
doi:10.1016/j.suc.2015.08.008 
 

 

 
 

 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

 
 

Appendix 1: Athletic Training Milestones Template. 
 
The diagram below presents the standardized structure for each competency, sub-competency, and milestone with interpretations for each of the six levels of 
performance. In addition, each sub-competency is cross-referenced back to a specific ACGME sub-competency in parentheses after the sub-competency is 
stated. For each assessment period (defined by the end-user), an individual’s performance on the milestones for each sub-competency will be indicated by:  

• selecting the level of milestones that best describes the individual’s performance in relation to the milestones or,  
• selecting the “Critical Deficiencies” option  

 

General Competency (e.g., Medical Knowledge): Sub-Competency Stated (Reference to corresponding ACGME milestone) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Behaviors are not 
within the spectrum 
of developing 
competence 
 
Significant deficiency 
in learner 
performance 

 
 
 

What are the 
expectations for a 
beginning learner? 

What are the 
milestones for a 
learner who has 
advanced beyond 
beginner, but is not 
performing at a level 
sufficient for 
unsupervised 
practice? 
 
What should the 
learner be able to do 
well at this point in 
their training? 
 

What does a graduate 
of a professional 
program look like? 
 
What additional 
knowledge, skills, and 
attitudes have they 
obtained? 
 
Are they ready for BOC 
certification? 

What does a graduating 
resident look like? 
 
What additional 
knowledge, skills, and 
attitudes have they 
obtained? 
 
Are they ready for 
specialty certification? 

What does clinical 
expertise look like? 
 
What are stretch goals to 
encourage continued 
progression towards 
mastery? 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments:  
 

 
Selecting a response box in the middle of a level implies that milestones in that level and in lower levels have been substantially demonstrated.  

Selecting a response box on the line in between levels indicates that milestones in lower levels have been substantially demonstrated as well as some milestones in the higher 
level(s).  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Table 2: Athletic Training Milestones.  

 

GENERAL COMPETENCIES: 

Patient-Care and Procedural Skills 

Athletic trainers must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and 
the promotion of health.  

Patient-Care and Procedural Skills (PC-1): Patient-Centered Care: Responds to each patient’s unique characteristics, needs, and 
goals. (Internal Medicine PROF-3)  
Critical Deficiencies Level 1 Level 2 Level 3 

(Ready for Unsupervised 
Practice) 

Level 4 
(Ready for Advanced Practice) 

Level 5 
Aspirational 

Is insensitive to 
differences related to 
culture, ethnicity, 
gender identify, race, 
age, and religion in 
the patient/caregiver 
encounter 
 
Is unwilling to modify 
care plan to account 
for a patient’s unique 
characteristics, 
needs, and goals 

Is sensitive to and has 
basic awareness of 
differences related to 
culture, ethnicity, gender 
identify, race, age, and 
religion in the 
patient/caregiver 
encounter 
 
Requires assistance to 
modify care plan to 
account for a patient’s 
unique characteristics, 
needs, and goals 
 
 

Seeks to fully understand 
each patients unique 
characteristics, needs 
and goals based upon 
culture, ethnicity, gender 
identify, religion, and 
personal preference 
 
Modifies care plan to 
account for a patient’s 
unique characteristics, 
needs, and goals with 
partial success 

Recognizes and 
accounts for the 
unique characteristics 
and needs of the 
patient/caregiver 
 
Appropriately modifies 
care plan to account 
for patient’s unique 
characteristics, needs, 
and goals 

Role models professional 
interactions to negotiate 
differences related to a 
patient’s unique 
characteristics or needs 
 
Role models consistent 
respect for patient’s 
unique characteristics, 
needs, and goals 

Develops best practice 
guidelines for 
professional 
interactions to 
negotiate differences 
related to a patient’s 
unique characteristics, 
needs, and goals 
 
Develops organizational 
policies and education 
to support respect for 
patient’s unique 
characteristics, needs, 
and goals 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
  

 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

 

Patient-Care and Procedural Skills (PC-2): Patient-Centered Care: Demonstrates humanism and cultural competency. (Family 
Medicine PROF-3) 
Critical Deficiencies Level 1 Level 2 Level 3 

(Ready for Unsupervised 
Practice) 

Level 4 
(Ready for Advanced Practice) 

Level 5 
Aspirational 

Fails to demonstrate 
appropriate 
compassion, 
respect, and 
empathy 
 
Has difficulty 
recognizing the 
impact of culture on 
health and health 
behaviors 
 
Exhibits resistance 
to improving 
cultural competence 
 

Consistently 
demonstrates 
compassion, respect, 
and empathy 
 
Recognizes impact of 
culture on health and 
health behaviors 
 

Displays a consistent 
attitude and behavior 
that conveys acceptance 
of diverse individuals and 
groups, including 
diversity in gender, age, 
culture, race, religion, 
disabilities, sexual 
orientation, and gender 
identity 
 
Elicits cultural factors 
from patients and 
families that impact 
health and health 
behaviors in the context 
of the biopsychosocial 
model 
 
Identifies own cultural 
framework that may 
impact patient 
interactions and 
decision-making 
 
 

Incorporates patients’ 
beliefs, values, and 
cultural practices in 
patient care plans 
 
Identifies health inequities 
and social determinants of 
health and their impact on 
individual and family 
health 
 
Anticipates and develops a 
shared understanding of 
needs and desires with 
patients and families; 
works in partnership to 
meet those needs 
 

Demonstrates leadership in 
cultural competence, 
understanding of health 
disparities, and social 
determinants of health 
 
Advocates for the rights of 
vulnerable patients / 
patient populations 
 
Recognizes and addresses 
lack of patient-
centeredness in 
colleagues/peers  

Develops 
organizational 
policies and 
education to 
support the 
application of these 
principles in the 
practice of athletic 
training 
 
Generates and 
disseminates new 
knowledge in 
humanism and 
cultural 
competence 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Patient-Care and Procedural Skills (PC-3): Diagnosis and Management: Gathers and synthesizes essential and accurate information 
to define each patient’s clinical problem(s). (Internal Medicine PC-1)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for 
Unsupervised Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Does not collect 
accurate historical 
data 
 
Does not use physical 
exam to confirm 
history 
 
Relies exclusively on 
documentation of 
others to generate 
own database or 
differential diagnosis  
 
Fails to recognize 
patients’ central 
clinical problems 
 
Fails to recognize 
potentially life 
threating problems 

 
 
 
 

Inconsistently able to 
acquire accurate 
historical information in 
an organized fashion 
 
Does not perform an 
appropriately thorough 
physical exam or misses 
key physical exam 
findings 
 
Does not seek or is 
overly reliant on 
secondary data 
 
Inconsistently 
recognizes patients’ 
central clinical problem 
or differential diagnoses 

Consistently acquires 
accurate and relevant 
histories from patients 
 
Seeks and obtains data 
from secondary sources 
when needed 
 
Consistently performs 
accurate and 
appropriately thorough 
physical exams 
 
Uses collected data to 
define a patient’s central 
clinical problem(s) 

Acquires accurate 
histories from 
patients in an 
efficient, prioritized 
and hypothesis-
driven fashion 
 
Performs accurate 
physical exams that 
are targeted to the 
patient’s complaints 
 
Synthesizes data to 
generate a 
prioritized 
differential 
diagnosis and 
problem list 
 
Effectively uses 
history and physical 
examination skills to 
minimize the need 
for further 
diagnostic testing 
 

Obtains relevant 
historical subtleties, 
including sensitive 
information that informs 
the differential diagnosis 
 
Identifies subtle or 
unusual physical exam 
findings 
 
Efficiently utilizes all 
sources of secondary 
data to inform 
differential diagnosis 
 
Role models and teaches 
the effective use of 
history and physical 
examination skills to 
minimize the need for 
further diagnostic testing 

Publishes clinical case 
reports on unique clinical 
problems 
 
Collaborates in practice-
based research efforts to 
gather, aggregate, and 
synthesize patient data to 
enhance diagnostic and 
management efforts 
 
Generates and 
disseminates new 
knowledge pertaining to 
diagnoses and 
management 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Patient-Care and Procedural Skills (PC-4): Diagnosis and Management: Physical Examination (systems-based examination adapted 
for health condition and contextual factors). (Physical Medicine and Rehabilitation PC-2)   

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to perform a 
thorough physical 
examination 
 
Fails to seek feedback 
or guidance on the 
accuracy and 
thoroughness of 
physical examination 
 
Performs physical 
examination 
procedures that are 
contraindicated and 
create increased 
patient discomfort or 
risk 
 

Performs a general 
physical exam 
 
Requires prompting to 
perform a thorough 
physical examination 
including all necessary 
elements (e.g., 
medical, neurologic) 

Performs a physical 
exam that assists in 
functional 
assessment (e.g., 
may include 
balance, gait, 
cognition, 
neurologic, or 
musculoskeletal 
assessments) 
 
Performs excessive 
physical 
examination using 
unwarranted 
techniques 
 
Begins to identify 
normal and 
pathologic findings 
 

Performs a relevant, 
accurate 
comprehensive 
disorder-specific 
physical exam 
 
Modifies exam to 
accommodate the 
patient’s impairments 
and minimize 
discomfort 
 
Efficiently performs a 
hypothesis-driven and 
targeted physical exam 
that drives clinical 
decision making across 
a spectrum of ages, 
impairments, and 
clinical settings 
 

Efficiently performs a 
hypothesis-driven and 
targeted physical exam that 
drives clinical decision 
making for complex cases 
 
Identifies and correctly 
interprets subtle or atypical 
physical findings 
 
Rapidly focuses on the 
presenting problem and 
elicits key information from 
the exam in a prioritized and 
efficient fashion 
 
Models and teaches exam 
skills in complex patients 

Efficiently produces a 
focused and prioritized 
physical examination 
accounting for rare 
conditions 
 
Streamlines physical 
examination for 
maximal cost- 
effectiveness and 
minimal patient burden 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Patient-Care and Procedural Skills (PC-5): Diagnosis and Management: Diagnostic Evaluation. (Physical Medicine and Rehabilitation 
PC-3)  This includes:  

• Differential diagnosis of primary and secondary conditions 
• Appropriate studies (e.g., laboratory, imaging, neuropsychological) 
• Functional assessments 

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to develop an 
appropriate list of 
differential diagnoses 
 
Uncertain of which 
diagnostic studies are 
appropriate for 
common medical 
conditions 
 
Fails to recognize when 
medical referral is 
necessary  
 

 
 
 
 

Identifies appropriate 
diagnostic studies for 
common medical 
conditions 
 
Identifies reasonable 
diagnosis for common 
medical conditions 
 
 
 

 
 

Produces a 
differential diagnosis 
for common medical 
conditions 
 
Recommends 
appropriate 
diagnostic studies 
for common medical 
conditions 
 
Inconsistently 
interprets diagnostic 
study results 
 
 

Develops a 
comprehensive 
differential diagnosis, 
including less common 
conditions 
 
Orders appropriate 
diagnostic studies for 
common medical 
conditions 
 
Appropriately 
prioritizes the 
sequence and urgency 
of diagnostic testing 
 
Correctly interprets 
diagnostic study results 
and appropriately 
pursues further testing 
or specialist input 
 
Appropriately 
integrates functional 
assessment measures 
into overall evaluation 

Efficiently produces a 
focused and prioritized 
differential diagnosis 
across a spectrum of ages 
and impairments and for 
complex conditions 
 
Orders diagnostic testing 
based on cost 
effectiveness and 
likelihood that results will 
influence clinical 
management 

Efficiently produces a 
focused and prioritized 
differential diagnosis 
accounting for rare 
conditions 
 
Streamlines testing for 
maximal cost- 
effectiveness and 
minimal patient burden 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Comments: 
 

 

Patient-Care and Procedural Skills (PC-6): Diagnosis and Management: Develops and implements comprehensive management plan 
for each patient. (Internal Medicine PC-2)  

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Care plans are 
consistently 
inappropriate or 
inaccurate 
 
Does not react to 
situations that require 
urgent or emergent 
care 
 
Does not seek 
additional guidance 
when needed 

 
 
 

Inconsistently 
develops an 
appropriate care plan 
 
Inconsistently seeks 
additional guidance 
when needed 

Recognizes patients 
requiring urgent or 
emergent care 
 
Seeks additional 
guidance and/or 
consultation as 
appropriate  

Consistently develops 
and implements 
appropriate care plan 
 
Appropriately modifies 
care plans based on 
patient’s clinical course, 
additional data, and 
patient preferences 
 

Recognizes patient 
presentations that 
deviate from common 
patterns and require 
complex decision-making 
 
Manages complex acute 
and chronic patients 
 
Role models and teaches 
complex and patient-
centered care 

Develops customized, 
prioritized care plans for 
the most complex patients, 
incorporating diagnostic 
uncertainty and cost 
effectiveness principles 
 
Serves as a regional 
consultant for complex 
patients 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

 

 

 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Patient-Care and Procedural Skills (PC-7): Diagnosis and Management: Manages patients with progressive responsibility and 
independence. (Internal Medicine PC-3)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised Practice) 
Level 4  

(Ready for Advanced 
Practice) 

Level 5 
 (Aspirational) 

Cannot advance 
beyond the need for 
direct supervision in 
the delivery of 
patient care 
 
Cannot manage 
patients who 
require urgent or 
emergent care  
 
Does not assume 
responsibility for 
patient 
management 
decisions 
 

 
 

Requires direct 
supervision to ensure 
patient safety and 
quality care 
 
Provides inconsistent 
preventative care 
 
Inconsistently 
provides 
comprehensive care 
for single or multiple 
diagnoses 
 

Requires indirect 
supervision to ensure 
safety and quality care 
 
Provides appropriate 
preventive care  
 
Provides comprehensive 
care for single or multiple 
diagnoses  
 
Under supervision, 
provides appropriate care 
for medically complex 
patients  
 
Initiates management 
plans for urgent or 
emergent care 
 
 

Independently manages 
patients who have a broad 
spectrum of clinical disorders 
including undifferentiated 
syndromes 
 
Seeks additional guidance 
and/or consultation as 
appropriate 
 
Appropriately manages 
situations requiring urgent 
or emergent care 
 

Manages unusual, rare 
or complex disorders 
 
Effectively supervises 
the management 
decisions of the athletic 
health care team 
 
Serves as a preceptor 
capable of recognizing 
and assessing milestone 
achievement in athletic 
training students and 
residents 
 
Recognizes and 
promotes clinical 
expertise in peers and 
implements policy to 
ensure patients are 
seen by appropriate 
members of the team 
 

Serves as a clinical care 
leader supervising 
multiple clinicians in a 
coordinated, team-
based manner 
 
Contributes to the 
development and 
refinement of models 
of education that 
promote progressive 
responsibility and 
independence  
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Patient Care and Procedural Skills 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
their education and training. This individual is demonstrating a learning trajectory that anticipates the achievement of competency 
for unsupervised practice (or advanced practice for residency programs) that includes the delivery of safe, timely, effective, efficient, 
equitable, and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Medical Knowledge  

Athletic trainers must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social- behavioral sciences, as 
well as the application of this knowledge to patient care.  

Medical Knowledge (MK-1): Demonstrates medical knowledge of sufficient breadth and depth to practice athletic training. (Family 
Medicine MK-2) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to 
demonstrate the 
capacity for 
medical knowledge 
improvement 
 
Fails to self-reflect 
and recognize 
personal limitations 
in medical 
knowledge 

 
 
 
 

Demonstrates the 
capacity to improve 
medical knowledge 
through targeted study 
 

Uses the Commission 
on Accreditation of 
Athletic Training 
Education (CAATE) 
curricular content 
and Board of 
Certification (BOC) 
Maintenance of 
Competence 
framework 
to further guide his or 
her education 
 
Demonstrates 
capacity to assess 
and act on personal 
learning needs 
 

Demonstrates 
appropriate medical 
knowledge to care for 
both individual patients 
and patient 
populations 
 
Recognizes the 
limitations of their 
medical knowledge and 
a willingness to 
continue to advance 
their medical 
knowledge across their 
career 
 
Passes the BOC 
examination  
 

Successfully completes a 
CAATE accredited 
residency program  
 
Passes a Board of Athletic 
Training Specialties (BATS) 
specialty examination 
 
Collaborates to produce 
clinical pathways and 
engage in practice-based 
research to inform best 
practices for patient care 
 
Demonstrates life-long 
learning through continual 
self-assessment and 
continuing education 
focused on maintenance of 
contemporary medical 
knowledge 
 

Generates and 
disseminates new medical 
knowledge 
 
Leads the development of 
clinical pathways for the 
delivery of high quality, 
affordable health care 
 
Coordinates practice-
based research to inform 
best practices for patient 
care 
 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Medical Knowledge (MK-2): Knowledge of diagnostic testing and procedures. (Internal Medicine MK-1) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Lacks foundational 
knowledge to apply 
diagnostic testing and 
procedures to patient 
care 
 
Chooses 
inappropriate 
diagnostic tests or 
procedures that place 
the patient at risk or 
pose a safety hazard 
 

 
 
 

 
 
 

Uncertain of which 
diagnostic tests and 
procedures are 
appropriate  
 
Understands which 
diagnostic tests and 
procedures to perform, 
but can not adequately 
explain why 
 
Does not understand 
the concepts of pre-test 
probability and test 
performance 
characteristics 
 
 

Inconsistently 
interprets basic 
diagnostic test 
accurately 
 
Needs assistance to 
understand the 
concepts of pre-test 
probability and test 
performance 
characteristics 
 
Minimally 
understands the 
rationale and risks 
associated with 
common 
procedures 

Consistently interprets 
basic diagnostic tests 
accurately 
 
Understands the 
concepts of pre-test 
probability and test 
performance 
characteristics 
 
Fully understand the 
rationale and risks 
associated with 
common procedures  

Interprets complex 
diagnostic tests accurately 
 
Anticipates and accounts 
for pitfalls and biases when 
interpreting diagnostic 
tests and procedures 
 
Teaches the rationale and 
risks associated with 
common procedures and 
anticipates potential 
complications when 
performing procedures 

Introduces innovation in 
diagnostic testing and 
procedures in athletic 
training 
 
Pursues knowledge of new 
and emerging diagnostic 
tests and procedures 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Medical Knowledge (MK-3): Basic Sciences of Athletic Training, including Biology, Chemistry, Physics, Psychology, Anatomy, 
Physiology, Statistics, Research Design, Epidemiology, Pathophysiology, Biomechanics and Pathomechanics, Exercise Physiology, 
Nutrition, Pharmacology. (Sports Medicine MK-1) 

Critical Deficiencies Level 1 Level 2 Level 3 
(Ready for Unsupervised 

Practice) 

Level 4 
(Ready for Advanced 

Practice) 

Level 5 
Aspirational 

Lacks appropriate 
foundational 
knowledge in the basic 
sciences  
 
Knowledge is limited to 
traditional athletic 
populations (e.g., 
college and secondary 
school aged) without 
appropriate 
understanding of 
anatomy and 
physiology across the 
lifespan 

Demonstrates knowledge 
of the basic sciences of 
athletic training 
 
Demonstrates knowledge 
of anatomy and 
physiology related to 
growth, development, 
and aging 
 
 

Demonstrates knowledge of 
basic sciences applied to 
athletic training in patients 
of all ages 
 
Demonstrates basic science 
knowledge foundational to 
prevention, rehabilitation, 
and management 
 
 

Synthesizes scientific 
knowledge in managing 
common medical 
conditions 
 
Integrates basic and 
clinical science 
knowledge of 
pathophysiology, tissue 
healing, and treatment 
interventions in return-
to-activity decisions 
 
Demonstrates 
knowledge of factors 
associated with risk of 
injury, including age, 
gender, and disability 
 
Demonstrates both 
basic science and 
clinical knowledge of 
the details of tissue 
healing and cellular 
physiology across the 
lifespan in selecting 
treatment options  
 

Synthesizes and 
applies scientific 
knowledge in complex 
medical conditions 
 
Possesses the 
scientific, 
socioeconomic, and 
behavioral knowledge 
required to 
successfully 
incorporate basic and 
clinical science to 
diagnose and treat 
uncommon, 
ambiguous, and 
complex conditions 

Generates and 
disseminates new 
basic science 
knowledge  
 
Introduces 
innovation from the 
basic sciences to 
advance athletic 
training 
 
Possesses the 
scientific 
socioeconomic and 
behavioral 
knowledge required 
to successfully 
incorporate basic 
and clinical science 
to diagnose and 
treat uncommon, 
ambiguous, and 
complex conditions  

 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Medical Knowledge 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
their education and training. The individual is demonstrating a learning trajectory that anticipates the achievement of 
competency for unsupervised practice (or advanced practice for residency programs) that includes the delivery of safe, timely, 
effective, efficient, equitable, and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Practice-Based Learning and Improvement 

Athletic trainers must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and 
to continuously improve patient care based on constant self-evaluation and life-long learning.  

Practice-Based Learning and Improvement (PBLI-1): Evidence-Based Practice: Locates, appraises, and assimilates evidence from 
scientific studies related to the patients’ health problems. (Family Medicine PBLI-1) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Unable to locate 
appropriate evidence 
related to the 
patients’ health 
problems to help 
direct care 
 
Unable to categorize 
and interpret the 
strength of a 
research study 

 
 
 
 

Describes basic 
concepts in clinical 
epidemiology, 
biostatistics, and clinical 
reasoning 
 
Categorizes the design 
of a research study 
 

Identifies pros and 
cons of various study 
designs, associated 
types of bias, and 
patient-centered 
outcomes 
 
Formulates a 
searchable question 
from a clinical 
question 
 
Evaluates evidence-
based point-of-care 
resources 

  

Applies a set of critical 
appraisal criteria to 
different types of 
research, including 
synopses of original 
research findings, 
systematic reviews and 
meta-analyses, and 
clinical practice 
guidelines 
 
Critically evaluates 
information from others, 
including colleagues, 
experts, and sales 
representatives, as well 
as patient-delivered 
information 
 
Incorporates principles of 
evidence-based care and 
information mastery into 
clinical practice 

Roles models evidence-
based practice and 
information mastery 
techniques  
 
Holds peers accountable to 
practice in an evidence-
based manner 
 
Identify important clinical 
questions and information 
gaps  
 
 

Engages in 
implementation science to 
support the rapid 
dissemination and 
adoption of evidence into 
clinical practice 

 
Develops and/or 
implements evidence-
based practice guidelines 
to improve system 
performance 
 
Develops organizational 
policies and education to 
support the 
implementation of 
evidence-based practice 

 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Practice-Based Learning and Improvement (PBLI-2): Quality Improvement: Improves systems in which the athletic trainer provides 
care. (Family Medicine PBLI-3)  

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to recognize the 
key STEEEP (safe, 
timely, effective, 
efficient, equitable, 
patient-centered) 
elements of quality 
health care 
 
Unable to accurately 
describe the system of 
care in which they are 
working 
 
Unable to identify 
quality gaps in their 
own health systems 

 
 
 
 

Understands the key 
elements of quality 
health care (STEEEP) 

Recognizes the 
importance of 
measuring the end 
results of health care 
in order to adequately 
assess health care 
quality 

Begins to identify 
potential gaps in 
quality care 

 

 

  

Recognizes 
inefficiencies, 
inequities, 
variation, and 
quality gaps in 
health care delivery 

Identifies potential 
gaps in quality care 
and identifies 
potential 
contributing factors 
within the system 

Recognizes the 
importance of 
developing quality 
improvement teams 

 

Assesses available health 
care outcomes data to 
compare their results to 
expected results within 
the system 

Uses a systematic 
improvement method 
(e.g., Plan-Do-Study- 
Act [PDSA] cycle) to 
address an identified 
area of improvement 

Compares care provided 
by self and practice to 
internal and external 
standards, identifies 
areas for improvement, 
and implements change 
in their practice. 

 

Establishes protocols for 
continuous review and 
comparison of practice 
procedures and outcomes 
and implementing changes 
to address areas needing 
improvement 

Uses an organized method, 
such as a registry, to assess 
and manage population 
health 
 
Performs multi-cycle 
quality improvement 
initiatives to improve 
health care quality 

Role models 
continuous quality 
improvement of 
personal practice, as 
well as larger health 
systems or complex 
projects, using 
advanced 
methodologies and 
skill sets 
 
Generates and 
disseminates new 
knowledge to advance 
effective strategies for 
improving systems in 
which athletic trainers 
provide care 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Practice-Based Learning and Improvement (PBLI-3): Quality Improvement: Learns and improves via performance audit. (Internal 
Medicine PBLI-2)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Disregards own 
clinical performance 
data 
 
Demonstrates no 
inclination to 
participate in or even 
consider the results 
of quality 
improvement efforts 

Limited awareness of or 
desire to analyze own 
clinical performance 
data 
 
Nominally participates 
in a quality 
improvement projects 
 
Not familiar with the 
principles, techniques, 
or importance of quality 
improvement 

Analyzes own clinical 
performance data 
and identifies 
opportunities for 
improvement 
 
Participates in a 
quality improvement 
project  
 
Understands 
common principles 
and techniques of 
quality improvement 
and appreciates the 
responsibility to 
assess and improve 
care  
 
 

Analyzes own clinical 
performance data and 
actively works to 
improve performance  
 
Actively engages in 
quality improvement 
initiatives 
 
Demonstrates the ability 
to apply common 
principles and techniques 
of quality improvement 
to improve care  

Actively monitors clinical 
performance through 
various data sources 
 
Leads quality 
improvement projects 
 
Utilizes common principles 
and techniques of quality 
improvement to 
continuously improve care  

Demonstrates 
professional leadership in 
promoting performance 
audits for quality 
improvement using 
clinical data monitoring  
 
Generates and 
disseminates new 
knowledge to advance 
performance audits for 
quality improvement 
using clinical data 
monitoring 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Practice-Based Learning and Improvement (PBLI-4): Quality Improvement: Monitors practice with a goal for improvement. 
(Internal Medicine PBLI-1)  

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Unwilling to self-reflect 
upon one’s practice or 
performance 
 
Not concerned with 
opportunities for 
learning and self-
improvement 
 

Inconsistently self-
reflects upon one’s 
practice or 
performance and 
inconsistently acts 
upon those reflections 
 
Misses opportunities 
for learning and self- 
improvement 

Regularly self-reflects 
upon one’s practice 
or performance and 
identifies areas to 
improve practice 
 
Inconsistently acts 
upon opportunities 
for learning and self-
improvement 
 
Recognizes the value 
of critical reviews and 
morbidity and 
mortality conferences 
(M and Ms) for 
learning and self-
improvement 
 

Regularly self-reflects 
upon one’s practice or 
performance and 
maximizes practice 
improvement 
 
Recognizes sub-optimal 
practice or performance 
as an opportunity for 
learning and self-
improvement 
 
Actively engages in 
critical reviews and 
morbidity and mortality 
conferences (M and Ms) 
to support learning and 
improvement in self and 
others  
 

Role models self-reflective 
practice and monitoring 
practice improvement 
 
Holds peers accountable 
for failures to recognize 
opportunities for 
improvement 
 
Leads critical reviews and 
morbidity and mortality 
conferences (M and Ms) 
to support learning and 
self-improvement in 
others 

Demonstrates 
professional leadership 
regarding self-reflective 
practice and monitoring 
practice performance 
 
Generates and 
disseminates new 
knowledge to advance 
self-reflective practice 
and monitoring practice 
performance 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Practice-Based Learning and Improvement 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
their education and training. The individual is demonstrating a learning trajectory that anticipates the achievement of 
competency for unsupervised practice (or advanced practice for residency programs) that includes the delivery of safe, timely, 
effective, efficient, equitable, and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Interpersonal and Communication Skills 

Athletic trainers must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration 
with patients, their families, and health professionals.  

Interpersonal and Communication Skills (ICS-1): Communicates effectively with patients and caregivers. (Internal Medicine ICS-1)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Ignores patient 
preferences for plan 
of care 
 
Makes no attempt to 
engage patient in 
shared decision-
making 
 
Routinely engages in 
antagonistic or 
counter-therapeutic 
relationships with 
patients and 
caregivers 
 

 
 

Engages patients in 
discussions of care 
plans and respects 
patient preferences 
when offered by the 
patient, but does not 
actively solicit 
preferences 
 
Attempts to develop 
therapeutic 
relationships with 
patients and 
caregivers but is 
often unsuccessful 
 
Defers difficult or 
ambiguous 
conversations to 
others 
 

Engages patients in 
shared decision making 
in uncomplicated 
conversations  
 
Requires assistance 
facilitating discussions in 
difficult or ambiguous 
conversations  
 
Requires guidance or 
assistance to engage in 
communication with 
persons of different 
socioeconomic and 
cultural backgrounds 

Identifies and 
incorporates patient 
preference in shared 
decision making across 
a wide variety of patient 
care conversations 
 
Quickly establishes a 
therapeutic relationship 
with patients and 
caregivers, including 
persons of different 
socioeconomic and 
cultural backgrounds 
 
Incorporates patient-
specific preferences into 
plan of care 

Role models effective 
communication and 
development of 
therapeutic relationships 
in both routine and 
challenging situations 
 
Models culturally 
competent 
communication and 
establishes therapeutic 
relationships with persons 
of diverse socioeconomic 
backgrounds 

Demonstrates 
professional leadership in 
promoting effective 
communication with 
patients and caregivers  
 
Generates and 
disseminates new 
knowledge to advance 
effective communication 
with patients and 
caregivers 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Interpersonal and Communication Skills (ICS-2): Communicates effectively with patients, families, stakeholders, and the public. 
(Family Medicine C-2) 

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Demonstrates 
disrespectful 
communication with 
patients, families, 
stakeholders, or the 
public 
 
Fails to recognize 
physical, cultural, 
psychological, and 
social barriers to 
communication 
 
Unable to establish 
rapport and facilitate 
patient-centered 
information exchange 

 
 
 

Recognizes that 
respectful 
communication is 
important to quality 
care 
 
Identifies physical, 
cultural, psychological, 
and social barriers to 
communication 
 
Uses the medical 
interview to establish 
rapport and facilitate 
patient-centered 
information exchange 

 

 

  

Matches modality of 
communication to 
patient needs, 
health literacy, and 
context 
 
Organizes information 
to be shared with 
patients and families 
 
Participates in life-
altering discussions 
and delivery of bad 
news 
 
Negotiates a visit 
agenda with the 
patient, and uses 
active and reflective 
listening to guide the 
visit 
 

Educates and counsels 
patients and families in 
disease management 
and health promotion 
skills 
 
Engages patients’ 
perspectives in shared 
decision making 
 
Recognizes non-verbal 
cues and uses non-
verbal communication 
skills in patient 
encounters 
 
Effectively 
communicates difficult 
information, such as 
life-altering discussions, 
delivery of bad news, 
acknowledgement of 
errors, and during 
episodes of crisis 
 

Role models patient-
centeredness and 
integrates all aspects of 
patient care to meet 
patients’ needs 

Role models effective 
communication with 
patients, families, 
stakeholders, and the 
public 
 
Engages community 
partners to educate the 
public 
 

Demonstrates 
professional leadership 
in promoting effective 
communication with 
patients, families, 
stakeholders, and the 
public 
 
Generates and 
disseminates new 
knowledge to advance 
effective communication 
with patients, families, 
stakeholders, and the 
public 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Interpersonal and Communication Skills (ICS-3): Communicates effectively in interprofessional teams. (Internal Medicine ICS-2) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Utilizes 
communication 
strategies that 
hamper collaboration 
and teamwork 
 
Verbal and/or non-
verbal behaviors 
disrupt effective 
collaboration with 
team members 

 
 

Uses unidirectional 
communication that 
fails to utilize the 
wisdom of the team 
 
Resists offers of 
collaborative input 
 
Exhibits defensive 
behaviors within the 
health care team 

Inconsistently engages 
in collaborative 
communication with 
appropriate members 
of the team 
 
Inconsistently employs 
verbal, non-verbal, and 
written communication 
strategies that facilitate 
collaborative care 
 

Consistently and 
actively engages in 
collaborative 
communication with all 
members of the team 
 
Verbal, non-verbal, and 
written communication 
consistently acts to 
facilitate collaboration 
with the team to 
enhance patient care 

Role models and teaches 
collaborative 
communication with the 
health care team to 
enhance patient care, 
even in challenging 
settings and with 
conflicting team member 
options 

Demonstrates 
professional leadership 
in promoting effective 
communication in 
interprofessional teams 
 
Generates and 
disseminates new 
knowledge to advance 
effective communication in 
interprofessional teams 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

 

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Interpersonal and Communication Skills (ICS-4): Health Information Technology: Appropriate utilization and completion of health 
records. (Internal Medicine ICS-3) 

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Health records are 
absent or missing 
significant portions of 
important clinical data 
 
Health records are 
disorganized and 
inaccurate 
 
Health records are not 
completed in a timely 
manner 
 
Privacy of health 
records is not 
adequately maintained 
 
Fails to recognize the 
criticality of 
appropriate utilization 
and completion of 
health records 

 

Health records are 
organized and 
accurate but are 
superficial and miss 
key data or fail to 
communicate clinical 
reasoning 
 
Health records are 
completed in a timely 
manner 
 
Privacy of health 
records is of prime 
importance 

Health records are 
organized, 
accurate, 
comprehensive, 
and effectively 
communicate 
clinical reasoning 

 
Health records are 
succinct, relevant, 
and patient specific 
 
 

Health records are 
organized and complete 
from patient intake to 
discharge, documenting 
all patient interactions, a 
thorough history and 
physical examination, 
daily treatment notes, 
referrals, and discharge 
summary 
 
Health records capture 
patient-rated outcomes 
 
Health records adhere to 
all state and federal 
guidelines 
 
 

Health records serve as 
a primary means of 
data collection and 
aggregation for the 
ongoing assessment of 
quality of care 
 
Role models and teaches 
importance of organized, 
accurate and 
comprehensive health 
records that are succinct 
and patient specific 
 
 

Demonstrates 
professional leadership 
in promoting the 
appropriate utilization 
and completion of 
health records 
 
Generates and 
disseminates new 
knowledge to advance 
appropriate utilization 
and completion of health 
records 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Interpersonal and Communication Skills 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
their education and training. The individual is demonstrating a learning trajectory that anticipates the achievement of 
competency for unsupervised practice (or advanced practice for residency programs) that includes the delivery of safe, timely, 
effective, efficient, equitable, and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Professionalism 

Athletic trainers must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.  

Professionalism (PROF-1): Completes a process of professionalization. (Family Medicine PROF-1) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Demonstrates lack 
of professionalism 
 
Places personal 
values ahead of 
professional values 
 
Fails to exhibit 
appropriate 
honesty, integrity, 
and respect to 
patients and team 
members 
 

 
 
 

Defines professionalism 
 
Knows the basic principles 
of medical ethics 
 
Recognizes that conflicting 
personal and professional 
values exist 
 
Demonstrates honesty, 
integrity, and respect to 
patients and team 
members 

Recognizes own 
conflicting personal 
and professional values 
 
Knows institutional and 
governmental 
regulations for the 
practice of athletic 
training 

Recognizes that 
athletic trainers have 
an obligation to self-
discipline and to self-
regulate 
 
Engages in self-
initiated pursuit of 
excellence 
 
Embraces the 
professional 
responsibilities of 
being an athletic 
trainer 
 
Practices to the full 
scope of education 
and training and 
formal privileging 
within a health system 
 

Demonstrates leadership 
and mentorship in applying 
shared standards and 
ethical principles, including 
the priority of 
responsiveness to patient 
needs above self-interest 
across the health care team 
 
Develops institutional and 
organizational strategies to 
protect and maintain these 
principles 
 

Demonstrates 
professional leadership 
in promoting 
professionalism with 
patients and caregivers 
 
Generates and 
disseminates new 
knowledge to advance 
effective strategies for 
instilling 
professionalization in 
others 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Professionalism (PROF-2): Has professional and respectful interactions with patients, caregivers, members of the interprofessional 
team, and stakeholders. (Internal Medicine PROF-1)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Lacks empathy and 
compassion for 
patients and 
caregivers 
 
Disrespectful in 
interactions with 
patients, caregivers, 
members of the 
interprofessional 
team, and 
stakeholders 
 
Sacrifices patient 
needs in favor of own 
self-interest 
 
Blatantly disregards 
respect for patient 
privacy and 
autonomy 

 
 

Inconsistently 
demonstrates 
empathy, compassion, 
and respect for 
patients and 
caregivers 
 
Inconsistently 
demonstrates 
responsiveness to 
patients’ and 
caregivers’ needs in 
an appropriate 
fashion 
 
Inconsistently 
considers patient 
privacy and autonomy 
 
 

Consistently 
respectful in 
interactions with 
patients, caregivers, 
and members of the 
interprofessional 
team, even in 
challenging situations 
 
Is available and 
responsive to needs 
and concerns of 
patients, caregivers, 
and members of the 
interprofessional 
team to ensure safe 
and effective care 
 
Emphasizes patient 
privacy and autonomy 
in all interactions 

Demonstrates 
empathy, compassion, 
and respect to patients 
and caregivers in all 
situations 
 
Anticipates, advocates 
for, and proactively 
works to meet the 
needs of patients and 
caregivers 
 
Demonstrates a 
responsiveness to 
patient needs that 
supersedes self-
interest 
 
Positively 
acknowledges input of 
members of the 
interprofessional team 
and incorporates that 
input into plan of care 
as appropriate 
 

Role models compassion, 
empathy, and respect for 
patients and caregivers 
 
Role models appropriate 
anticipation and advocacy for 
patient and caregiver needs 
 
Fosters collegiality that 
promotes a high-functioning 
interprofessional team 
 
Teaches others regarding 
maintaining patient privacy 
and respecting patient 
autonomy   

Demonstrates 
professional leadership 
in promoting 
professionalism with 
patients, caregivers, 
members of the 
interprofessional team, 
and stakeholders 
 
Generates and 
disseminates new 
knowledge to advance 
effective strategies for 
professionalism with 
patients, caregivers, 
members of the 
interprofessional team, 
and stakeholders 
 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Professionalism (PROF-3): Demonstrates professional conduct and accountability. (Internal Medicine PROF-2 and Family Medicine 
PROF-2)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Is unreliable in 
completing patient 
care responsibilities 
or assigned 
administrative 
tasks  

Shuns 
responsibilities 
expected of an 
athletic training 
professional  

 
 
 

Completes most 
assigned tasks in a 
timely manner but may 
need multiple reminders 
or other support  

Accepts professional 
responsibility only when 
assigned or mandatory  

Documents and reports 
clinical and 
administrative 
information truthfully 

Maintains patient 
confidentiality  
 
 

Attends to 
responsibilities and 
completes duties as 
required 
 
Identifies appropriate 
channels to report 
unprofessional 
behavior  
 
Recognizes 
professionalism lapses 
in self and others 
 
Completes assigned 
professional 
responsibilities 
without the need for 
reminders 
 
Consistently 
recognizes limits of 
knowledge and asks 
for assistance 
 

Presents themselves in a 
respectful and 
professional manner 
 
Completes 
administrative and 
patient care tasks in a 
timely manner in 
accordance with local 
practice and/or policy  
 
Reports professionalism 
lapses using appropriate 
reporting procedures 
 
Willingness to assume 
professional 
responsibility regardless 
of the situation or 
consequences  

Prioritizes multiple 
competing demands in 
order to complete tasks 
and responsibilities in a 
timely and effective 
manner  

 

Role models prioritizing 
multiple competing 
demands in order to 
complete tasks and 
responsibilities in a timely 
and effective manner 
 
Assists others to improve 
their ability to prioritize 
multiple, competing tasks 

Negotiates professional 
lapses of the athletic health 
care team 
 
Exhibits self-awareness, 
self-management, social 
awareness, and 
relationship management 
 
Helps implement 
organizational policies to 
sustain athletic training as a 
profession 
 
 

Models professional 
conduct placing the 
needs of each patient 
above self-interest  
 
Demonstrates the 
highest degree of 
professional conduct and 
accountability that 
others seek to emulate  
 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Professionalism (PROF-4): Exhibits integrity and ethical behavior in professional conduct. (Internal Medicine PROF-4 - Modified)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Dishonest in clinical 
interactions, 
documentation, 
research, or 
scholarly activity 
 
Refuses to be 
accountable for 
personal actions 
 
Does not adhere to 
basic ethical 
principles 
 
Blatantly disregards 
formal policies or 
procedures 

 

Honest in clinical 
interactions, 
documentation, 
research, and scholarly 
activity.  
 
Requires oversight for 
professional actions 
 
Has a basic 
understanding of 
ethical principles, 
formal policies and 
procedures, and does 
not intentionally 
disregard them 

Demonstrates 
accountability for the 
care of patients 
 
Adheres to ethical 
principles for 
documentation, follows 
formal policies and 
procedures, 
acknowledges and 
limits conflict of 
interest, and upholds 
ethical expectations of 
research and scholarly 
activity 
 
Begins to reflect on 
personal professional 
conduct 
 

Honest and forthright in 
clinical interactions, 
documentation, 
research, and scholarly 
activity 
 
Demonstrates integrity, 
honesty, and 
accountability to 
patients, society and 
the profession 
 
Identifies and responds 
appropriately to lapses 
of professional conduct 
among peer group 
 

Actively manages 
challenging ethical dilemmas 
and conflicts of interest  
 
Regularly reflects on 
personal professional 
conduct 
 
Assists others in adhering to 
ethical principles and 
behaviors including integrity, 
honesty, and professional 
responsibility  
 

Role models integrity, 
honesty, accountability, 
and professional 
conduct in all aspects of 
professional life 
 
Demonstrates 
professional leadership 
in promoting integrity 
and ethical behavior in 
professional conduct 
 
Generates and 
disseminates new 
knowledge to advance 
integrity and ethical 
behavior in professional 
conduct 
 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Professionalism 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
their education and training. The individual is demonstrating a learning trajectory that anticipates the achievement of 
competency for unsupervised practice (or advanced practice for residency programs) that includes the delivery of safe, timely, 
effective, efficient, equitable, and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Systems-Based Practice 

Athletic trainers must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call 
effectively on other resources in the system to provide optimal health care.  

Systems-Based Practice (SBP-1): Patient Safety: Recognizes system error and advocates for system improvement. (Internal 
Medicine SPB-2)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Ignores a risk for 
error within the 
system that may 
impact the care of a 
patient 
 
Ignores feedback and 
is unwilling to change 
behavior in order to 
reduce the risk for 
error 
 

 
 

Does not recognize the 
potential for system 
error 
 
Makes decisions that 
could lead to error 
which are otherwise 
corrected by the system 
or supervision 
 
Resistant to feedback 
about decisions that 
may lead to error or 
otherwise cause harm 

Recognizes the 
potential for error 
within the system 
 
Identifies obvious or 
critical causes of error 
and notifies 
supervisor 
accordingly 
 
Recognizes the 
potential risk for 
error in the 
immediate system 
and takes necessary 
steps to mitigate that 
risk 
 
Willing to receive 
feedback about 
decisions that may 
lead to error or 
otherwise cause harm 

Identifies systemic 
causes of medical error 
and navigates them to 
provide safe patient 
care 
 
Activates formal system 
resources to investigate 
and mitigate real or 
potential medical error 
 
Reflects upon and 
learns from own critical 
incidents that may lead 
to medical error 
 

Advocates for system 
leadership to formally 
engage in quality 
assurance and quality 
improvement activities  
 
Advocates for safe patient 
care and optimal patient 
care systems 
 
Teaches others regarding 
the importance of 
recognizing and mitigating 
system error 
 
 

Demonstrates 
professional leadership in 
promoting patient safety  
 
Generates and 
disseminates new 
knowledge to advance 
effective strategies for 
promoting patient safety 
 
Viewed as a leader in 
identifying and advocating 
for the prevention of 
medical error 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Systems-Based Practice (SBP-2): Patient Safety: Emphasizes patient safety. (Family Medicine SPB-2) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Ignores medical 
errors  
 
Fails to understand 
that medical errors 
vary widely across 
settings and between 
providers 
 
Ignores the 
importance of team-
based care in 
ensuring patient 
safety 

 
 

Understands that 
medical errors affect 
patient health and 
safety and that their 
occurrence varies 
across settings and 
between providers 
 
Understands that 
effective team-based 
care plays a role in 
patient safety 

Recognizes medical 
errors when they occur, 
including those that do 
not have adverse 
outcomes 
 
Understands the 
mechanisms that cause 
medical errors 
 
Understands and 
follows protocols to 
promote patient safety 
and prevent medical 
error 
 
Participates in effective 
and safe hand-offs and 
transitions of care 
 

Uses current methods of 
analysis to identify 
individual and system 
causes of medical errors 
common to athletic 
training 
 
Develops individual 
improvement plan and 
participates in system 
improvement plans that 
promote patient safety 
and prevent medical 
errors 
 
Performs effective and 
safe hand-offs and 
transitions of care 

Consistently engages in 
self-directed and practice 
improvement activities 
that seek to identify and 
address medical errors 
and patient safety in daily 
practice 
 
Fosters adherence to 
patient care protocols 
amongst team members 
that enhance patient 
safety and prevent 
medical errors 
 

Leads self-directed and 
system improvement 
activities that seek to 
continuously 
anticipate, identify, 
and prevent medical 
errors to improve 
patient safety in all 
practice settings, 
including the 
development, use, and 
promotion of patient 
care protocols and 
other tools 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Systems-Based Practice (SBP-3): Cost-Effectiveness: Identifies forces that impact the cost of health care, and advocates for, and 
practices cost-effective care. (Internal Medicine SBP-3) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Ignores cost issues 
in the provision of 
care 
 
Demonstrates no 
effort to overcome 
barriers to cost-
effective care 

 
 

Lacks awareness of 
external factors (e.g., 
socio-economic, cultural, 
literacy, insurance 
status) that impact the 
cost of health care and 
the role that external 
stakeholders (e.g., 
providers, suppliers, 
financers, purchasers) 
have on the cost of care 
 
Recognizes the costs 
associated with the 
provision of athletic 
training services, even 
when they aren’t being 
billed for / reimbursed 
 
 

Recognizes that 
external factors 
influence a patient’s 
utilization of health 
care and may act as 
barriers to cost-
effective care  
 
Possesses an 
incomplete 
understanding of cost-
awareness principles 
for a population of 
patients (e.g., screening 
tests) 
 
Does not consider 
limited health care 
resources regarding 
diagnostic or 
therapeutic 
interventions 
 
 

Consistently works to 
address patient specific 
barriers to cost-effective 
care 
 
Advocates for cost-
conscious utilization of 
resources  
 
Incorporates cost-
awareness principles 
into standard clinical 
judgments and decision-
making, including 
screening tests 
 
Minimizes costs 
associated with 
unnecessary diagnostic 
and therapeutic tests 
 

Teaches patients and 
healthcare team members 
to recognize and address 
common barriers to cost-
effective care and 
appropriate utilization of 
resources 
 
Actively participates in 
initiatives and care 
delivery models designed 
to overcome or mitigate 
barriers to cost-effective 
high quality care 
 

Demonstrates 
professional leadership 
in promoting cost-
effective athletic 
training services 
 
Generates and 
disseminates new 
knowledge to advance 
cost-effective athletic 
training services 
 
Develops best practice 
guidelines for the 
provision of cost-
effective care 
 
Develops organizational 
policies and education 
to support cost-
effective care 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Systems-Based Practice (SBP-4): Interprofessional Teams: Works effectively within an interprofessional team. (Internal Medicine 
SBP-1; Level 1 from Family Medicine SBP-4)  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Refuses to recognize 
the contributions of 
other 
interprofessional 
team members  
 
Frustrates team 
members with 
inefficiency and 
errors 
 
Disregards need for 
communication at 
time of transition 
 
Does not respond to 
request of 
caregivers in other 
delivery systems 
 
 

 

Understands that quality 
patient care requires 
coordination and 
teamwork, and 
participates as a 
respectful and effective 
team member  
 
Identifies roles of other 
team members but does 
not recognize how/when 
to utilize them as 
resources 
 
Frequently requires 
reminders from team to 
complete athletic 
training responsibilities  
 
Inefficient transitions of 
care lead to unnecessary 
expense or risk to a 
patient (e.g., duplication 
of tests, reinjury)  
 
 

Understands the roles 
and responsibilities of all 
team members but uses 
them ineffectively  
 
Participates in team 
discussions when 
required but does not 
actively seek input from 
other team members  
 
Communication with 
future caregivers is 
present but with lapses 
in pertinent or timely 
information  
 

Understands the roles 
and responsibilities of 
and effectively 
partners with, all 
members of the team 
 
Actively engages in 
team meetings and 
collaborative decision-
making 
 
Proactively 
communicates with 
past and future care 
givers to ensure 
continuity of care 
 

Integrates all members of 
the team into the care of 
patients, such that each 
is able to maximize their 
skills in the care of the 
patient 
 
Viewed by other team 
members as a leader in 
the delivery of high 
quality care 
 
Coordinates care within 
and across health 
delivery systems to 
optimize patient safety, 
increase efficiency, and 
ensure high quality 
patient outcomes 
 
Anticipates needs of 
patient, caregivers, and 
future care providers and 
takes appropriate steps 
to address those needs  
 

Demonstrates 
professional leadership 
in promoting safe and 
effective transitions of 
care within and across 
health delivery systems 
as part an 
interprofessional team 
 
Generates and 
disseminates new 
knowledge to advance 
interprofessional team-
based care 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Systems-Based Practice (SBP-5): Advocates for individual and community health. (Family Medicine SBP-3) 
Critical 

Deficiencies 
Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Refuses to 
recognize social 
context and 
environmental 
impact on 
individual and 
community health 
 
Ignores how a 
community’s 
public policy 
decisions affect 
individual and 
community health 
 

Recognizes social context 
and environment, and 
how a community’s 
public policy decisions 
affect individual and 
community health 

Recognizes that 
athletic trainers can 
impact community 
health 
 
Lists ways in which 
community 
characteristics and 
resources affect the 
health of patients and 
communities 
 
 

Identifies specific 
community characteristic 
that impact specific 
patients’ health 
 
Understands the process 
of conducting a 
community strengths and 
needs assessment 
 

Collaborates with other 
athletic training 
practices/systems, public 
health, and community-
based organizations to 
educate the public, guide 
policies, and implement 
and evaluate community 
initiatives 
 
Role models active 
involvement in community 
education and policy 
change to improve health 
of patient and communities 
 

Demonstrates 
professional leadership 
in community education 
and policy change to 
improve health of 
patient and 
communities 
 
Generates and 
disseminates new 
knowledge in 
community education 
and policy change to 
improve health of 
patient and 
communities 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Systems-Based Practice (SBP-6): Health Information Technology: Utilizes technology to optimize communication. (Family Medicine 
C-4) 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to recognize 
the effects of 
technology on 
information 
exchange and the 
athletic 
trainer/patient 
relationship 
 
Ignores the ethical 
and legal 
implications of using 
technology to 
communicate in 
health care 

Recognizes effects of 
technology on 
information exchange 
and the athletic 
trainer/patient 
relationship 
 
Recognizes the ethical 
and legal implications of 
using technology to 
communicate in health 
care 

Ensures that clinical 
and administrative 
documentation is 
timely, complete, and 
accurate 
 
Maintains key patient-
specific databases, 
such as problem lists, 
medications, health 
maintenance, chronic 
disease registries 
 
 

Effectively and ethically 
uses technology in a 
manner which enhances 
communication and 
does not interfere with 
the appropriate 
interaction with the 
patient 
 
Ensures transitions of 
care are accurately 
documented, and 
optimizes 
communication across 
systems and continuums 
of care 
 
Stays current with 
technology to improve 
communication with 
patients, other 
providers, and systems 
 

Uses comprehensive 
multi-media 
communication strategies 
to enhance patient care 
 
Uses technology to 
optimize continuity care 
of patients and transitions 
of care  
 
Uses technology to adapt 
systems for improving 
communication with 
patients, other providers, 
and systems 
 

Demonstrates 
professional leadership 
in utilizing technology to 
optimize communication 
 
Generates and 
disseminates new 
knowledge in utilizing 
technology to optimize 
communication 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 
 

 

 

 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Systems-Based Practice 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
their education and training. The individual is demonstrating a learning trajectory that anticipates the achievement of competency 
for unsupervised practice (or advanced practice for residency programs) that includes the delivery of safe, timely, effective, efficient, 
equitable, and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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SPECIALTY COMPETENCIES: 

Orthopaedics 

Athletic trainers must demonstrate the ability to conduct an appropriate diagnostic evaluation to define each patient’s clinical problem and to 
effectively manage increasingly complex patient problems. 

Orthopaedics (Ortho-1): Diagnostic Evaluation: Gathers and synthesizes essential and accurate information (history, physical exam, lab work, imaging 
studies, neuropsychological testing, functional assessment measures, etc.) to define each patient’s clinical problem(s). 

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to identify 
appropriate 
diagnostic tests 
 
Fails to accurately 
identify appropriate 
differential diagnoses 
 
Fails to identify 
deviations from the 
normal course of 
orthopaedic 
conditions 

Perform a relevant 
patient history  
 
Performs a basic 
physical examination 
 
Recognizes normal 
movement patterns 
 
Demonstrates 
knowledge of 
common orthopaedic 
conditions 

Demonstrates both 
basic science and 
clinical knowledge of 
the details of tissue 
healing and cellular 
physiology across the 
lifespan 
 
Performs a regional 
orthopaedic exam 
with appropriate 
diagnostic selective 
tissue tests 
 
Recognize source of 
abnormal movement 
patterns and 
structures 
 
Applies clinical rules 
for diagnostics (such 
as Ottawa Ankle, 
Canadian C-spine) 

Demonstrates 
knowledge of factors 
associated with risk 
of injury, including, 
age, gender, and 
disability  
 
Accurately and 
efficiently diagnoses 
common, non-
complex, 
orthopaedic 
conditions 
 
Recognizes the need 
for and recommends 
appropriate plain 
films/radiographs  
 
Accurately interprets 
plain 
films/radiographs 

Appropriately prioritizes the 
urgency and sequencing of 
diagnostic testing 
 
Utilizes clusters of diagnostic 
tests and evaluates complex 
conditions with or without co-
morbidities and recognizes 
atypical presentations  
 
Recognizes appropriate 
differentials that include non-
orthopaedic conditions that 
present as orthopaedic 
conditions 
 
Recommends and interprets 
advanced orthopaedic imaging, 
such as MSUS, MRI, and CT 
 
Educates others to improve 
their orthopaedic diagnostic 
evaluation knowledge and 
skills 

Efficiently produces a 
focused and prioritized 
orthopaedic examination 
accounting for rare 
conditions 
 
Serves as a consultant 
for rare and/or complex 
orthopaedic patients 
 
Demonstrates 
professional leadership 
in orthopaedic diagnostic 
evaluation 
 
Generates and 
disseminates new 
knowledge to advance 
orthopaedic diagnostic 
evaluation 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Comments: 
 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Orthopaedics (Ortho-2): Management: Effectively manages patients with increasingly complex orthopaedic conditions.  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Inappropriate 
management places 
patient at risk 
 
Care plans are 
consistently 
inappropriate or 
inaccurate 
 
Fails to refer when 
appropriate 
 
Fails to measure the 
end-results of care 
 
Fails to inform patient 
of long-term health 
consequences 
 

Participates in 
patient management 
being conducted by 
other appropriately 
qualified providers 
 
Demonstrates 
knowledge of basic 
care plans for 
common orthopaedic 
conditions  
 
Inconsistently 
develops an 
appropriate care plan 
 
Participates in 
patient education 
regarding the nature 
of their condition 
and corresponding 
care plan 
 

Synthesizes 
information gathered 
to guide patient care 
 
Consistently develops 
appropriate care plan 
 
Protects patient from 
further injury and 
understands the 
implications of activity 
on recovery time  
 
Performs patient 
education regarding 
their condition and 
corresponding care 
plan 
 
Initiates management 
plans for urgent or 
emergent care 
 
Demonstrates 
knowledge of 
treatment options of 
operative and non-
operative 
management of 
orthopaedic 
conditions  

Effectively manages 
common, non-complex 
orthopaedic conditions 
 
Appropriately modifies 
care plans based on 
patient’s clinical course, 
additional data, and 
patient preferences 
 
Performs patient 
education regarding 
long-term consequences 
of orthopaedic 
conditions 
 
Appropriately applies 
criteria for safe return to 
activity and participation 
 
Appropriately manages 
situations requiring 
urgent or emergent care 
 
Recognizes 
complications in 
operative and non-
operative management 
of orthopaedic 
conditions 

Effectively manages 
complex orthopaedic 
conditions with or without 
co-morbidities  
 
Develops customized, 
prioritized care plans for 
the most complex patients, 
incorporating diagnostic 
uncertainty and cost 
effectiveness principles 
 
Patient advocate for 
maximizing long-term 
health-related quality of 
life (HRQOL)  
 
Care plan extends beyond 
return to safe activity to 
maximize participation 
 
Educates others to improve 
their orthopaedic 
management knowledge 
and skills 
 
Demonstrates knowledge 
of controversies in 
operative and non-
operative management of 
orthopaedic conditions  

Effectively manages rare 
conditions 
 
Serves as a consultant for 
rare and/or complex 
orthopaedic patients 
 
Demonstrates 
professional leadership in 
orthopaedic 
management 
 
Generates and 
disseminates new 
knowledge to advance 
orthopaedic 
management 
 
Develops best practice 
guidelines for developing 
orthopaedic care plans 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Orthopaedics  

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
their education and training. The individual is demonstrating a learning trajectory that anticipates the achievement of 
competency for unsupervised practice (or advanced practice for residency programs) that includes the delivery of safe, timely, 
effective, efficient, equitable, and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

  

Comments: 
 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Behavioral Health 

Athletic trainers must demonstrate the ability to appropriately assess and recognize each patient’s clinical problem and to effectively manage 
behavioral health problems. 

Behavioral Health (BH-1): Assessment and recognition of conditions, that include, but are not limited to, suicidal ideation, depression, anxiety disorder, 
psychosis, mania, eating disorders, and attention deficit disorders. 

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to recognize 
behavioral health 
concerns in patients  
 
Fails to recognize an 
at-risk or in crisis 
patient 
 
Fails to intervene on 
behalf of an at-risk or 
in crisis patient 
 
Fails to identify 
appropriate 
assessment measures 
 
Fails to identify 
deviations from the 
normal course of 
behavioral health 
conditions 
 

Demonstrates 
knowledge of 
common behavioral 
health conditions 
 
Performs a relevant 
patient history  
 
Identifies common 
characteristics of at 
risk or in crisis 
patients 
 
Inconsistently seeks 
additional guidance 
when needed 
 
 
 

Identifies common 
behavioral health 
conditions 
 
Identifies at risk 
patients and 
populations 
 
Recognizes 
appropriate 
behavioral responses 
to life events 
 
Recognizes the need 
to intervene on behalf 
of an at-risk or in crisis 
patient 
 
Seeks additional 
guidance, consultation 
and/or referral as 
appropriate 
 

Recognizes the need for 
and recommends 
appropriate behavioral 
health assessments 
 
Demonstrates both 
basic science and 
clinical knowledge of 
behavioral health 
conditions 
 
Accurately interprets 
behavioral health 
assessments 
 
Accurately identifies 
common, non-complex, 
behavioral health 
conditions  
 
Establishes a network of 
behavioral health 
professionals 

Recognizes complex 
conditions with or without 
co-morbidities, and atypical 
presentations 
 
Accurately identifies at-risk 
populations and is able to 
intervene early in the 
process 
 
Recognizes different 
presentations, sequelae, 
and prognoses of 
behavioral health 
conditions across the 
lifespan  
 
Appropriately prioritizes 
the urgency and 
sequencing of behavioral 
health assessments 
 
Educates others to improve 
their behavioral health 
knowledge and skills 
 

Serves as a consultant for 
complex behavioral health 
patients 
 
Demonstrates 
professional leadership in 
behavioral health  
 
Generates and 
disseminates new 
knowledge to advance 
behavioral health 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments:  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Behavioral Health (BH-2): Management: Effectively manages patients with behavioral health conditions. 
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to recognize need 
for referral  
 
Fails to refer when 
appropriate 
 
Inappropriate 
management places 
patient at further risk or 
in crisis  
 

 
 
 

Activates emergency 
action plan in a 
suspected behavioral 
health crisis 
 
Participates in patient 
management being 
conducted by other 
appropriately qualified 
providers 
 
Adheres to all 
institutional/facility 
behavioral health 
policies  

Demonstrates knowledge 
of basic care plans for 
common behavioral 
health conditions  
 
Recognizes when referral 
is needed and when a 
situation is 
emergent/non-emergent 
 
Understands when an 
individualized behavioral 
health care team needs to 
be developed  
 
Performs patient 
education regarding 
behavioral health 
conditions 
 
Initiates and recommends 
appropriate management 
plans for urgent or 
emergent care of 
behavioral health 
conditions 
 
 

Is an active member of the 
behavioral health care team 
 
Synthesizes information 
gathered to guide patient 
care 
 
Effectively manages 
common, non-complex 
behavioral health conditions 
 
Communicates with care 
team and participates in the 
implementation of the care 
plan  
 
Appropriately manages 
situations requiring urgent 
or emergent care 
 
Recognizes common 
complications in behavioral 
health conditions 
 
Able to educate patients 
and stakeholders of at-risk 
populations on prevention 
and long-term 
consequences of behavioral 
health conditions 
 
Develops and implements 
behavioral health EAP and 
other policies governing 
behavioral health conditions 
 

Demonstrates knowledge of the 
use of psychotropic medications 
and their interactions and side 
effects  
 
Manages day-to-day 
considerations for behavioral 
health patients  
  
Patient advocate for maximizing 
long-term health-related quality 
of life (HRQOL)  
 
Educates others to improve 
their knowledge and skills in 
managing behavioral health 
conditions 
 
Within a patient population, 
identify individual and group 
behavioral health needs and 
develops more advanced 
behavioral health policies (e.g., 
team policy, individual 
contracts) 
  

Serves as a consultant for 
management of behavioral 
health conditions 
 
Demonstrates professional 
leadership in management of 
behavioral health conditions 
 
Generates and disseminates 
new knowledge to advance 
the management of 
behavioral health conditions 
 
Develops best practice 
guidelines for the 
management of behavioral 
health conditions 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments:  
 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Behavioral Health 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
training. He/she is demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised practice (or 
advanced practice for residency programs) that includes the delivery of safe, timely, effective, efficient, equitable, and patient-
centered care.  

_____ Yes _____ No _____ Conditional on Improvement  

 

 

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Pediatrics 

Athletic trainers must demonstrate the ability to conduct an appropriate diagnostic evaluation to define each pediatric patient’s clinical problem 
and to effectively manage increasingly complex pediatric patient problems. 

Pediatrics (Peds-1): Diagnostic Evaluation: Gathers and synthesizes essential and accurate information (history, physical exam, lab work, imaging studies, 
neuropsychological testing, and functional assessments) to define each pediatric patient’s clinical problem(s). 

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to identify 
conditions unique to the 
pediatric patient 
 
Fails to identify 
appropriate pediatric 
diagnostic tests 
 
Fails to accurately 
identify appropriate 
differential diagnoses 
for the pediatric patient 
 
Fails to identify 
deviations from the 
normal course of 
pediatric conditions 
 

 
 

Perform a relevant 
patient history 
including growth and 
developmental 
milestones 
 
Performs a basic 
physical examination 
 
Demonstrates 
knowledge of common 
pediatric conditions 

Demonstrates 
clinical knowledge 
of pediatric growth 
and development 
 
Demonstrates 
knowledge of basic 
science of tissue 
healing, cellular 
physiology, and 
physis physiology in 
pediatrics 
 
Applies clinical rules 
for diagnostics (such 
as Pediatric Ottawa 
Ankle, PECARN Head 
Trauma Rules, 
Canadian C-spine) 

Demonstrates knowledge of 
factors associated with risk of 
injury, including, age, gender, 
and disability  
 
Performs a regional pediatric 
orthopaedic exam with 
knowledge of the growth plate 
locations and appropriate 
diagnostic tests 
 
Accurately diagnoses common, 
non-complex, pediatric 
conditions 
 
Accurately recommends and 
interprets appropriate plain 
films/radiographs, recognizing 
the importance of comparison 
views to evaluate physis injury 
 
Recognizes appropriate 
pediatric differentials that 
include asthma, Diabetes (Type 
1 and 2), anaphylaxis, syncope, 
congenital and acquired heart 
disease, exercise, dehydration, 
supplements, and medication 
side effects 

Appropriately prioritizes the 
urgency and sequencing of 
diagnostic testing 
 
Utilizes clusters of diagnostic 
tests and evaluates complex 
conditions with or without co-
morbidities, and recognizes 
atypical presentations  
 
Recognizes appropriate 
differentials that include non-
orthopaedic conditions that 
present as orthopaedic 
conditions in the pediatric 
patient 
 
Respects cumulative radiation 
effects in pediatric patients 
and recommends and 
interprets advanced pediatric 
orthopaedic imaging, such as 
MSK US, MRI, and CT 
 
Educates others to improve 
their pediatric diagnostic 
evaluation knowledge and 
skills 

Efficiently produces a 
focused and prioritized 
pediatric examination 
accounting for rare 
conditions 
 
Serves as a consultant for 
rare and/or complex 
pediatric patients 
 
Demonstrates professional 
leadership in pediatric 
diagnostic evaluation 
 
Generates and disseminates 
new knowledge to advance 
pediatric diagnostic 
evaluation 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Comments:  
 

 

Pediatrics (Peds-2): Management: Effectively manages pediatric patients with increasingly complex conditions.  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Inappropriate 
management places 
patient at risk 
 
Care plans are 
consistently 
inappropriate or 
inaccurate 
 
Fails to refer when 
appropriate 
 
Fails to measure the 
end-results of care 
 
Fails to inform patient 
and family/caregiver of 
long-term health 
consequences 
 

 
 
 
 

Participates in 
pediatric patient 
management being 
conducted by other 
appropriately qualified 
providers 
 
Demonstrates 
knowledge of basic 
care plans for common 
pediatric conditions  
 
Inconsistently 
develops an 
appropriate care plan 
 
Participates in 
pediatric patient and 
family/caregiver 
education regarding 
the nature of their 
condition and 
corresponding care 
plan 
 
 
 
 
 

Synthesizes information 
gathered to guide 
pediatric patient care 
 
Consistently develops 
appropriate care plan 
 
Protects pediatric patient 
from further injury and 
understands the 
implications of activity, 
overuse injury, and physis 
injury on recovery time  
 
Performs pediatric 
patient and 
family/caregiver 
education regarding their 
condition and 
corresponding care plan 
 
Demonstrates knowledge 
of treatment options of 
operative and non-
operative management 
of pediatric conditions  

Effectively manages 
common, non-complex 
pediatric conditions 
 
Appropriately modifies care 
plans based on patient’s 
clinical course, additional 
data, and patient and 
family/caregiver 
preferences 
 
Educates family and patient 
regarding long-term 
consequences of pediatric 
conditions 
 
Appropriately applies 
criteria for safe return to 
activity and participation 
 
Appropriately manages 
situations requiring urgent 
or emergent care 
 
Recognizes complications in 
operative and non-
operative management of 
pediatric conditions 
 
Educates patient and family 
regarding medication side 
effects (prescribed, OTC, 
and supplements). 

Effectively manages complex 
pediatric conditions with or 
without co-morbidities such 
as asthma, allergy, diabetes, 
heart disease, seizures etc. 
 
Develops customized, 
prioritized care plans for the 
most complex patients, 
incorporating diagnostic 
uncertainty and cost 
effectiveness principles 
 
Care plan extends beyond 
return to safe activity to 
maximize participation and 
long term health 
 
Educates others to improve 
their pediatric patient 
management knowledge and 
skills 
 
Demonstrates knowledge of 
controversies in operative and 
non-operative management 
of pediatric conditions  

 

Effectively manages rare 
conditions 
 
Serves as a consultant for 
rare and/or complex 
pediatric patients 
 
Demonstrates professional 
leadership in pediatric 
condition management 
 
Generates and 
disseminates new 
knowledge to advance 
pediatric condition 
management 
 
Develops best practice 
guidelines for developing 
pediatric condition care 
plans 
 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments:  
 

 

 

Pediatrics  

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
their education and training. The individual is demonstrating a learning trajectory that anticipates the achievement of competency 
for unsupervised practice (or advanced practice for residency programs) that includes the delivery of safe, timely, effective, efficient, 
equitable, and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

 

  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Primary Care 

Athletic trainers must demonstrate the ability to conduct an appropriate diagnostic evaluation to define each patient’s clinical problem and to 
manage increasingly complex primary care problems.  

Primary Care (PC-1): Diagnostics: Medical Issues across all systems (e.g., circulatory, pulmonary, nervous, psychologic, digestive, endocrine, musculoskeletal, 
immune, reproductive, integumentary, lymphatic, urinary). (Sports Medicine MK-2) 

Critical 
Deficiencies 

Level 1 Level 2 Level 3 
(Ready for Unsupervised 

Practice) 

Level 4 
(Ready for Advanced Practice) 

Level 5 
(Aspirational) 

Failure to 
understand patients 
personal healthcare 
needs 
(comprehensive 
medicine) 
 
Fails to identify 
knowledge of 
systems involved 
based on patient 
presentation 
 
Fails to identify 
deviations from the 
normal course of 
systems functioning 
 
 
 
 
 
 

Demonstrates 
general knowledge 
of personal 
healthcare needs 
across all systems  
 
Able to identify 
pertinent 
information to 
guide patient care 
 
Demonstrates 
knowledge of 
pathophysiology of 
common medical 
conditions  
 
 

Identifies appropriate 
history and 
symptomatology of 
common conditions 
 
Identifies relationships 
between involved 
systems in common 
medical conditions  
  
Demonstrates 
knowledge of diagnostic 
testing to evaluate 
medical conditions 
 
Demonstrates both 
basic science and clinical 
knowledge of the details 
of disease process and 
natural course of illness 
 
 

Recognizes the need and 
selects appropriate 
diagnostic studies used to 
evaluate common medical 
conditions (e.g., EKG, 
pulmonary function test, 
laboratory results, PHQ2, 
radiographs, vestibular 
oculomotor motor screen) 
 
Correctly interprets 
diagnostic study results and 
appropriately pursues 
further testing or specialist 
input  
 
Synthesizes knowledge of 
condition(s) and effect on 
system(s), and vice versa, 
to develop differential 
diagnoses.  
 
Accurately and efficiently 
diagnoses common, non-
complex, medical 
conditions 

Appropriately prioritizes the 
urgency and sequencing of 
diagnostic testing 
  
Recommends and interprets 
advanced diagnostic studies 
used to evaluate common and 
complex medical conditions 
 
Utilizes clusters of diagnostic 
tests and evaluates complex 
conditions with or without co-
morbidities, and recognizes 
atypical presentations  
 
Integrates knowledge of 
conditions (common and 
complex), systems, and 
interactions to arrive at 
diagnosis 
 
Educates others to improve 
their primary care diagnostic 
evaluation, knowledge, and 
skills 

Publishes peer-reviewed 
scientific work related to 
medical issues 
 
Possesses the scientific, 
socioeconomic, and 
behavioral knowledge 
required to diagnose and 
treat uncommon, ambiguous, 
and complex medical 
conditions 
 
Efficiently produces a focused 
and prioritized general 
medical examination 
accounting for rare conditions 
 
Serves as a consultant for 
rare and/or complex primary 
care patients 
 
Generates and disseminates 
new knowledge to advance 
primary care diagnostic 
evaluation 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments:  



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Primary Care (PC-2): Management: Effectively manages patients with increasingly complex medical conditions.  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to intervene 
correctly with patients 
personal healthcare 
needs 
 
Inappropriate 
management places 
patient at risk 
 
Care plans are 
consistently 
inappropriate or 
inaccurate 
 
Fails to refer when 
appropriate 
 
Fails to measure the 
end-results of care 
 
Fails to inform patient of 
long-term health 
consequences 

 

Participates in patient 
management being 
conducted by other 
appropriately qualified 
providers 
 
Demonstrates 
knowledge of basic 
care plans for common 
general medical 
conditions  
 
Inconsistently develops 
an appropriate care 
plan 
 
Participates in patient 
education regarding 
the nature of their 
condition and 
corresponding care 
plan 
 
Demonstrates 
knowledge of the role 
of medications and 
substances  
 
 

Recognizes the need for 
urgent care  
 
Synthesizes information 
gathered to guide 
patient care 
 
Develops appropriate 
care plans 
 
Protects patient from 
further injury and 
understands the 
implications of activity 
on recovery time  
 
Performs patient 
education regarding 
their condition and 
corresponding care 
 
Demonstrates 
knowledge of treatment 
options of operative and 
non-operative 
management of medical 
conditions  

Identifies common 
medication and 
substance use and 
misuse 
 

Appropriately manages 
situations requiring urgent 
care 
 
Accurately and efficiently 
manages patients with 
common, non-complex, 
medical conditions  
 
Identifies and 
recommends appropriate 
consultation and/or 
referral of patients with 
medical conditions 
 
Demonstrates knowledge 
of activity and 
participation guidelines for 
common medical 
conditions  
 
Appropriately modifies 
plan of care based on 
clinical course and 
individual risk factors 
 
Recognizes complication in 
operative and non-
operative management of 
medical conditions 
 
Recognizes appropriate 
medication and substance 
use for specific conditions 
and identifies multiple 
drug interactions 

Implements advanced 
interventions for situations 
requiring urgent care  
 
Effectively manages 
uncommon and/or complex 
medical conditions with or 
without co-morbidities  
 
Demonstrates knowledge of 
activity and participation 
guidelines for complex 
medical conditions 
 
Recommends appropriate 
medication(s) based on clinical 
course and individual risk 
factors 
 
Identifies common signs and 
symptoms of medication 
and/or substance abuse 
 
Educates others to improve 
their medical management 
knowledge and skills 
 

Effectively manages rare 
medical conditions 
 
Serves as a consultant for 
rare and/or complex primary 
care patients 
 
Collaborates with other 
experts to advance medical 
management  
 
Demonstrates professional 
leadership in primary care 
management 
 
Generates and disseminates 
new knowledge to advance 
primary care management 
 
Develops best practice 
guidelines for developing 
primary care plans 
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

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Comments:  
 

Primary Care 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
training. The individual is demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised 
practice (or advanced practice for residency programs) that includes the delivery of safe, timely, effective, efficient, equitable, 
and patient-centered care.  

_____ Yes _____ No _____ Conditional on Improvement  

 

 

 

 

 

 

 

 

 

 

 

 

 

Rehabilitation  

Athletic trainers must demonstrate the ability to conduct an appropriate assessment to define each patient’s clinical problem and to implement 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

effective rehabilitation strategies for increasingly complex patient problems.  

Rehabilitation (R-1): Diagnostic Evaluation: Gathers and synthesizes essential and accurate information (history, physical exam, lab work, imaging studies, 
neuropsychological testing, functional assessment measures, etc.) to define each patient’s clinical problem(s). 

Critical Deficiencies Level 1  Level 2 Level 3 
 (Ready for Unsupervised 

Practices) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Fails to identify 
appropriate diagnostic 
tests  

Fails to accurately 
identify appropriate 
differential diagnoses  

Fails to re-assess at 
appropriate intervals 

Fails to identify 
deviations from the 
normal course of care  

 
 
 
 
 
 
 
 

Perform a relevant 
patient history  

Performs a basic 
physical examination  

Assesses the patient 
perspective including 
goals & values  

Recognizes normal 
movement patterns 

Demonstrates 
knowledge of body 
systems and basic 
pathology 
 
 

Demonstrates both 
basic science and 
clinical knowledge of 
tissue healing and 
cellular physiology 
across the lifespan  

Identifies precautions 
and contraindications 
to rehabilitation 
 
Assesses patient’s 
overall health-related 
quality of life 
 
Identifies abnormal 
and adaptive 
movement patterns 
 
Recognizes need to re-
assess based on 
healing and function  

Demonstrates 
knowledge of factors 
associated with risk of 
injury and disease, 
including age, gender 
and disability  

Recognizes the need for 
and recommends 
appropriate diagnostic 
tests (e.g., labs, 
imaging) 

Accurately interprets 
diagnostic tests  

Recognizes the impact 
of specific conditions on 
the whole person (e.g., 
psychologic, 
physiologic) 
 
Recognize source of 
abnormal and adaptive 
movement patterns and 
structures  

Appropriately prioritizes 
the urgency and 
sequencing of diagnostic 
testing  

Utilizes clusters of 
diagnostic tests and 
evaluates complex 
conditions with or without 
co- morbidities, and 
recognizes atypical 
presentations  

Demonstrates ability to 
analyze abnormal 
movement patterns and 
identify causation    

Educates others to improve 
their rehabilitation 
diagnostic evaluation 
knowledge and skills  

 
 

Efficiently produces a 
focused and prioritized 
rehabilitative examination 
accounting for rare 
conditions  
 
Serves as a consultant for 
rare and/or complex 
rehabilitation patients 
 
Demonstrates 
professional leadership in 
rehabilitative diagnostic 
evaluation 
 
Generates and 
disseminates new 
knowledge to advance 
rehabilitative diagnostic 
evaluation  
 

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 
Comments: 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

Rehabilitation (R-2): Management: Effectively manages the rehabilitation of patients with increasingly complex conditions.  
Critical Deficiencies Level 1  Level 2 Level 3 

 (Ready for Unsupervised 
Practice) 

Level 4  
(Ready for Advanced Practice) 

Level 5 
 (Aspirational) 

Inappropriate 
management places 
patient at risk  

Care plans are 
consistently 
inappropriate or 
inaccurate 

Fails to identify 
appropriate patient 
progress 
 
Fails to refer when 
appropriate  

Fails to measure the 
end-results of care  

Fails to inform patient 
of long-term health 
consequences  

 

Participates in 
patient management 
being conducted by 
other appropriately 
qualified providers 
 
Demonstrates 
knowledge of basic 
rehabilitation 
principles  
 
Participates in 
patient education 
regarding the nature 
of their condition and 
corresponding care 
plan 
 
Describes basic 
impairments, activity 
limitations, and 
participation 
restrictions resulting 
from disease or 
injury 
 

Synthesizes 
information gathered 
to guide patient care  

Consistently develops 
appropriate care plan  

Protects patient from 
further injury and 
understands the 
implications of activity 
on recovery time  

Addresses 
foundational 
movement 
dysfunction as part of 
intervention 
 
Implements systems-
based rehabilitation 
strategies  
 
Identify when referral 
to others will expedite 
care 
 
Performs patient 
education regarding 
their condition and 
corresponding care 
plan 

Effectively manages 
common, non-complex 
conditions  

Appropriately modifies 
care plans based on 
patient’s clinical course, 
additional data (e.g., 
PROs, CROs), and 
patient preferences  

Performs patient 
education regarding 
long-term 
consequences of injury 
or disease  

Appropriately applies 
criteria for safe return 
to activity and 
participation  

Prescribes commonly 
used assistive and 
adaptive devices and 
strategies 
 
Considers the whole 
person (e.g., 
psychologic, 
physiologic) in the care 
plan 

Effectively manages 
uncommon and/or complex 
patient conditions with or 
without co-morbidities  

Develops customized, 
prioritized care plans for 
the most complex patients, 
incorporating diagnostic 
uncertainty and cost 
effectiveness principles  

Patient advocate for 
maximizing long-term 
health-related quality of life 
(HRQOL)  

Care plan extends beyond 
return to safe activity to 
maximize participation  

Effectively manages the 
whole person (e.g., 
psychologic, physiologic) 
 
Effectively leads or directs 
interdisciplinary care team 

Educates others to improve 
their rehabilitation 
management, knowledge 
and skills  

Effectively manages 
patients with rare 
conditions  

Serves as a consultant for 
rare and/or complex 
rehabilitation cases  

Demonstrates 
professional leadership in 
rehabilitation 
management  

Generates and 
disseminates new 
knowledge to advance 
rehabilitation 
management  

Develops best practice 
guidelines for developing 
rehabilitation care plans  

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 



The Development, Implementation, and Value of the Athletic Training Milestones for Assessing Progressive Clinical Behaviors  

Copyright © 2018-2023 All rights reserved. The copyright owners grant third parties the right to use the Athletic Training Milestones on a non-exclusive basis for educational purposes.   

 

Rehabilitation 

The individual is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in 
training. The individual is demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised 
practice (or advanced practice for residency programs) that includes the delivery of safe, timely, effective, efficient, equitable, 
and patient-centered care. 

_____ Yes _____ No _____ Conditional on Improvement  

 

 

 

 

 

 

 

 

 

 

Comments:  


	Manuscript 225 Final_Final_HW.pdf
	Manuscript 225 Appendix 1 .pdf

