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PubMed1991

Protein intake and athletic performance.

For most of the current century, exercise/nutritional scientists have generally accepted the belief that exercise has little effect on protein/amino acid requirements. However, during the same time period many athletes (especially strength athletes) have routinely consumed diets high in protein. In recent years, the results of a number of investigations involving both strength and endurance athletes indicate that, in fact, exercise does increase protein/amino acid need. For endurance athletes, regular exercise may increase protein need by 50 to 100%. For strength athletes, the data are less clear; however, protein intakes in excess of sedentary needs may enhance muscle development. Despite these observations increased protein intake may not improve athletic performance because many athletes routinely consume 150 to 200% of sedentary protein requirements. Assuming total energy intake is sufficient to cover the high expenditures caused by daily training, a diet containing 12 to 15% of its energy from protein should be adequate for both types of athletes.

Dietary Proteins↗
PubMed1998

High school athletes and marijuana use.

Identifying groups of young people that might be especially susceptible to marijuana use would aid in the design and implementation of drug policy programs. This article examines whether those who participated in high school athletics have a different pattern of marijuana use than comparable non-athletes. The results indicate that male athletes have a higher incidence of marijuana use than non-athletes. The same is not true for female athletes, who actually engage in less marijuana use than their non-athlete counterparts. However, female athletes are more likely than non-athletes to wait until their post-high school years to try the drug for the first time.

Adolescent↗
PubMed1994

Assessment of vitamin B2 status in performance athletes of various types of sports.

To determine the vitamin B2 supply, 62 athletes in various types of sports and 16 non-athletes were examined, using a weighed food record (7-day), alpha-EGR determination, microbiological blood, and HPLC urinary measurements. If the guidelines of 1.5 or 1.7 mg/day vitamin B2 or 0.6 mg/4,184 kJ (GRDA) are defined for adequate status, all sports groups (M +/- SEM) are above this level. The vitamin B2 blood concentrations show a range (mean) from 303-372 nmol/liter, which indicates that more than 90% of the athletes are above the reference value of 327 nmol/liter (mean). There is a correlation of r = 0.49 between the vitamin B2 intake (mean over 7 days) and the vitamin B2 blood level. Determination of vitamin B2 blood concentration is characterized by good precision (C.V. +/- 3.2%) and recovery (95.7%). The enzyme activation measurement (alpha-EGR) shows that all of the athletes are below the alpha-EGR reference value of < 1.50 (good supply). No significant correlations could be determined between alpha-EGR and vitamin B2 intake, blood concentrations, and urinary excretion. The measurement also shows high precision (C.V. 1.7%). The Vitamin B2 excretion in urine (mumol/g Cr.) was higher than the reference values for non-athletes in more than 90% of the athletes. There is a correlation of r = 0.89 between the vitamin B2 intake on the last day (Day 7) of the food record and the riboflavin excretion, and between vitamin B2 in blood and urinary excretion of r = 0.52. The C.V. of vitamin B2 urinary measurement using HPLC is 2.5%, with recovery of 98.2%. Combined measurement of vitamin B2 intake, blood concentration, and urine excretion appears to be a suitable procedure for determining the vitamin B2 status. Most of the performance athletes were sufficiently supplied with vitamin B2, compared to the reference values for non-athletes.

Adolescent↗
PubMed1999

[Distinguishing between physiologic hypertrophy in athletes and primary hypertrophic cardiomyopathies. Importance of tissue color Doppler].

In order to assess the value of Doppler tissue imaging (DTI) in the differentiation of physiological hypertrophy of athletes from primary hypertrophic cardiomyopathy (HCM), the authors compared a group of 20 normal, non-athletic subjects, a group of 43 competitive athletes and a group of 20 patients with mild HCM. In addition to the conventional echocardiographic criteria, the velocity of wall motion at the endocardium and epicardium of the interventricular septum and the posterior wall as well as their gradients, were measured throughout the cardiac cycle. No significant difference was observed between normal subjects and the athletes with respect to velocities and the gradients of velocity. Early diastolic velocities of the posterior wall and interventricular septum were significantly lower than those of normal subjects and athletes. The systolic and early diastolic gradients of velocity of the posterior wall were significantly lower in HCM compared with the normal subjects and athletes. The gradient of velocity between the endocardium and epicardium of the interventricular septum was significantly lower in HCM compared with normal subjects in early diastole and with athletes in systole and early diastole. The best Doppler tissue imaging parameter to differentiate pathological hypertrophy of HCM from physiological hypertrophy of athletes was analysis of the gradient of velocity in early diastole of the posterior wall. A value of 0.7 sec-1 differentiated HCM with a sensitivity of 89%, a specificity of 95% and a diagnostic accuracy of 94%. Doppler tissue imaging is a more sensitive and specific technique than conventional Doppler echocardiography for detecting moderate forms of HCM.

Adult↗
PubMed1999

Commotio cordis: sudden cardiac death in athletes.

Commotio cordis due to blunt trauma to the precordium is a rare cause of death in young athletes, occurring less frequently than all of the other athletics-related deaths. Several measures, such as the use of safety baseballs and the use of chest protectors, can help protect young athletes from commotio cordis. In general, sudden cardiac death in athletes is receiving increasing attention from the public as a result of recent deaths of high-profile athletes. Sudden cardiac death, however, is rare, with an estimated 1 out of 200,000 high school athletes at risk each year. However, the personal, physiological, and cardiovascular benefits of athletics far outweigh the risks. Therefore, the message to parents is to allow their children to participate in athletics because the benefits far outweigh the risks.

Adolescent↗
PubMed1999

Can reticulocyte parameters be of use in detecting iron deficient erythropoiesis in female athletes?

BACKGROUND: The purpose of this study was to investigate whether monitoring reticulocyte profiles, which are known to respond to iron store depletion in sedentary populations, could also be utilised with intensely training athletes. METHODS: A retrospective study of blood samples from 134 national level athletes (61 males, 73 females) at the Australian Institute of Sport were analysed, from which reference ranges were calculated. To ascertain the stability of reticulocyte profiles during periods of intense physical training, the intra-individual variation of these parameters in 12 iron-replete female athletes over a four month period of training was documented. The precision with which the analyzer measured these parameters was also determined using duplicate samples from 37 female athletes. To establish whether reticulocyte parameters were sensitive to iron deficient erythropoiesis in athletes, reticulocyte profiles of five female athletes diagnosed by medical personnel as having depleted iron stores were compared before and after iron therapy to seven controls. RESULTS: Corpuscular hemoglobin concentration mean (CHCMr) and mean corpuscular volume (MCVr) showed little variation over time in iron-replete females, with 95% of all fluctuations being within 5.8% and 4.3% of original values, respectively. Iron supplementation in athletes with depleted iron stores elicited an increase in CHCMr (p = 0.01), and a decrease in the distributions of reticulocyte volume (RDWr, p = 0.01) and cell hemoglobin concentration (HDWr, p < 0.01). The ratios of reticulocyte to mature cell MCV (p < 0.01) and CHCM (p < 0.01) also changed following iron therapy. No such changes occurred in non-supplemented controls with normal iron stores. CONCLUSIONS: These data lend support to the thesis that monitoring of reticulocyte parameters can be of use in detecting iron deficient erythropoiesis in female athletes.

Analysis of Variance↗
PubMed1999

Is prevention of sudden death in young athletes feasible?

A wide spectrum of cardiovascular abnormalities may cause sudden death in young athletes, and even minor lesions may be life-threatening by jeopardizing the electrical order of the heart during effort. The culprit diseases are clinically covert and difficult to diagnose or suspect. Early identification during systematic preparticipation screening might reduce the risk and incidence of sudden death. In the time interval 1979-1996, 49 young athletes died suddenly in the Veneto Region. The prevalence of sudden death was calculated as 0.75/100,000/year among young nonathletes and 1.6/100,000/year among young athletes (p < 0.01). Among athletes, arrhythmogenic right ventricular cardiomyopathy was the leading cause, followed by atherosclerotic coronary artery disease and congenital coronary anomalies. Hypertrophic cardiomyopathy has been a very uncommon cause of fatal events, due to the identification and disqualification of affected subjects at the preparticipation screening. Only arrhythmogenic right ventricular cardiomyopathy and congenital anomalies of coronary arteries occurred more frequently in athletes than in nonathletes, as to indicate that these diseases are particularly prone to cardiac arrest during effort. The rarity of prodroma in patients affected by coronary artery disease, both acquired and congenital, particularly the absence of chest pain, stresses the difficulty in suspecting these lesions. On the opposite, most of athletes with arrhythmogenic right ventricular cardiomyopathy had something that might have alerted, either in terms of family history or electrical disorders. Our data are strongly in favor of an effective role of the Italian protocol for preparticipation screening in preventing sudden death in young athletes affected by hypertrophic cardiomyopathy. With increased awareness of diagnostic criteria, also athletes with concealed arrhythmogenic right ventricular cardiomyopathy will be identified in the future and sudden death possibly prevented.

Adolescent↗
PubMed1999

Doppler echocardiographic examinations in the assessment of the athletic heart.

Doppler echocardiography is a method with the help of which flow velocity and the duration of different intervals can be estimated. The ratio between early and late peak velocities (E/A) is linearly proportional to diastolic function, i.e. to ventricular compliance. Data of 179 athletes and of 42 nontrained young healthy men indicated that the E/A quotient was higher in athletes than in the sedentary controls (2.086 +/- 0.505 vs. 1.905 +/- 0.384) in young adult age, but of the different athletes it was the only group of endurance athletes that showed a significant increase. Regular physical training seems to protect against an age-dependent impairment of left ventricular compliance, as an increased E/A ratio can be observed at the age of 31-45 years (1.77 +/- 0.46 vs. 1.43 +/- 0.276) as well as in men above 45 years of age (1.61 +/- 0.36 vs. 1.24 +/- 0.36). Bradycardia of the athletic heart resulted in a significantly longer duration of the cardiac cycle in athletes than in non-athletes. Different phases of the cardiac cycle, however, were not equally modified. There were periods the absolute duration of which were slightly decreased, unchanged or slightly increased, but the relative ones are strongly decreased: such as isovolumetric contraction time (ICT), acceleration of the transaortic flow (AOAT), deceleration of the transaortic flow (AODT), acceleration period of the early diastolic filling (EACC), and deceleration period of the early diastolic filling (EDT). There were periods the absolute duration of which increased proportionally to the increase of the whole cardiac cycle, while relative duration was not changed: isovolumetric contraction time (IVRT) and the atrial systole (A). There was one period that showed the greatest variability in the different subjects and both its absolute and relative duration was definitely increased in the athletes: this was the EA period, i.e. the period from the end of early filling to the beginning of the atrial systole.

Adolescent↗
PubMed1999

Cardiopulmonary and Cardiovascular Physiology in Elderly Competitive Endurance Athletes.

Thirteen elderly male high intensity endurance athletes and 12 healthy age matched nonathletes were evaluated to determine differences in their cardiovascular physiology. Contrary to several pervious reports, this study did not demonstrate superiority of left ventricular (LV) systolic or diastolic function in athletes compared with controls, either at rest or immediately following exercise. Fasting serum lipids failed to demonstrate a favorable cholesterol profile in the athletes compared to inactive controls. Our results point to superior oxygen utilization (mean peak Vo2 44 vs. 27 mL/kg/min; athletes vs. controls) and the capacity to exercise both aerobically (mean duration 24 vs. 12 min; athletes vs. controls) and anaerobically (mean duration 10 vs. 4 min; athletes vs. controls) as distinguishing parameters between the two cohorts. Our study suggests that in senior athletes, enhanced LV diastolic function may not be as great a contributing factor to athletic performance as previously reported. (c)1999 by CVRR, Inc.

Journal Article↗
PubMed2000

Position of Dietitians of Canada, the American Dietetic Association, and the American College of Sports Medicine: Nutrition and Athletic Performance.

It is the position of Dietitians of Canada, the American Dietetic Association, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of food and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This position paper reviews the current scientific data related to athletes' energy needs, assessment of body composition, strategies for weight change, athletes' nutrient and fluid needs, special nutrient needs during training, the use of supplements and nutritional ergogenic aids, and nutrition recommendations for vegetarian athletes. During times of high physical activity, energy and macronutrient needs - especially carbohydrate and protein intake - must be met in order to maintain body weight, replenish glycogen stores, and provide adequate protein for building and repairing tissue. Fat intake should be adequate to provide essential fatty acids and fat-soluble vitamins, as well as to help provide adequate energy for weight maintenance. Overall, diets should provide moderate amounts of energy from fat (20-25% of energy); there appears to be no health or performance benefit to consuming a diet containing less than 15% of energy from fat. Body weight and composition can affect exercise performance, but should not be used as the sole criterion for sports performance; daily weigh-ins are discouraged. Consuming adequate food and fluid before, during, and after exercise can help maintain blood glucose levels during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before beginning exercise; they should also drink enough fluid during and after exercise to balance fluid losses. Consumption of sport drinks containing carbohydrates and electrolytes during exercise will provide fuel for the muscles, help maintain blood glucose levels and the thirst mechanism, and decrease the risk of dehydration or hyponatremia. Athletes will not need vitamin-and-mineral supplements if adequate energy to maintain body weight is consumed from a variety of foods. However, supplements may be required by athletes who restrict energy intake, have severe weight-loss practices, eliminate one or more food groups from their diet, or consume high-carbohydrate diets with low micronutrient density. Nutritional ergogenic aids should be used with caution, and only after careful evaluation of the product for safety, for efficacy, for potency, and to determine whether or not it is a banned or illegal substance. Nutrition advice, by a qualified nutrition expert, should be provided only after the athlete's health, diet, supplement and drug use, and energy requirements have been carefully reviewed.

Journal Article↗
PubMed2002

Body composition estimations by BIA versus anthropometric equations in body builders and other power athletes.

BACKGROUND: Two main questions are stated: 1) are BIA and anthropometric equations accurate in estimating body composition in male power athletes and more specifically in body builders and 2) is there a difference in body composition when body builders are compared to weight and power lifters? METHODS EXPERIMENTAL DESIGN: this is a descriptive, comparative study on a selected sample of power athletes. PARTICIPANTS: 49 Belgian elite and sub-top male power athletes (34 body builders and 15 weight and power lifters) were included in this sample. More than 70% was in preparation of competition at time of data collection. MEASURES: an extended set of anthropometric measures was taken. Body composition was estimated by BIA (Bioelectrical Impedance Analysis) and by regression equations of skinfolds. Somatotype and muscle+bone areas were calculated. Factor analysis on all anthropometric measures was carried out to determine the body structure of the athletes. RESULTS: Compared to external visual criteria, the equations of Durnin and Womersley and Lohman (skinfolds) and the Guo-equation (BIA) were the only equations that could accurately estimate the body composition for this specific group of athletes. However, the sum of skinfolds attains the most accurate estimate of subcutaneous fatness. Body builders have significantly (p<0.01) larger arm and thigh circumferences and are more mesomorfic than the other power athletes (5.9 vs 3.8). CONCLUSIONS: This study shows that to estimate body composition in extreme power athletes BIA is not as accurate as compared to anthropometric equations. Moreover, the sum of a larger set of skinfolds is preferred to anthropometric prediction equations. In addition, body builders are more muscular and leaner than other power athletes.

Adipose Tissue↗
PubMed2003

The effect of common hematologic abnormalities on the ability of blood models to detect erythropoietin abuse by athletes.

BACKGROUND AND OBJECTIVES: Algorithms that combine scores from multiple blood parameters are demonstrably effective in highlighting recombinant human erythropoietin (rHuEPO) administration, and have been used to deter rHuEPO use by athletes. These models are sensitive to atypical levels of blood parameters encountered during altered states of red cell production. Because hematologic abnormalities can also result in unusual blood profiles, the aim of this study was to document the incidence and magnitude of such abnormalities in an elite athlete population. DESIGN AND METHODS: We screened blood samples obtained from 413 female and 739 male elite athletes from 12 countries for known hematologic abnormalities, and compared the algorithm scores for these athletes with those of their healthy counterparts. We also established the magnitude of blood parameters required for model scores to exceed cut-offs associated with rHuEPO use. RESULTS: We found that 0.7% of male and 2.4% of female athletes were iron deficient either with our without anemia. An additional 1.4% of males and 1.0% of females had hemoglobinopathies. On average these athletes' model scores were at or below the score of their healthy counterparts. The greatest influence on our models was hemoglobin concentration. Values of other parameters must exceed normal ranges by a substantial margin in order for model scores to approach levels associated with rHuEPO use. INTERPRETATION AND CONCLUSIONS: The hematologic disorders we encountered in elite athletes were not associated with model scores that exceeded the nominal cut-offs that we have previously recommended to delineate rHuEPO use. We did not find any abnormalities among elite endurance athletes that were associated with high model scores.

Adolescent↗
PubMed2001

Preadmission Criteria as Predictors of Academic Success in Entry-Level Athletic Training and Other Allied Health Educational Programs.

OBJECTIVE: To investigate preadmission criteria, Scholastic Aptitude Test (SAT) scores, and high school grade point average (HSGPA) and to determine the ability of those criteria to predict the college grade point average (CGPA) of graduates from programs in athletic training and 5 other allied health disciplines. DESIGN AND SETTING: Descriptive data, including age, sex, year of graduation, HSGPA, CGPA, and SAT scores (SAT mathematics [SATM], SAT verbal [SATV], and SAT total) were gathered from the files of graduates (1992 to 1997) of allied health education programs. SUBJECTS: The complete records of 373 graduates (244 women and 129 men) of 6 allied health education programs in athletic training, health management systems, occupational therapy, perfusion technology, physician assistant, and physical therapy were used in this study. Subjects with incomplete files were excluded from this study. MEASUREMENTS: We collected data from official college transcripts, official high school transcripts, and SAT scores reported to the university. Descriptive statistics, analysis of variance, Pearson correlation, and stepwise forward regression analyses were used to determine the ability of SATV score, SATM score, and HSGPA to predict CGPA. RESULTS: Both SATV score and HSGPA were found to predict 14% of the variance in student success (CGPA) in all allied health programs; however, only HSGPA was predictive of student success in athletic training (P =.00). Both SATV score and HSGPA were predictive of CGPA in both physical (P =.02 and.03, respectively) and occupational (P =.02 and.00, respectively) therapy graduates; however, they predicted only 12% and 21%, respectively, of the variance in CGPA. The SATM score was predictive of CGPA in both perfusion technology (P =.05) and physician assistant (P =.00) graduates, accounting for 7% and 18% of the variance in outcomes. CONCLUSIONS: Overall, HSGPA and SATV score were predictive of student success (CGPA) in the allied health group as a whole and should continue to be used as part of the process of admission in higher education until such time that more predictive criteria are determined. The HSGPA was predictive of CGPA (r(2) = 0.38) in athletic training graduates, predicting more than one third of the professional program success. Athletic training educators should continue to use HSGPA as a predictor of success; however, they may wish to establish similar baseline comparisons between athletic training and other disciplines at their schools before determining the importance of standardized preadmission criteria for future students. This work should be considered a pilot study for the profession of athletic training and should be repeated at individual schools to determine the findings' applicability to other athletic training education programs.

Journal Article↗
PubMed2001

Qualitative Inquiry in Athletic Training: Principles, Possibilities, and Promises.

OBJECTIVE: To discuss the principles of qualitative research and provide insights into how such methods can benefit the profession of athletic training. BACKGROUND: The growth of a profession is influenced by the type of research performed by its members. Although qualitative research methods can serve to answer many clinical and professional questions that help athletic trainers navigate their socioprofessional contexts, an informal review of the Journal of Athletic Training reveals a paucity of such methods. DESCRIPTION: We provide an overview of the characteristics of qualitative research and common data collection and analysis techniques. Practical examples related to athletic training are also offered. APPLICATIONS: Athletic trainers interact with other professionals, patients, athletes, and administrators and function in a larger society. Consequently, they are likely to face critical influences and phenomena that affect the meaning they give to their experiences. Qualitative research facilitates a depth of understanding related to our contexts that traditional research may not provide. Furthermore, qualitative research complements traditional ways of thinking about research itself and promotes a greater understanding related to specific phenomena. As the profession of athletic training continues to grow, qualitative research methods will assume a more prominent role. Thus, it will be necessary for consumers of athletic training research to understand the functional aspects of the qualitative paradigm.

Journal Article↗
PubMed2001

A Survey of Athletic Training Employers' Hiring Criteria.

OBJECTIVE: To identify athletic training employers' hiring criteria and to determine if the importance of individual hiring criteria vary by setting. DESIGN AND SETTING: The Athletic Training Employer Needs Assessment Survey was mailed to athletic training employers advertising in the National Athletic Trainers' Association (NATA) placement vacancy notice between October 1996 and October 1998. SUBJECTS: A total of 111 athletic training employers in NATA Districts 7, 8, and 10 were surveyed. MEASUREMENTS: Employers rated the importance of hiring criteria on a 7-point Likert scale. Means and standard deviations were calculated for each criterion and compared these values to ascertain the importance of individual criteria. A principal component analysis was done to determine the underlying factors. RESULTS: Hiring characteristics can be divided into 4 factors that include highly related criteria: (1) personal characteristics, (2) educational experience, (3) professional experience, and (4) work-related attributes. In addition, the hiring characteristics desired by employers varied among athletic training settings. CONCLUSIONS: When interviewing and presenting themselves for entry-level positions, athletic trainers should pay particular attention to the attributes within the 4 hiring criteria factors. Also, the desired hiring criteria of athletic training employers differed by setting. Applicants need to pay particular attention to these hiring criteria differences when constructing résumés, cover letters, and professional correspondence and when interviewing with prospective employers.

Journal Article↗
PubMed2001

Principles of Liability for Athletic Trainers: Managing Sport-Related Concussion.

OBJECTIVE: To provide an overview of the general legal principles of negligence for sports medicine professionals and apply these principles to situations involving athletes with head injury. DATA SOURCES: Case law dating back to 1976 and recent studies of sport-related concussion. SUMMARY: One of the most difficult problems facing athletic trainers and team physicians is the recognition and treatment of sport-related concussion. Providing medical clearance for sports participation and treatment of athletic injuries involves legal as well as medical issues. The threat of lawsuits exists for the sports medicine professional, whether the athlete is allowed to play or not. In general, established medical malpractice principles govern claims by athletes for injury or death caused by improper treatment by health care providers. The elements of negligence are examined, as well as the primary defenses an athletic trainer would use in court and risk management techniques to avoid litigation. CONCLUSIONS/RECOMMENDATIONS: Athletic trainers may protect themselves from liability by including standardized cognitive or postural stability testing in preparticipation examinations, using objective tests rather than subjective judgement to evaluate athletes who have sport-related concussion, working closely with physicians, and keeping excellent records.

Journal Article↗
PubMed2002

Critical-Thinking Predisposition Among Undergraduate Athletic Training Students.

OBJECTIVE: To investigate the tendency of undergraduate athletic training students to think critically, to assess their likelihood of using specific components of critical thinking, and to study the effect of selected demographic and educational variables on critical-thinking tendencies in this sample of students. DESIGN AND SETTING: Data were collected before regularly scheduled athletic training classes at the beginning of the spring semester. SUBJECTS: Ninety-one students enrolled in 3 Commission on Accreditation of Allied Health Education Programs-accredited undergraduate athletic training education programs in the southeast. The subjects ranged in age from 19 to 29 years (mean age = 22.33 +/- 1.94). Forty-six (50.5%) of the subjects were men and 45 (49.5%) were women. MEASUREMENTS: The California Critical Thinking Disposition Inventory contains 75 Likert-type items assessing 7 components of critical thinking: truth seeking, open mindedness, analyticity, systematicity, inquisitiveness, cognitive maturity, and critical-thinking self-confidence. RESULTS: The overall mean indicated a general but mild trend toward critical thinking, with weak scores on the truth-seeking subscale. One-way analysis of variance reflected significant differences among the schools for truth seeking, open mindedness, and maturity subscales and for the overall mean score for the entire inventory. Only the open-mindedness difference persisted between 2 of the schools after post hoc testing. Correlation analyses indicated no significant relationship between total score and age, sex, ethnicity, year in athletic training program, cumulative grade point average, completed semester hours, or clinical-experience hours. CONCLUSIONS: Athletic training students are inclined toward critical thinking, but this tendency is relatively weak. Classroom and clinical instructors should use teaching methods and techniques that facilitate the components of critical thinking. The promotion of critical thinking and critical-thinking skills has implications for athletic training education and the advancement of certified athletic trainers and the profession of athletic training.

Journal Article↗
PubMed2002

Historical Perspective of Athletic Training Clinical Education.

OBJECTIVE: To present a historical perspective of the development and evolution of clinical education in the medical and allied health professions, with a special interest in athletic training; to gain a better understanding and appreciation of the depth and breadth of the structured and formal clinical education needed in athletic training, for both the present and the future. DATA SOURCES: Information was drawn from the Educational Resources Information Center (1966-2001), MEDLINE (1966-2001), SPORT Discus (1830-2002), and CINAHL (1982-2002) searches of historical literature relating to the development of medical, allied health, and athletic training clinical education. Key words searched were clinical education, clinical instruction, medical education, allied health education, history of medical education, athletic training education, and history of clerkships. We also used reference materials cited in historical textbooks on medical education. DATA SYNTHESIS: Clinical education in American medical schools evolved from a primarily didactic process to the clinical-clerkship model. In contrast, athletic training professional preparation was initially more steeped in clinical experiences and less in didactic instruction. CONCLUSIONS/RECOMMENDATIONS: Reviewing medical education over the past century and allied health clinical education over the past 30 years provides interesting insights about the past, present, and future of athletic training professional preparation. Athletic training clinical education is undergoing reform and development, which will subsequently enhance the profession. Athletic training has entered an exciting era in its history.

Journal Article↗