ISSN: 1543-9518|Vol. 24

Development of an Athletic Training Curriculum for Universities in South Korea

Submitted by: Jon Yeansub Lim, Ed.D., C.S.C.S.

Abstract

The purpose of this study was to develop a competency based undergraduate sports medicine curriculum for universities in the Republic of Korea (R.O.K.). The survey questionnaire used in this study was derived from five performance domains and universal competencies of the 1995 Role Delineation Study For Entry-Level Athletic Trainers (NATA-BOC, 1995).

The sample in this study consisted of all 180 athletic trainers, medical doctors, and sport educators from the Korean Society of Sports Medicine (KSSM) in the R.O.K. One hundred eighty survey questionnaires were sent to the subjects. Of the 180 questionnaires, 104 were returned out. Two were discarded because they were incomplete. The 102 questionnaires yielded a 56.7% overall return rate. Frequencies, percentages, means, and standard deviations were computed to describe the data. One way ANOVA and Scheffe post-hoc tests were used to analyze the data.

Results of this study indicated that there was a strong need for a sports medicine curriculum in the R.O.K. The subjects rated the NATA sports medicine competencies in five performance domains to be either “important” or “very important”. The results of one-way ANOVA tests indicated there were statistically significant differences between groups in their competency ratings in Domain I, Domain II, Domain III and Domain V. The results of the Scheffe post-hoc tests indicated the means of competency ratings in the four domains by the athletic trainers were statistically significantly higher than the means of the medical doctors. In general, the findings of this study support competencies developed by the NATA and utilized by most United States colleges and universities. The researcher made a few modifications of the current NATA approved curriculum, commensurate with the findings of this study.

Introduction
Since the 1988 Olympic Games in Seoul, interest in sport activities and sport education has grown rapidly in the Republic of Korea (Lim, 1997). However, there is a prevalence of sport injuries in secondary schools, colleges and universities in the R.O.K because young athletes are susceptible to injury (An, Yoo & Kim, 1992). Most institutions in the R.O.K. do not provide a qualified athletic trainer because there is no formal, standard sports medicine training program in the R.O.K. (Lee, 1995).

The value of having an athletic trainer in secondary schools, colleges and universities for the prevention and treatment of athletic injuries has been well-documented (Hossler, 1993; Rankin, 1998). The findings of these studies indicated an athletic trainer provided by institutions significantly reduced the rate of injury and re-injury.

The National Athletic Trainers’ Association (NATA) and many researchers in the United States have studied professional preparation for athletic trainers since the inception of the NATA. Competencies developed by the NATA and utilized by most United States colleges and universities served as a basis to develop a competency based undergraduate sports medicine curriculum in the R.O.K.

Methods

Subjects
The sample in this study consisted of all 180 members of the Korean Society of Sports Medicine (KSSM). Athletic trainers, medical doctors, and sport educators in the R.O.K. comprised this membership. The researcher obtained a list of the member names and addresses from the KSSM officials. One hundred and four questionnaires were returned. Two of these were discarded because they were incomplete. The 102 questionnaires yielded a 56.7% overall return rate.

Instrument
Following a review of related literature, an initial survey questionnaire instrument to measure the importance of the competencies of entry-level athletic trainers was derived from five performance domains and the universal competencies of the NATA role delineation study, third edition (NATA-BOC, 1995).

Statistical Analysis
Frequencies, percentages, means, and standard deviations were used to describe the data. One way ANOVA and the Scheffe post-hoc tests were used to analyze subject demographic characteristics. One-way analysis of variance (ANOVA) was conducted to determine the differences between means of competency ratings in five performance domains based on the subject employment. When the results of the ANOVA test were statistically significant, the Scheffe post-hoc test was conducted to determine where differences between means existed. Statistical significance was accepted at p<.05.

Results

Demographic Characteristics of Subjects
Of the total 102 subjects, 26 (25.5%) were athletic trainers, 32 (31.4%) were medical doctors and 44 (43.1%) were sport educators. The majority of the subjects were males, had an advanced degree, and were in the age group of 31 – 50 years. Most subjects (80.3%) had one to 10 years of experience in sports medicine, whereas the rest had no experience in sports medicine. Only fifty percent of the subjects devoted 25% or more of their daily work to sports medicine.

Most subjects (87.2%) expressed “needed” to “strongly needed” for a sports medicine curriculum in the R.O.K.

Ratings of NATA Competencies
The findings indicated the subjects rated the NATA five domains of sports medicine competencies to be either “important” or “very important”. The subjects rated Domain II (Recognition, Evaluation, and Immediate Care of Athletic Injuries) to be the most important. Domain III (Rehabilitation and Reconditioning of Athletic Injuries), Domain I (Prevention of Athletic Injuries), Domain V (Professional Development and Responsibility) and Domain IV (Health Care Administration) followed in order of importance.

The results of one-way ANOVA tests indicated there were statistically significant differences between the subject groups in their competency ratings of Domain I (Prevention of Athletic Injuries), Domain II (Recognition, Evaluation and Immediate Care of Athletic Injuries), Domain III (Rehabilitation and Reconditioning of Athletic Injuries) and Domain V (Professional Development and Responsibility). Statistical significance was not found for Domain IV (Health Care Administration). The results of the Scheffe post-hoc tests indicated the means of competency ratings in the four domains by the athletic trainers were statistically significantly higher than the means of the medical doctors.

Ratings of Sports Medicine Curricular Components for R.O.K. Universities

The subjects rated all 11 areas of basic knowledge to be “important” to “extremely important”. The most important area was domain-specific content. The other areas of the basic knowledge, ranked in order from most to least important, were as follows: athletic training evaluation, human anatomy, human physiology, exercise physiology, biomechanics, psychology/counseling, organization and administration, nutrition, physics and pharmacology.

The majority of the subjects believed a sports medicine program should be housed in the physical education (sport) department/college. Most subjects believed it is “very important” to “extremely important” to have an internship in order for students to prepare for careers in sports medicine. The majority of the subjects thought it necessary for a student to have more than 1,000 work hours for a successful internship experience in sports medicine. The majority of the subjects believed the internship should be for 12 semester credit hours.

An Undergraduate Sports Medicine Curriculum for Universities in the R.O.K.

The findings support competencies developed by the NATA and utilized by most colleges and universities in the United States. The researcher made a few modifications to the current NATA approved curriculum, commensurate with the findings of this study. The following subject areas comprise an undergraduate sports medicine curriculum for universities in the R.O.K.:

  1. Sports Medicine Subject Areas
  2. First aid and emergency care
  3. Prevention of athletic injuries/illnesses
  4. Evaluation of athletic injuries/illness
  5. Therapeutic modalities
  6. Therapeutic exercise
  7. Administration of athletic training programs
  8. Science Subject Areas
  9. Human anatomy
  10. Human physiology
  11. Exercise physiology
  12. Kinesiology/biomechanics
  13. Health Related Subject Areas
  14. Nutrition
  15. Psychology/Counseling
  16. Personal and community health

The above subject areas should constitute the academic core of the curriculum. However, institutions should not be required to offer specific courses, as long as there is evidence that each subject area is addressed within the curriculum and students are able to demonstrate an acceptable level of knowledge and skills in each area.

An internship should be a minimum of 1,000 hours of work experience in the sports medicine field. The internship should include all of the knowledge and skills specific to the five domains of athletic training.

Discussion

      The results of this study indicated the subjects rated all NATA competency items to be “important” to “extremely important.” This would support the results of the NATA’s role delineation study (NATA-BOC, 1995). However, the rating of the NATA competency items by all of the subjects in this study were slightly lower than a similar study (Rudy, 1997). Rudy indicated all competency items were found to be “very important” to extremely important.” This may be explained by the differences in the subjects in Rudy’s study. The subjects in the present study were not only athletic trainers, but also medical doctors and sport educators, whereas Rudy’s study included only athletic trainers. The findings of the present study indicated athletic trainers were found to rate each competency significantly higher than medical doctors and sports educators.

Although it was still rated as being between “important” and very important,” the least important area of the 11 areas of basic knowledge areas in this study was pharmacology (Mean = 3.16). Rudy also found pharmacology (Mean = 3.49) to be the least important in his study. It may be meaningful to have pharmacology as a unit in other courses or make it a one or two-credit course.

The internship was found to be a very important component of a sports medicine curriculum in this study. The majority of the subjects in this study indicated a need for a minimum of 1,000 hours, whereas the current guidelines of the NATA approved program require a minimum of 800 hours.

Recommendations
Based on the findings of this study, the following recommendations are made for the development and implementation of an undergraduate sports medicine program in the R.O.K.

  1. Ministry of Education officials in the R.O.K. should consider the curriculum model developed from this study as a standard for new undergraduate sports medicine programs.
  2. University officials in the R.O.K interested in establishing an undergraduate sports medicine program should use the curriculum model as a basis for program development.
  3. Universities should have a program director who has wide experience in the field of sports medicine and teaching experience in sports medicine. If qualified personnel can not be found in the R.O.K., consideration should be made to recruit personnel from the United States.
  4. To improve sports medicine programs, university officials in the R.O.K. should consider developing an international exchange program with American institutions which have credible sports medicine programs.
  5. The program director should develop good relationships with sports medicine organizations and communities in the R.O.K. in order to provide students with internships and increased job opportunities.
  6. The program director should consider having sports medicine experts as adjunct faculty members for the university. The adjunct faculty members can share their expertise with students, which may make the program stronger.
  7. University officials should consider providing a sports medicine program to prepare students for entry-level athletic training along with a teaching credential in order to provide students with more job opportunities and higher salaries. The curriculum should meet the requirements of athletic training and teaching.

The following recommendations are made for further study:

  1. This study should serve as a basis for developing a graduate sports medicine curriculum in the R.O.K.
  2. As the scope and practice of athletic training changes, similar studies should be conducted periodically to update competencies of entry-level athletic trainers and to modify the curriculum accordingly.
  3. A replicate study could be conducted to develop an undergraduate sports medicine curriculum for other countries that lack professional preparation programs in sports medicine.
  4. Additional research should be conducted to determine the reasons for differences in the evaluation of the competencies by athletic trainers, medical doctors and sport educators.

References
An, I., Yoo, T., & Kim, C. (1992). A study of high school students’ sports activity and related injuries in Jinju. Korean Journal of Sports Medicine, 10(1), 63-76.

Hossler, P. (1993). The high school athletic training program – An organization guide. Dubuque IA: Kendall/Hunt Publishing.

Lee, E. (1998). How to become an athletic trainer, Tennis Korea, 11, 76-77.

National Athletic Trainers’ Association. (1995) 1995 Role delineation study of the entry-level athletic trainer.

Lim, B. (1997). The relationship between the leisure types and the satisfaction of the university students. The Journal of Hankuk Sports Association, 35(4), 408-440.

Rudy, J. (1997). Educational requirements for high school athletic trainers. Unpublished doctoral dissertation, Department of Secondary Education, Kansas State University, Manhattan, Kansa.

Rankin, J. (1989). Athletic training education – new dimensions. JOPERD, 68-71.

ACKNOWLEDGEMENTS
I would like to acknowledge the following people for their special contributions which made this study possible: Dr. Lawrence Bestmann, Dr. William Carroll, Dr. Richard DeSchriver, Dr. Jae-Woo Kim, Dr. Pete Koehneke, and Dr. Young-Jun Park.

2013-11-27T17:34:11-06:00February 12th, 2008|Sports Facilities, Sports Management, Sports Studies and Sports Psychology|Comments Off on Development of an Athletic Training Curriculum for Universities in South Korea
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Exercise Physiology In The Web-Based Environment

Submitted by: Robert Pankey, Ed.D. and Timothy W Henrich, Ph.D.

Introduction
In the summer of 1998, the Department of Kinesiology and Health at Texas A&M University-Corpus Christi (TAMUCC) offered an Exercise Physiology course over the Internet as the first step in developing a distance learning track with their exercise science curriculum. This class was partially supported with a grant from the University Outreach program and administered through the Center of Teaching Excellence at TAMUCC. The primary feature to this online course was to present lectures and practice quizzes complete with QuickTime movies and graphic illustrations. Additionally, The use of electronic mail and exercise physiology lab experiences were required as a means of maintaining communication with students and providing them with application to what was being discussed in lectures respectively. In this article, we discuss the details and results of this pilot project.

Since TAMUCC opened its doors to a four year curriculum in 1994, the natural constituency of potential students who desire non-traditional courses from the University has increased dramatically. Since a high percentage of our students are working part-time or full-time while attending college, it has become apparent that attending actual classes during regular working hours is difficult (if not impossible). Additionally, many of the adult students live in neighboring towns along the Coastal Bend, far away from the campus. As a state institution of higher education, we felt that we had a responsibility to try to offer some alternatives to the members of our regional community who were attempting to obtain their undergraduate degrees in Kinesiology.

A secondary interest was to find out if students effectively learn in a science oriented environment when using the technologies that are available through the Internet. To this date, there is no other course being taught in the area of exercise physiology via the Internet. So there are various questions that need to be answered as to whether or not such a field of science can be taught well enough to accommodate students needing distance learning. We have observed other courses such as the science of athletic injuries classes which seem to be offer little more than reading assignments, sharp graphics and cute animations. There are few (if any) courses being distributed over the Internet, which offer combinations of learning environments similar to the traditional classroom, where socialization, interaction and laboratory assignments are prevalent.

Lastly, in the interest of education, it was our aim to investigate the pedagogical issues that involve learning in a web-based environment. What are the positive and negative aspects? What strategies work best in the delivery of subject matter? What differences can be found between students in a traditional and web-based exercise physiology class?

As we look to the future prospects of distance learning in the field of Kinesiology, this pilot study could provide us with first-hand knowledge and experience from which to draw on for future endeavors. This project has supplied a wealth of information and then some. In the final analysis, the pilot has been very successful. However, as with any new development in education, one should always proceed with some caution.

In the early stages of developing a web-based class in exercise physiology, it became apparent that the instructor had to have abilities not only to develop interactive web sites, but to assure that the course content was being designed and delivered. As we soon discovered, teaching at a distance effectively was very different from the traditional lecture-based format, even for the most experienced. It is recommended that future distance learning instructors attend formal training workshops and/or clinics in order to properly prepare for the multifaceted aspects of putting together a web-based program.

Of greater importance is the need to have the proper hardware and technological support in place prior to designing the program. In our case, we were able to utilize two computer laboratories, a fully equiped human performance lab and an audio/visual lab to assist in the delivery of course content. Because our lectures were web-based, students with home computers having Internet capabilities were able to logon from their residence. Additionally, it was necessary to have media and computer experts to assist with troubleshooting and advise us when problems arose either with the design or configuration of our web sites on the Internet.

The foundation to our web-based class in exercise physiology centered on the development of Internet oriented lectures and practice quizzes. Additionally, students were instructed to view video-based presentations and perform outside laboratory assignments in exercise physiology on their own. The software we used in developing our lectures was Adobe Pagemill. This software was found to be the user-friendliest. Most graphics, illustrations, digital movies and other images can be dragged into Pagemill web pages without having a vast knowledge of HTML language. This saved us all a significant amount of time and energy. Additionally, Microsoft PowerPoint 98 was used in creating outlined lectures in HTML format. The advantage to PowerPoint 98 is that the HTML saving feature allows web site designers to transfer traditional PowerPoint presentations to HTML presentations with the click of a button. PowerPoint directs one through a Wizard (series of questions) and upon completion, the presentation is created automatically into a bundled file, ready to be downloaded onto a server. Due to the complexities of integrating digital movies, audio advanced images and email links, some HTML language changes were made after the presentations were created.

Cognitive Evaluations
Student’s cognitive abilities were evaluated through two written examinations and five web-based practice quizzes. Due to the nature of the exercise physiology course materials, the instructor required that the students return to campus and take their mid-term and final examinations. One hundred True/False and multiple choice questions were given to students and compared to the results from the same tests given in the Fall of 1998 when the course was offered in a lecture-based format. The summary of these findings is presented later in this article.

Practice quizzes (n=5) utilized during the semester were intended for students to test their knowledge of the content and review those areas where they had identified weaknesses in. The practice quizzes were developed with Pagemill and linked to a database made with Claris FileMaker Pro. The computer professionals involved with overseeing the server where the exercise physiology program was located, helped us with the UNIX language needed to grade and provide feedback to students taking the quizzes. The advantage of having quiz results placed onto a FileMaker Pro database was that the results could be observed and monitored by the exercise physiology instructor who had access to these files. In order to assure that students were taking the practice quizzes, a percentage of their grade (10%) was based on their performance on the practice quizzes. The instructor allowed students to take the practice quizzes as many times as possible, until they had scored well enough to feel they had mastered the content.

Laboratory Tests and Assignments
Seventeen laboratory experiences were required to ensure that students would be able to make practical applications from lecture material. Students were able to download their lab forms off the Internet then perform their laboratory assignments either in their home locations or on campus in the Human Performance Laboratory. Such assignments as learning to take resting or active blood pressures and sub-VO2 Max tests could easily be accomplished in a clinic or at home. When laboratory assignments were completed, students were instructed to attach their lab forms (Word or WordPerfect format) to their email and forward them to the instructor. At the end of each lab assignment were questions pertaining to their results and how the results applied to what they had learned through the lectures.

Student Interactions
At any time while observing web-based lectures and practice quizzes, the students were encouraged to ask questions through email. Email links are provided on each presentation slide as well as the daily agendas. The instructor was available during the morning and afternoon hours of the semester to answer student questions, provide advice and further direction. This method of delivering course content is commonly known as “Asynchronous Distance Learning.” Asynchronous refers to a method of communication where the learner and instructor do not interact in real time. In this case interaction took place on the Internet at a time that was convenient for each person. Students were also encouraged to interact among themselves, their laboratory partners and the laboratory assistants who where monitoring the human performance lab.

Student Interactions were encouraged through email and during group activity in the laboratory setting. There were some lab assignments that required students to return to the Human Performance Lab (e.g. Astrand Ryhming Bicycle Ergometer Test). The instructor and lab assistants were on hand in the laboratory to answer questions and encourage group discussions concerning the accuracy of the tests and how they applied to what was presented in lecture.

Evaluating Student Performance
Because little is known about how students may perform in a distance learning (web-based) exercise physiology class compared to a lecture-based exercise physiology environment, a comparison of examination scores from students taking the same test was performed to determine if learning differed between the type of class formats. The investigators hypothesized that a more effective way of teaching the science of exercise physiology would be from a lecture-based class format. Lecture-based formats allow for the possibility of immediate and concurrent feedback between student and instructor via non-verbal and verbal communicative channels while web-based instruction does not. Therefore, it was expected that students in lecture format would outperform students in a web-based format on midterm and final examinations. A focused comparison of performance on these examinations confirmed the hypothesis that students in lecture-based instruction generally outperformed students in web-based instruction. On the midterm examination there was a significant difference between student scores in the lecture-based and web-based classes. Students in the lecture-based format scored 74.11, SD=10.32 while students in the web-based averaged 69.65, SD=8.28 T=1.927, p<.05. On the final examination, there was no significant difference between student scores in the web-based and lecture-based classes. Students in the lecture-based format scored 80.27, SD=6.75 while students in the web-based averaged 78.76, SD=7.1 T=.917, p>.05. (See Figure 1). The investigators suggest that the pattern of performance on examination scores will be useful in the future for exploring the extent to which particular curriculum items are more or less suited for web-based or lecture-based instructional formats. From the data analyzed in this pilot study, it appears that the web-based class in exercise physiology was able to deliver content at a level comparable to that of the traditional class lecture-based format. However, an analysis of midterm and final examination test scores between lecture-based and web-based class examinations suggest that additional strategies may need to be developed to improve retention levels on content in the web-based format. The fact that no significant difference was found in test scores on the final examination may imply that students became more comfortable with working through lectures and practice quizzes in the web-based format throughout the semester. Additionally, the results from the final examination may indicate that higher levels of retention and learning had taken place with students in the web-based class when compared to their midterm examinations.

Post-Class Surveys

At the end of the semester, the instructor conducted a survey and collected comments and suggestions pertaining to student perceptions of the web-based class. The results of the web-based course survey were very encouraging. For example, 88% of the students (n=26) felt that the class was worthwhile and would take another Internet-based class if given the opportunity. A summary of the findings from the student survey is shown in Table 1.

Table 1

88% Would take another Internet-based course given the opportunity
88% Did feel that this class in Exercise Physiology was worthwhile
40% Thought the lectures were excellent, while 40 % felt they were good.
60% Felt that the graphics and illustrations were excellent, while 28% indicated them as good.
68% Believed the content of the Exercise Physiology class was excellent, while 20% felt that the content was good.
52% Strongly agreed that on the whole, this course was a good course, while 36 simply agreed.
84% Strongly agreed that on the whole, the instructor was good, while 8% simply agreed that the instructor was good.
12% Of the class felt that the lectures were either difficult to comprehend or totally unclear
12% Of the class indicated they were either undecided or unclear about some of the graphics and illustrations
12% Of the class felt undecided or sometimes unclear about the content of the Exercise Physiology class.
12% Of the class disagreed or strongly disagreed that the course was, on the whole, a good course.

Future Implications
There is good evidence that the Internet has changed the way educators teach and students learn in our society. Furthermore, research is revealing that the delivery of information through technology can be an effective tool in student motivation and the learning process. In this pilot study, it was found that students enjoyed the process of learning exercise physiology via the Internet, and given the opportunity would take additional web-based courses. With our student populations demanding higher access to Internet-based courses, colleges are shifting their focus on learning rather than teaching. Because of this demand, there is a need for additional support in training educators in technology and providing the financial support for hardware and software needed in the development of distance learning courses. As we enter the 21st century, we must begin to accept the idea that the Internet is a tool, which can be effectively used to augment the learning process.

2013-11-27T17:47:48-06:00February 11th, 2008|Sports Facilities, Sports Management|Comments Off on Exercise Physiology In The Web-Based Environment
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