Effective Athletic Training

Teaching and Learning

Presentation

Problem Based Learning

with

Psychosocial Strategies

and Referral in Athletes

Signature Choice Assignment

December 6, 2015

Candace Pait Morales, LAT, ATC

Fresno Pacific University

KIN 750: Athletic Training Pedagogical Studies

Jim Ave, Ph.D., ATC, CES

Introduction

Problem Based Learning

Content of Lesson

Problem Based Learning been used in the classroom

How and Why

Lesson plan Problem-Based Learning with Psychosocial Strategies

Psychosocial Strategies and Referral in Athletes Introduction

Student Learning Outcomes

Content of Lesson

Conclusion

Assessment

Assessment

Summary

Problem Based LearningContent of Lesson

What does the literature reveal about problem based learning

How would this topic be used in the classroom and clinical setting

Why would this topic be used in the classroom and clinical setting

What Does The Literature Reveal About Problem Based Learning

Athletic Training (AT) educators have been using instructional strategies that will help students incorporate classroom and clinical knowledge into standard practice (Smith-Goodwin & Wimer, 2010).

This educational approach is based off of social interactions and team approach to solving problems that will result in deeper learning (Smith-

Goodwin, & Wimer, 2010).

This learning style is used for teaching ATS how to think critically and develops their problem solving skills (Heinrichs, 2002).

Students often struggle to learn information when presented in the classroom into clinical practice; however students do benefit when professors use a diversity of pedagogical methods that advance cognitive and psychomotor skills (Heinrichs, 2002, Rotgans, & Schmidt, 2011, Smith-Goodwin, &

Wimer, 2010).

Problem Based LearningHow Would This Topic Be Used In The Classroom

This learning style is used for teaching ATS how to think critically and develops their problem solving skills (Heinrichs, 2002).

traditional lecture-based methods, skills-based methods (laboratory settings for teaching psychomotor skills, drill and practice, conceptualized practice, and modeling), technology-enhanced methods (electronic tools, computer simulations, Internet-based or -assisted courses, electronic assessment), individual versus group methods (self-study, cooperative learning), and inquiry-based methods (cases, projects, problems)” (Heinrichs, 2002, p. S-189).

Professors use small groups of students (3-5) to discuss problems (Rotgans, &

Schmidt, 2011, Smith-Goodwin & Wimer, 2010).

What could be viewed to an experienced clinician as a minor injury could be viewed as complex injury to a student due to lack of experience, thus PBL helps promote one’s clinical skill in a positive way (Smith-Goodwin & Wimer, 2010).

Problem Based LearningWhy Would This Topic Be Used In The Classroom

PBL encourages self-direction and development of learning and promotes sharing of learning within groups and classes (Smith-Goodwin &

Wimer, 2010).

PBL is more active than tradition classroom lecture and it teaches to collect and verify data and determines conclusions (e.g. systematic reasoning) (Smith-Goodwin & Wimer, 2010).

The NATA states PBL helps “student move general skills learned in early phases of clinical education into specific therapeutic skill which will require the use of sound judgment and critical thinking” (Smith-Goodwin &

Wimer, 2010, p. 24).

Cognitive learning in the classroom via PBL can cause students to put forth more effort to truly understand the information presented which in turns increases knowledge and studying over time (Rotgans, & Schmidt,

2011).

Problem-Based LearningMy Experience

How and When PBL was used

How it benefited me

My thoughts on the success of PBL

Psychosocial Strategies and Referral in AthletesLesson Plan

Situational Factors: • Length of lesson/class session- 60 minutes, 1 week (3 class meetings)• Senior Level Class• Sport Psychology Class• This lesson will be circumstantial as it will be applied when the opportunity arises in the clinical setting to experience an athlete who

is experiencing psychosocial problems during return to play from an injury. This could occur in a variety of different sports thereby being very situational.

• For this particular instance, the professor will be supervising the interactions of the senior ATEP class who will be completing a case study (Problem-Based Learning) on a female basketball player. The female basketball player sustained a patellar tendon rupture who is currently undergoing the return to play process of her rehabilitation. This student-athlete has been non-compliant and experiencing emotional distress.

• The majority of this lesson will occur during the last phase of her return to play rehabilitation protocol as the athlete faces emotional distress. This lesson will be intensive during the first 30 to 60minutes.

Learning Environment: • Classroom and Clinical Setting

Teaching Method or Topic:• Problem Based Learning

Student Preparation:• Read and Review

• Tenenbaum, G. (2007). Handbook of sport psychology (3rd ed.). Hoboken, N.J.: Wiley.• Women’s Basketball players case study packet

• They should also be mentally prepared to handle intense emotions from the athlete and be prepared to effectively and professionally communicate with the individual.

Psychosocial Strategies and Referral in AthletesLesson Plan

Student Learning Objectives (SLOs):• Competency Area: Psychosocial Strategies and Referral (PS).• PS-3, Describe how psychosocial considerations affect clinical decision-making related to return to activity or participation (eg,

motivation, confidence). • The NATA states, “Athletic trainers must be able to recognize clients/patients exhibiting abnormal social, emotional, and

mental behaviors. Coupled with recognition is the ability to intervene and refer these individuals as necessary. Additionally, athletic trainers appreciate the role of mental health in injury and recovery and use interventions to optimize the connection between mental health and restoration of participation”.

• The student will be able to accurately recognize psychosocial stressors associated with return to sport with 80-100% accuracy as supervised by the processor . The student will be able to use knowledge and skill set to intervene and refer an athlete who displays

• The student will intervene when psychosocial distress is recognized and apply psychosocial strategies • Goal Setting

• The student will be able to collaborate with the athlete and set reachable short and long term goals throughout the rehabilitation process

• Communication• The student will be able to effectively communicate with the athlete who displays psychosocial distress. The student

will be able to expand this in communicating information about the injury, pain associated, rehabilitation process, and help ensure the athlete does not have any unexpressed concerns, questions, or other distresses that could affect positive return to play.

• Rewards• The student will be able to understand how to give positive rewards to the athlete once obtaining goals to help

reassure positive thinking and rehabilitation. • Inclusion

• The student will be able to understand the importance and apply strategies of including the athlete in with team activities (e.g. travel, sport specific activity)

• Emotional• The student will be able to understand and apply emotional techniques to aid in the athletes psychosocial distress.

• Motivation• The student will be able to apply positive motivational techniques for the athlete.

Psychosocial Strategies and Referral in AthletesLesson Plan

Equipment, Materials, or Technology Needs:• Note taking material• Women’s Basketball players case study packet

Lesson:Introduction

• 5-10 minutes• Ask/explain what the student should perform and ask them to do so under your supervision with

continuous feedback.

Body• 20-40 minutes• Supervise performance of applying psychosocial strategies using case study while asking/answering

questions and providing continuous feedback.

Conclusion• 10-20 minutes• Summarize key points in after action review, ask questions, ask for questions, and provide on-going

support and supervision through applicable rehab and follow-up.

Assessment:• Students will be assessed via proficiencies (Problem-Based Learning); a formal assessment will be made to check

for learning and determine if the students has met the SLOs. Students will be given 4 scenarios and they will have to explain how to formulate a solution based on information provided. The student will write up a formal document on each scenario and turn in. Once the student is marked as proficient, they will be able to employee the psychosocial strategies and referrals.

Psychosocial Strategies and Referral in AthletesThe lesson

Introduction

Student Learning Outcomes

Content

Conclusion

Case Study

Psychosocial Strategies and Referral in AthletesIntroduction

There are over 400,00 athletes competing in the National Collegiate Athletic Association (NCAA) and over 12,000 athletic injuries occur each year (Covassin, Crutcher, Bleecker, Heiden, Dailey, & Yang, 2014).

Factors that increase psychosocial distress are severity of injury and loss of practice or competition (Clement, Granquist, & Arvinen-Barrow, 2013).

Many researchers have suggested that athletic trainers are in an ideal position to care for psychosocial distresses that athletes experience due to their regular contact they have with the athletes (Arvinen-Barrow, Massey, & Hemmings, 2014).

An athlete’s cognitive response (how the athlete view’s the injury) to an injury and how the athlete’s emotional (how the athletes feels about the injury) and behavioral (how the athlete acts and reacts to the injury) responses (Clement et al., 2013 ).

With the use of “goal setting, imagery, positive self-talk, and relaxation strategies” have been proven productive in helping an athlete cope with their injury (Clement et al., 2013, p. 512).

Psychosocial Strategies and Referral in AthletesStudent learning Outcomes

Competency Area: Psychosocial Strategies and Referral (PS).

PS-3, Describe how psychosocial considerations affect clinical decision-making related to return to activity or participation (eg, motivation, confidence).

The NATA states, “Athletic trainers must be able to recognize clients/patients exhibiting abnormal social, emotional, and mental behaviors. Coupled with recognition is the ability to intervene and refer these individuals as necessary. Additionally, athletic trainers appreciate the role of mental health in injury and recovery and use interventions to optimize the connection between mental health and restoration of participation”.

The student will be able to accurately recognize psychosocial stressors associated with return to sport. The student will be able to use knowledge and skill set to intervene and refer an athlete who display psychosocial distress.

The student will intervene when psychosocial distress is recognized and apply these psychosocial strategies

Goal Setting

Communication

Rewards

Inclusion

Emotional

Motivation

Psychosocial Strategies and Referral in AthletesContent of lesson

Athletic trainers play a crucial part in an athlete’s rehabilitation and thus they are most appropriate to inform, educate, and support the athlete with psychosocial and physical process (Clement et al., 2013).

Family is a larger part of an athlete’s social support, however due to many athlete being away from home, they often turn to coaches, teammates, and athletic trainers to support (Yang et al., 2010).

The top rated psychological responses to an injury are; “stress or anxiety, anger, and treatment adherence problems” (Clement et al., 2013).

Techniques used to decrease psychosocial distress are, goal setting, inclusion of team activities, rewarding, motivation, emotional, communication, visualization and imagery, and centering techniques (Arvinen-Barrow, Massey, & Hemmings, 2014, Clement et al., 2013, Stiller-Ostrowski, & Ostrowski, 2009, Yang et al, 2010, Yang et al., 2014).

Psychosocial Strategies and Referral in AthletesConclusion

With the use of PBL with psychosocial strategies and referral in athletes, once can conclude it can have positive outcomes in an ATS learning.

Psychosocial strategies and referral in athletes teach athletic trainers how to recognizes psychosocial distress in athletes post injury, as well as to be able to intervene and refer the injured athlete as necessary (Stiller-Ostrowski, & Ostrowski, 2009).

It is important to treat the psychosocial distresses in injured athletes for them to have a successful recovery.

ATS are able to combine the information they learning in the classroom via PBL and apply it into the clinical setting.

With the use of group work, ATS can collaborate together to determine a solution. This aids in self-directed learning.

Psychosocial Strategies and Referral in AthletesCase study: The lesson

19 year-old Female Basketball Player

Patellar Tendon Rupture during conference tournament

Non-compliance with rehabilitation

Skipping exercises in rehabilitation

Lacks communication

Over all moody when coming to the ATR

Psychosocial Distress

Anxiety/Stress

Rehab Boredom

Affect the athlete has

Sensations the athlete is experiencing

Drug use

Psychosocial Techniques

Goal Setting

Inclusion of Team Activities

Motivation, Emotional, and Communication

Visualization and Imagery

Centering Techniques

Psychosocial Strategies and Referral in AthletesCase study: Discussion

Psychosocial Strategies and Referral in AthletesMy Experience

How and When Psychosocial Strategies and Referral in Athletes was used

How it benefited me

My thoughts on the success of Psychosocial Strategies and Referral in Athletes

Assessment

Problem-Based Learning Assessment

Problem-Based Learning Effectiveness

Psychosocial Strategies and Referral in Athletes Effectiveness in Setting

Psychosocial Strategies and Referral in Athletes Effectiveness in ATEP Competencies

Practiced-Based LearningAssessment

Review and assess the students proficiency with teaching PBL. State expectations, provide feedback on assessment

Ask the students for feedback Did they find the PBL beneficial?

Would they participate in a PBL environment again?

Did they feel comfortable to ask questions and work in groups to determine a solution for the problem given? Haven them clarify thoughts and possible failures?

Do they feel confident in the learning objective?

What do they feel they need more assistance on?

Practiced-Based LearningEffectiveness

PBL teaches ATS how to think critically

PBL develops an ATS problem solving skills

PBL focuses on self-directed learning via problem solving

Students struggle to learn information presented in the classroom into their clinical practice. PBL is the bridge in-between the two.

Solving problems helps an ATS cognitive function, cognitive reasoning skills, psychomotor skills, and one’s motivation to learn

(Heinrichs, 2002, Rotgans, & Schmidt, 2011, Smith-Goodwin, & Wimer, 2010).

Psychosocial Strategies and Referral in AthletesEffectiveness in Setting

Effective in both Classroom and Clinical Setting

This educational approach is based off of social interactions and team approach to solving problems that will result in deeper learning

(Smith-Goodwin, & Wimer, 2010).

Using PBL in the clinical practicum provides a mechanism for connection to one’s clinical experience.

(Smith-Goodwin & Wimer, 2010).

PBL requires students to investigate cases or problems that are prepared in advance by the processor. Professors use small groups of students (3-5) to discuss problems. This helps students generate problem-based (self-directed) learning

(Rotgans, & Schmidt, 2011, Smith-Goodwin & Wimer, 2010).

Psychosocial Strategies and Referral in AthletesEffectiveness in ATEP Competencies

This lesson is effective at addressing the knowledge, skills, clinical integration proficiencies, and learning objectives

Based on literature, PAL will be effective if Professors have planned actives

Use small groups of 3-5 students

Have students discuses to the class the solutions they came up with

PBL helps “student move general skills learned in early phases of clinical education into specific therapeutic skill which will require the use of sound judgment and critical thinking”.

(Smith-Goodwin & Wimer, 2010, p. 24).

Because of this the learning objectives can be met and mastered (PS-3)

Summary

PBL educational approach Is based off of social interactions and team approach to solving problems.

Will result in deeper learning.

Can better retrieve from their memory when needed in the clinical setting.

(Smith-Goodwin, & Wimer, 2010).

Psychological Strategies and Referral in Athletes Ahletes experience negative psychological responses to injuries.

Rehabilitation is designed by the AT to help the athlete return to sport pre-injury level.

Strategies include goal setting, imagery, positive self-talk, and relaxation strategies

(Clement, Granquist, & Arvinen-Barrow, 2013).

Questions

What are your thoughts about PBL? Will you add this into your teaching methods, or have you already done so?

Have you experienced psychosocial distress with your athletes? How have you handled the situation?

Do you believe that PBL is a positive way to teach psychosocial strategies and referral in athletes? If so why, if not, what do you believe would be a good teaching method?

In the case study used, how would you have used psychosocial strategies and referrals to help this athlete?

The End

References

N.A., (2011). Athletic Training Education Competencies. Retrieved December 1, 2015, from https://caate.net/wp-content/uploads/2014/06/5th-Edition-Competencies.pdf

Arvinen-Barrow, M., Massey, W. V., & Hemmings, B. (2014). Role of Sport Medicine Professionals in Addressing Psychosocial Aspects of Sport-Injury Rehabilitation: Professional Athletes' Views. Journal Of Athletic Training (Allen Press), 49(6), 764-772. doi:10.4085/1062-6050-49.3.44

Clement, D., Granquist, M. D., & Arvinen-Barrow, M. M. (2013). Psychosocial Aspects of Athletic Injuries as Perceived by Athletic Trainers. Journal Of Athletic /Training (Allen Press), 48(4), 512-521.

Covassin, T., Crutcher, B., Bleecker, A., Heiden, E. O., Dailey, A., & Yang, J. (2014). Postinjury Anxiety and Social Support Among Collegiate Athletes: A Comparison Between Orthopaedic Injuries and Concussions. Journal of Athletic Training, 49(4), 462–468. http://doi.org/10.4085/1062-6059-49.2.03

Gulliver, A., Griffiths, K. M., & Christensen, H. (2012). Barriers and facilitators to mental health help-seeking for young elite athletes: a qualitative study. BMC Psychiatry, 12, 157. http://doi.org/10.1186/1471-244X-12-157

Heinrichs, K. I. (2002). Problem-Based Learning in Entry-Level Athletic Training Professional-Education Programs: A Model for Developing Critical-Thinking and Decision-Making Skills. Journal of Athletic Training, 37(4 suppl), S–189–S–198.

ReferencesContinued

Kerr, Z. Y., DeFreese, J. D., & Marshall, S. W. (2014). Current Physical and Mental Health of Former Collegiate Athletes. Orthopaedic Journal of Sports Medicine, 2(8), 2325967114544107. http://doi.org/10.1177/2325967114544107

Rotgans, J. I., & Schmidt, H. G. (2011). Cognitive engagement in the problem-based learning classroom. Advances in Health Sciences Education, 16(4), 465–479. http://doi.org/10.1007/s10459-011-9272-9

Smith-Goodwin, E., & Wimer, J. W. (2010). Using Problem-Based Learning to Link Classroom and Clinical Education. Athletic Therapy Today, 15(1), 23-27.

Stiller-Ostrowski, J. L., & Ostrowski, J. A. (2009). Recently Certified Athletic Trainers’ Undergraduate Educational Preparation in Psychosocial Intervention and Referral. Journal of Athletic Training, 44(1), 67–75.

Yang, J., Peek-Asa, C., Lowe, J. B., Heiden, E., & Foster, D. T. (2010). Social Support Patterns of Collegiate Athletes Before and After Injury. Journal of Athletic Training, 45(4), 372–379. http://doi.org/10.4085/1062-6050-45.4.372

Yang, J., Schaefer, J. T., Zhang, N., Covassin, T., Ding, K., & Heiden, E. (2014). Social Support From the Athletic Trainer and Symptoms of Depression and Anxiety at Return to Play. Journal of Athletic Training, 49(6), 773–779. http://doi.org/10.4085/1062-6050-49.3.65