Diagnostic Problem Solving in Male Collegiate Athletic Trainers

Context: Knowledge and experience may be important factors for understanding expertise based upon a clinician's ability to select and execute an appropriate response as a clinician during injury evaluation. Objective: To describe how collegiate male certified athletic trainers represent injury-evaluation domain knowledge during a situational interview using a think-aloud protocol. Design: Qualitative. Setting: National Collegiate Athletic Association Division I and II colleges in National Athletic Trainers' Association District 3. Patients or Other Participants: A total of 20 male certified athletic trainers (n = 10 with less than 2 years of experience in the college setting and n = 10 with at least 10 years of experience in the college setting) participated in the study. Data Collection and Analysis: We collected data using a situational interview and questionnaire. Data were transcribed, reduced to meaningful units, and analyzed using verbal analysis procedures. Member checks, triangulation of data, field journaling, and peer-debriefing techniques were used to ensure trustworthiness of the data. Knowledge concepts were enumerated to describe differences between experts and novices. Results: Compared with novices, experts had more knowledge concepts of patient history and predictions and fewer concepts of situation appraisal. Conclusions: Expertise in athletic training shares traits with other areas in health care. Athletic training education and professional development may benefit from our understanding which cognitive processes differentiate expert practice. Future investigators should attempt to describe other settings and study diagnostic problem solving in a natural environment.