Globalization of the Athletic Training Profession

In 1998, the National Athletic Trainers' Association (NATA) Board of Directors, under the leadership of President Kent Falb, decided to study the role of the athletic trainer worldwide. The NATA convened international leaders to examine the education, credentialing, and development of an international organization for the profession. After several years of investigation, globalization was determined to be an important factor for the continued development and evolution of the athletic trainer/therapist. Athletic training, as we know it, is primarily a North American phenomenon. Currently, only the United States and Canada have educational systems leading to university degrees and structured credentialing processes for athletic trainers and athletic therapists. However, recent developments in Asia, and Japan in particular, have led to new and exciting opportunities for the athletic trainer. Other countries use an array of health care professionals, including nurses, physiotherapists, and massage therapists, to provide medical services to athletes and other patients. The overriding goal is to provide the best health care services to our patients, a goal that can be accomplished with different techniques and procedures. For example, on a trip to Italy, I was exposed to a new modality called cryosound. This was a standard ultrasound machine with a frozen head that provided superficial cold to the injured body part. The theory was that the combination of cold with pulsed ultrasound would enhance the healing process and allow for faster recovery. It was an interesting application for a common modality.

In 2000, the World Federation of Athletic Training and Therapy (WFATT) was created to provide a forum for health care professionals to exchange ideas, treatment techniques, and knowledge. The WFATT is an organization of associations whose vision is to improve health care for athletes and physically active individuals. The charter members included organizations from Canada, South Africa, Japan, Taiwan-ROC, the United Kingdom, and the United States. Since inception, we have added members from other countries (Spain, South Korea, Italy), enhancing the WFATT as a strong and vibrant organization. The WFATT has hosted several successful World Congresses, organized by the NATA in 2001, the Canadian Athletic Therapists Association (CATA) in 2003, and the United Kingdom's Association of Chartered Physiotherapists in Sports Medicine in 2005. The next World Congress will be hosted by the Japanese Amateur Sports Association, with support from the Japanese Athletic Trainers Organization, in January 2007 in Tokyo.

The WFATT has 2 major projects that will further expand the knowledge and understanding of the athletic trainer. First, the Board of Certification (BOC) and CATA signed a mutual recognition arrangement (MRA) in July 2005. An MRA is a non-governmental agreement among organizations that recognize each other's education and credentialing systems. This 2-year process and intensive self-study culminated in a landmark international agreement. Canadian athletic therapists can now take the BOC certification examination, and candidates from the US can sit for the CATA certification examination. The beauty of this process is that other countries' professional organizations can initiate participation to join the MRA. For example, if a country's organization demonstrates similar educational and credentialing systems as the existing organizations involved in the MRA, it can join the ranks of the MRA, expanding into a trilateral agreement. When a fourth country's organization joins the arrangement, it becomes a quadrilateral agreement. As more organizations join, the MRA continues to grow.

The second project is a global practice analysis. This is similar to the BOC's Role Delineation Study, ¹ which analyzed the necessary skills and knowledge needed to function in a comprehensive health care environment. In January 2005, member organizations from the WFATT gathered in Chicago to embark on this project. We assembled a variety of health care professionals, such as nurses, athletic trainers, physical therapists, and biokineticists, who were currently practicing in the field. Where the BOC has developed 6 major domains, the WFATT developed 4: Assessment, Intervention, Administration, and Education. The vision for this project is to validate the major domains for the global athletic trainer/ therapist with a subset of information to function in a specific region or country. For example, acupuncture is a skill that is specific to Asia, although this set of skills is not currently viewed as important in some western countries. Both the MRA and global practice analysis could have tremendous effects upon the profession.

In order to be successful in this global environment, we must employ a personal, hands-on approach. We must continue to take an active role in international face-to-face meetings, to share our ideologies, our research, and our treatment techniques. Ron Courson, Director of Sports Medicine at The University of Georgia, has said on numerous occasions, “People don't care how much you know, they want to know how much you care.” Although these 16 words appear simple, they are also very profound. Whether we are athletic trainers, physical therapists, physicians, nurses, or other allied health care providers, we must continue to interact with our patients, our colleagues, our families, and our friends. We are a worldwide sports medicine community with different backgrounds and languages, but unquestionably, our goals are universal: attaining the best health care for our patients. For more information about the WFATT, see www.wfatt.org or contact President Catherine Ortega at gro.ttafw@OyhtaC.

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