A Time for Reflection: Should We Reconsider the Direct Supervision Standard in Clinical Education?

Context:Educational reform is occurring again in athletic training. The profession, at this time, should reflect on the structure of clinical education, particularly with direct supervision. Clinical education plays a critical role in the development of future practitioners and should provide students with a chance to gain autonomous experience, with appropriate feedback and discourse.Objective:In this commentary, we discuss direct supervision and present an alternative model for supervision (graduated supervision) in athletic training.Background:Currently, there are concerns regarding the readiness of students to transition to independent practice. These trepidations are centered on the policies related to direct supervision and chances for students to gain autonomous experiences needed to prepare them to make clinical decisions.Synthesis:Graduated supervision may provide an alternative lens for athletic training to regulate clinical education, while facilitating experiences that can assist in student development and preparedness to transition into independent, credentialed patient care.Results:Athletic training supervision policies do not align with other health care professions, yet a major impetus for educational reform was founded on the premise that we should model our degree level more comparably.Recommendation(s):Programs should allow for supervision that encompasses a trusting relationship between preceptors and students. Supervision can be modified (more versus less constant interactions) based upon the students' performance, knowledge, and skills. Shifting the way supervision is implemented can still allow for ensuring patient and student safety, but also allow for students to become critical thinkers.Conclusion(s):Direct supervision policies should be updated to allow students to develop confidence, competence, and critical thinking abilities as well as to better align the athletic training profession with other health care programs.