For Your Health
For Your Health

News from the University of North Dakota School of Medicine & Health Sciences

Setting the pace

UND’s Department of Sports Medicine celebrates 30 years of leading the nation in best practice care for student athletes.

In the end, making history took only 25 words.

“This is to express support for the location of the Athletic Training Education Program in the School of Medicine at the University of North Dakota.”

With the single sentence, written by former UND President Thomas Clifford and delivered to then-Dean of what is today the UND School of Medicine & Health Sciences (SMHS), Dr. Edwin C. James, UND’s Department of Athletic Training became the first such program in the nation to be housed within an accredited medical college.

Smiling at the 10 April 1990 memo that he collected as part of a fuller report on his department’s history, Chair and Associate Professor in the now Department of Sports Medicine Dr. Steve Westereng reflected on just how risky and profound such a move felt at the time.

“In 1991, nobody had done that,” explained Westereng from a meeting room on the third floor of the SMHS building in Grand Forks, clarifying that while his department was admitted to the medical college shortly after the Clifford memo, the athletic training program was not officially accredited until 1993. “This was the first athletic training program to go into a med school. And now that’s where everybody else is – it’s actually a standard now. You should be doing this.”

‘Unchallengeable authority’

Crediting former Director of Sports Medicine Jim Rudd and former Chair of the UND Department of Family & Community Medicine Dr. William Mann with making the move happen more officially, Westereng noted how the transition 30 years ago marked the first of what was to become many trendsetting decisions by the Department.

“In 2011 the NFL mandated all teams have a physical therapist on staff, whereas we already had this in place at UND since 2000,” Westereng continued, pointing out another innovation. “A more recent development was working with the Department of Physical Therapy on a Sports Residency for physical therapists who work within the UND Center for Sports Medicine and with the athletic training faculty on student athletes. This program is interdisciplinary, educational, and contributes to the service of area athletes.”

Here’s another example:

Based on advice and input it received from the National Athletic Trainers Association, the NCAA approved, in 2016, new rules aimed at guaranteeing medical independence for athletic training and sports medicine staff.

As one NCAA report put it at the time, schools’ sports medicine staff – team physicians and athletic trainers – must be given “unchallengeable authority” over the medical treatment and return-to-play decisions for injured athletes.

“While it is common and accepted for head coaches to hire and fire assistant coaches and certain support staff,” the report noted, “the new rules draw a line when it comes to medical staff, insisting that the employment, supervision and decision-making of team physicians and athletic trainers be made independent of coaches.”

That is to say, the NCAA recommended schools take both athletic training programs and injury reporting out of university athletics programs, advising instead that they reside in academic and/or health-adjacent departments.

“NCAA-mandated independent medical decision making in 2016, but UND was already there back in 1991 because of its placement in the School of Medicine & Health Sciences,” Westereng stated.

30 years and a new degree

Indeed, UND Sports Medicine seems to have made a habit of being ahead of the curve.

Thirty years after making its first pace-setting decision, then, North Dakota’s premier athletic training program celebrates the inaugural leg of its marathon at the School’s 2023 Homecoming Week festivities, Oct. 1-6 on the UND campus.

As the star of the annual SMHS Homecoming Banquet this October, the athletic training program will be the focus of Westereng’s keynote speech to UND alumni who are back in Grand Forks not only for Homecoming events but for the UND football and hockey games that will feature Department of Sports Medicine alumni, faculty, students, and staff.

Part of the festivities will include a celebration of the Master of Athletic Training (MAT) degree the department formalized in 2022 and which Westereng reports is going very well.

“The faculty have worked very hard to make this transition and we feel the first year has gone very well,” said Westereng, who started at UND in 1999 and has served as department chair since 2003. “Students are learning and engaged, and we’re excited to see the development of our first MAT class as they close in on graduation.”

Sara Bjerke, assistant professor in the Department of Sports Medicine, described how the years-long effort to convert a Bachelor of Athletic Training degree program into one of only a few MAT programs in the upper-Midwest will both boost enrollments at UND and diversify the applicant pool.

The new degree “will improve the care future athletes receive on and off the field,” Bjerke told North Dakota Medicine. Why? Because athletic training is no longer just for those of us in action on the field, court, or rink.

“Athletic training has moved from the sidelines to where now we’re in clinics, industrial settings, and really anywhere there are active people,” Bjerke said. “We’re much more ingrained in the healthcare setting generally. Being in the School of Medicine and Health Sciences, we’ve been the anomaly – historically – in that most athletic trainers were hired solely within university athletic departments. We’ve really been on the forefront of being within the healthcare setting, though – and we’re pushing even more.”

Part of that push, added Westereng, is giving more students more clinical experiences sooner, which today is also considered an industry best practice.

“We wanted to maximize the amount of clinical experience that a student garnered, so we designed the curriculum to allow students to get elective clinical rotations in any area of athletic training they are interested in,” he explained of a program that follows a medical preceptor model. That is to say: each of Westereng’s core faculty provide real-time athletic training services to area athletes, including at UND games, and follow a problem-based learning outline. “We’re huge believers in the clinical education portion of our curriculum. A lot of other places have a couple of instructors and then students have clinical preceptors out in the field. But our UND athletic trainers also teach in our program. Research shows students who experience experiential learning with faculty learn more and retention rates go up.”

Such a move for more and better real-world training better aligns UND with developments in the profession industry-wide, Westereng noted.

And being housed within a medical college at a flagship university with Division I athletics gives UND athletic training students another advantage: currency of domain knowledge with top tier student athletes in nationally-known programs.

“It’s easy to forget some of those techniques and to lose touch with what our students really need to learn, and what they need to do to stay current,” added Westereng, thinking of programs whose instructors likely see less time with college and future-professional athletes on the sidelines. “It’s a huge benefit that we are able to use our expertise and then show the students what we’ve learned and what we’re learning on the field, because you learn something new every single day.”

By Brian James Schill