Defense Date


Graduation Date

Summer 2013


Immediate Access

Submission Type


Degree Name



Rehabilitation Science


Rangos School of Health Sciences

Committee Chair

Paula Turocy

Committee Member

Leesa DiBartola

Committee Member

Gregory Frazer


Athletic training, Athletic training education, Clinical education, Critical thinking, Supervision, Supervision responses


The purpose of this study was to 1) assess the critical thinking skill level of the athletic training student at onset and end of the clinical education experience 2) to examine the influence of the students' critical thinking skills and the CIs' supervision responses to the changes in the students' critical thinking skills and 3) to compare the students' and the clinical instructors' perceptions of the CIs' supervision responses to the athletic training students' critical thinking skill levels.

Methods: A descriptive research study design was used. To explore the critical thinking skill levels of the athletic training students (ATSs), the California Critical Thinking Skills Test (CCTST) was used. Perceived clinical supervision responses of the Clinical Instructors (CIs) to the ATSs' level of thinking were analyzed using two tools developed for this study-ATS Perception of Clinical Instructor Supervision Response (S-PS) and the CI Self-Evaluation of Supervision Response (CI-S) assessments. The S-PS and CI-S were assessed for validity and reliability. Data were collected at the beginning and at the end of the students' clinical education experiences. A sample of convience was used from the CAATE approved programs in the state of Pennsylvania. 121 students from eight participating institutions chose to participate in the study. The CIs of each participating student were solicitated to participate in the study. 23 CIs completed and returned the suvey at the beginning and at the end of the students' clinical education expeiences. Correlations and paired t-tests were used to analyze the data. Results: The students demonstrated an overall moderate critical thinking skill level. Although there was a decrease in the overall CCTST score over time, the score did not fall below the moderate critical thinking level. There was no statistically significant difference between the critical thinking skill levels of the students who had completed 3 or more years of higher education and the students who completed 1-2 years of higher education.

The athletic training students perceived a statistically significant change in the CIs' supervision responses over the period of one clinical education experience. The ATSs perceived an increase in the amount of autonomy given to the ATSs by the CIs during their clinical education experiences, as well as increases in their own motivation and self-awareness occurring during those clinical education experiences. The data reflected no statistically significant changes in the CIs' self-perception of their supervision responses to the students' levels of critical thinking over time. The CIs did perceive that they gave the students greater amounts of autonomy in the clinical experiences, as well as provided higher levels of motivation and encouraged greater self-awareness in the students than what the students perceived occurred.

Conclusion: Clinical education for students in this sample may not be structured in the most effective way to encourage development of the students' critical thinking skills. This sample demonstrated little improvement in CTS and exemplified the need for better ways to develop of higher levels of critical thinking during their entry-level athletic training preparation. One way this concern may be addressed is that during clinical education experiences, the CIs could adapt their supervision responses to better challenge students and force them to integrate critical thinking skills more often and at higher levels into their decision making processes to advance to higher levels of thinking over time. An improvement in the type of reflection by the students, combined with more frequent and critical evaluation and feedback to the students during clinical education experiences may improve the students' levels of thinking. A more active role of the clinical education coordinator in clinical education of the students also may assist in improving the students' levels of critical thinking