Standardizing Baselines for Better Clinical Decision-Making
Overview
Dustin Gatens has served as an athletic trainer for Nova Southeastern University in sunny Ft. Lauderdale, Florida, since 2006. He’s held several positions at the University, including staff Athletic Trainer, Head Athletic Trainer in Research and Development, and most recently the Assistant Athletic Director for Sports Medicine. In his current role, Gatens supervises a staff of six athletic trainers and is responsible for all aspects of the sports medicine program. Gatens also works with NSU’s men’s soccer and women’s tennis teams. Service within the profession is important to Gatens as well. He was previously the Southern 1 Regional Representative for the Athletic Trainers’ Association of Florida and was awarded the ATAF Service Award and the Present’s award in 2019.
The Problem
Compliance with the NCAA and the Arrington rules is important to Gatens. But Gatens didn’t just want to be in compliance with NCAA requirements, he wanted something that met the criteria and was reliable year in and year out. “I knew I wanted a tool in my back pocket to use when I felt it was appropriate. I wanted something reliable that I could standardize to make it easier for my team.” Before implementing Sway, Gatens’ team did manual BESS testing one-on-one with the athletes.
Implementing Sway
Doing one-on-one testing just wasn’t going to cut it. “Just having the baseline test be electronic, where I can do 10-15 people at once - how much time does that save me in an average year?” exclaimed Gatens. But Gatens doesn’t just see implementing Sway as a time-saving measure. “It’s the information we’re getting out of it. I want the information to be as valuable as the time being put into it. I wanted something reproducible in a clinical scenario. Recording BESS tests one-on-one, was that really valuable if I’m not going to be able to guarantee I’m going to be the one doing it after an injury?” Having the balance component of Sway and standardizing it within baseline testing was a crucial change for Gatens. “I knew this needed to be a part of the evaluation, standardized to make it more uniform, and therefore potentially make it more reliable. We don’t live in a vacuum.”
Clinical Decision Making
Gatens recognizes that not every sideline evaluation will be the same. “Sometimes we may have an athlete who needs a sideline evaluation and maybe isn’t wearing their contact lenses that day or an athlete who has been managing hip impingement. This affects the sideline evaluation compared to the baseline.” This is when Gatens appreciates how Sway can back up his clinical judgment. “I always want to back up my clinical decision-making, but also, from a documentation standpoint, be able to validate or justify putting an athlete back into a game by having as much information as possible. We’re all human and need data and information to help inform our choices. Sway helps us do that.”
Treatment Pathways
During the return-to-play protocol, Gatens appreciates how Sway has supplemented clinical calls and treatment paths for his athletes. “I can look at their symptoms and see where their potential deficits are.” This can help support and guide us to where the athlete may need more help in their return-to-play rehabilitation.” Gatens also enjoys the continuing education that Sway provides for free to any athletic trainer who may want to learn more about treatment pathways for athletes with an injury.
Finally, Gatens noted, “If you have a large student-athlete to clinician ratio, or you’re a single athletic trainer in a high school, I’d absolutely recommend implementing Sway.”