After reading James W. Watson's editorial of February 14, "More time needed to assess NATA changes," I thought it necessary to comment on some of his assumptions, or at least inferences, regarding the changes taking place in athletic training education. These changes will affect athletic health care as it is now provided to the student-athlete, but we are confident that those changes will be positive.

My comments have a bias. I'm both a practicing athletic trainer and the president of the Commission on Accreditation of Allied Health Education Programs (CAAHEP). CAAHEP is the accrediting body for athletic training education. It is the largest specialized accrediting body in the country, accrediting the educational programs for 18 allied health professions. I want to approach the topic from the point of view of the value of accreditation and what it brings to the institution, the program and the student. Let me be clear that I'm addressing Mr. Watson's statements regarding the changes in athletic training education and not the issues associated with certification.

Historically, accreditation developed as a method of establishing minimum standards in educational programs, assuring transferability of academic credits, a guard against fraudulent and unethical practices, and, later, a method to determine the eligibility of institutions for federal funding. Through the implementation of its strategic plan, built around a mission to "nurture quality health sciences education to serve the public interest," CAAHEP attempts to develop collaborative efforts between itself and its customers, establish outcomes-based standards, streamline the programmatic accreditation process, and provide the opportunity for accreditation services worldwide. This practice allows diversity and choice in programs while at the same time maintaining quality assurance and quality improvement.

Mr. Watson is absolutely right, then, when he states that the goals of the changes in educational standards are to (1) "achieve consistency in the level of instruction," which (2) "results in a higher standard of care." These goals also are parallel to his statement of the NCAA's "goal of better, more comprehensive sports medical care for student-athletes." The CAAHEP mission is "to nurture quality health sciences education to serve the public interest."

In this case the public interest must be protected both during the educational programming and as students complete the programs. Accredited programs must demonstrate that the safety of the patient, in this case the student-athlete, is protected as the athletic training student learns. They also must demonstrate that the graduates of that program are qualified to become entry-level professionals. This process is a function of the accreditation procedure.

Who, then, assures quality of care, or even safety of the care, given to student-athletes at the non-accredited athletic training programs? How can an institution justify to the public (for example, the parents) that the health care for their student-athletes is performed by undergraduate students who are not in a formal instructional program?

Athletic training education, as well as all allied health education, has evolved. Yes, many of us graduated from institutions without accredited athletic training programs and we have been successful. The knowledge base for athletic training has grown, though. It is now impossible to teach what the entry-level athletic trainer needs to know without formal coursework, by having a student work only within the apprenticeship model.

No other allied health profession educates their students that way. I've been an athletic trainer at the high-school, small college and Division I levels. I know that there will have to be changes in the way some institutions deliver health care. Don't, though, attempt to entangle an effort to improve educational programming with the lack of ability to provide a service to your student-athletes.

Both the NCAA and the NATA want to provide the best care possible for those student-athletes. Let's work together to accomplish that goal.

Larry J. Leverenz, ATC/L
President, CAAHEP
Purdue University