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Washington Athletic Trainer — Requirements & Free Practice

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Athletic Trainer License

Ordinary Washington athletic trainer license. The Secretary of Health administers licensure with advice from the Athletic Training Advisory Committee. Initial issuance, endorsement, renewal and return to active status are represented separately.

Licensing authority: Washington State Department of Health, Secretary of Health · Application information

Annual active license renewal
No examination is required for this applicant pathway.
Continuing Education
Complete 50 hours every two years, including at least 10 evidence-based-practice hours, or document current BOC certification under WAC 246-916-060(3). Current BOC certification satisfies a continuing-education alternative; the renewal provisions do not demand a certification-exam score.
Course Assessments
A non-BOC-provider multimedia or home-study activity selected under WAC 246-916-060(5)(d)(ii) must have an examination. That unnamed course assessment is a continuing-education condition, not a registered licensure examination.
Health Equity
Complete one hour of health-equity continuing education every two years; it counts toward the required hours and is due by the first full reporting period after January 1, 2024 or initial licensure, whichever is later.
Renewal Cycle
Renew annually on or before the practitioner's birthday, pay renewal fees and any required monitoring surcharge, and submit required declarations.
Suicide Prevention
Complete the secretary-approved one-time training of at least six hours in suicide assessment, screening, referral and imminent harm via lethal means by the first full applicable reporting period.

Official no-examination sources

Effective from 2026-06-14.

Licensure by endorsement — substantially equivalent jurisdiction
No examination is required for this applicant pathway.
Application
Submit the Department application, licensing fees and license-history proof demonstrating RCW 18.130.077(1) and (3) compliance.
Current Eligibility Limitation
The Department Licensing Information page states: "*At this time no other states have been deemed substantially equivalent to Washington state licensure requirements. Please check back periodically for updates." This is an eligibility condition of the legally established route; it does not eliminate the statutory route or create an examination leaf.
Discipline
Meet RCW 18.130.077(3): not subject to denial or conditional licensure, no disqualifying disciplinary action during the preceding two years or application pendency, and no investigation or charges during pendency.
Examination Waiver
RCW 18.130.077(1) requires waiver of education, training, experience and exam requirements for qualifying applicants. WAC 246-916-030(2) sends applicants who fail endorsement criteria to initial licensure.
Lower Ranked Application
The general application checklist for a new graduate or a license holder in another state states: "The Board of Certification for Athletic Trainers (BOC) examination is the approved license exam." That general instruction is not applied to override the statutory mandatory endorsement waiver.
Prior Licensure
Currently licensed in a substantially equivalent state or jurisdiction; licensed for at least two years immediately before applying, with no interruption longer than 90 days.

Official no-examination sources

Effective from 2025-12-31.

Return to active status — expired for more than one renewal cycle but less than three years
No examination is required for this applicant pathway.
Continuing Education
Complete 50 hours every two years, including at least 10 evidence-based-practice hours, or document current BOC certification under WAC 246-916-060(3). Current BOC certification satisfies a continuing-education alternative; the renewal provisions do not demand a certification-exam score.
Course Assessments
A non-BOC-provider multimedia or home-study activity selected under WAC 246-916-060(5)(d)(ii) must have an examination. That unnamed course assessment is a continuing-education condition, not a registered licensure examination.
Expiration Interval
expired for more than one renewal cycle but less than three years
Health Equity
Complete one hour of health-equity continuing education every two years; it counts toward the required hours and is due by the first full reporting period after January 1, 2024 or initial licensure, whichever is later.
Restoration Requirements
Submit the abbreviated application, late penalty, renewal and reissuance fees and any required surcharge; declare unrestricted practice, no surrender to avoid action, and completion of the two most recent years of required continuing education or competency.
Suicide Prevention
Complete the secretary-approved one-time training of at least six hours in suicide assessment, screening, referral and imminent harm via lethal means by the first full applicable reporting period.

Official no-examination sources

Effective from 2026-06-14.

Return to active status — expired for one renewal cycle or less
No examination is required for this applicant pathway.
Continuing Education
Complete 50 hours every two years, including at least 10 evidence-based-practice hours, or document current BOC certification under WAC 246-916-060(3). Current BOC certification satisfies a continuing-education alternative; the renewal provisions do not demand a certification-exam score.
Course Assessments
A non-BOC-provider multimedia or home-study activity selected under WAC 246-916-060(5)(d)(ii) must have an examination. That unnamed course assessment is a continuing-education condition, not a registered licensure examination.
Expiration Interval
expired for one renewal cycle or less
Health Equity
Complete one hour of health-equity continuing education every two years; it counts toward the required hours and is due by the first full reporting period after January 1, 2024 or initial licensure, whichever is later.
Restoration Requirements
Pay the late penalty and current renewal fee and any required monitoring surcharge; provide required declarations and meet current continuing education or competency requirements.
Suicide Prevention
Complete the secretary-approved one-time training of at least six hours in suicide assessment, screening, referral and imminent harm via lethal means by the first full applicable reporting period.

Official no-examination sources

Effective from 2026-06-14.

Return to active status — expired for three years or more
No examination is required for this applicant pathway.
Continuing Education
Complete 50 hours every two years, including at least 10 evidence-based-practice hours, or document current BOC certification under WAC 246-916-060(3). Current BOC certification satisfies a continuing-education alternative; the renewal provisions do not demand a certification-exam score.
Course Assessments
A non-BOC-provider multimedia or home-study activity selected under WAC 246-916-060(5)(d)(ii) must have an examination. That unnamed course assessment is a continuing-education condition, not a registered licensure examination.
Expiration Interval
expired for three years or more
Health Equity
Complete one hour of health-equity continuing education every two years; it counts toward the required hours and is due by the first full reporting period after January 1, 2024 or initial licensure, whichever is later.
Restoration Requirements
Submit the abbreviated application, late penalty, renewal and reissuance fees and any required surcharge; declare unrestricted practice, no surrender to avoid action, and completion of the two most recent years of required continuing education or competency; satisfy any other competency requirements imposed by the regulatory entity.
Suicide Prevention
Complete the secretary-approved one-time training of at least six hours in suicide assessment, screening, referral and imminent harm via lethal means by the first full applicable reporting period.

Official no-examination sources

Effective from 2026-06-14.

Return to active status from nonmilitary inactive status
No examination is required for this applicant pathway.
Continuing Education
Complete 50 hours every two years, including at least 10 evidence-based-practice hours, or document current BOC certification under WAC 246-916-060(3). Current BOC certification satisfies a continuing-education alternative; the renewal provisions do not demand a certification-exam score.
Course Assessments
A non-BOC-provider multimedia or home-study activity selected under WAC 246-916-060(5)(d)(ii) must have an examination. That unnamed course assessment is a continuing-education condition, not a registered licensure examination.
Declarations
Declare no jurisdictional or hospital action restricting practice, no voluntary surrender or restriction to avoid formal action, and completion of required continuing education and competency for the two most recent years.
Health Equity
Complete one hour of health-equity continuing education every two years; it counts toward the required hours and is due by the first full reporting period after January 1, 2024 or initial licensure, whichever is later.
Other Competency
Provide other required documentation and satisfy other regulatory-entity competency requirements; no named licensure examination is imposed by WAC 246-12-110 or Chapter 246-916 WAC.
Prior Credential
Existing Washington athletic trainer license in nonmilitary inactive status.
Request And Fees
Notify the Department in writing; pay current active renewal fee and any required monitoring surcharge.
Suicide Prevention
Complete the secretary-approved one-time training of at least six hours in suicide assessment, screening, referral and imminent harm via lethal means by the first full applicable reporting period.

Official no-examination sources

Effective from 2026-06-14.

Initial licensure — approved accredited education
BOC Certification Exam
Application
Submit the complete Department application, licensing fee, signed attestation, personal-data responses and required supporting documentation.
Background Check
Complete the Department background check; fingerprint-based national checks may be required at the applicant's expense.
Education
Receive a bachelor's or advanced degree from an accredited four-year college or university meeting the accepted athletic-training academic standards, and complete an accredited educational program accepted by BOC for certification-exam eligibility. Submit official transcripts directly from the educational institution.
Examination
Provide direct BOC verification of a passing score; passing before application is still part of this route. Applicants eligible for the national-certification documentation waiver may instead use that pathway.
Fitness
Positive personal-data answers require explanations and supporting documents. The Department may require a mental, physical or psychological examination as a fitness assessment; these are applicant conditions, not athletic-training examination leaves.
License History
Disclose all current and previous health-profession credentials and obtain verification directly from each issuing jurisdiction as required.
Other Approved Examination
WAC 246-916-010(1)(c) also accepts its predecessor or another organization approved by the Secretary. No additional current examination is identified by these sources; a predecessor score or an unnamed approved alternative is applicant evidence or a condition, not an invented examination.
Initial licensure — degree attained before January 1, 2004
BOC Certification Exam
Application
Submit the complete Department application, licensing fee, signed attestation, personal-data responses and required supporting documentation.
Background Check
Complete the Department background check; fingerprint-based national checks may be required at the applicant's expense.
Coursework
Document health (or an accepted pathology, pathophysiology or pharmacology substitution), human anatomy, kinesiology/biomechanics, human physiology, exercise physiology, and basic and advanced athletic training coursework.
Degree Date
Bachelor's or advanced degree attained before January 1, 2004.
Examination
Provide verification of a BOC passing score; prior passage of a currently offered exam remains an examination leaf.
Fitness
Positive personal-data answers require explanations and supporting documents. The Department may require a mental, physical or psychological examination as a fitness assessment; these are applicant conditions, not athletic-training examination leaves.
Internship
Document at least 1,500 practical internship hours under direct supervision of a BOC-certified athletic trainer.
License History
Disclose all current and previous health-profession credentials and obtain verification directly from each issuing jurisdiction as required.
Other Approved Examination
WAC 246-916-010(1)(c) also accepts its predecessor or another organization approved by the Secretary. No additional current examination is identified by these sources; a predecessor score or an unnamed approved alternative is applicant evidence or a condition, not an invented examination.
Return to active status following mandated suspension
No examination is required for this applicant pathway.
Continuing Education
Complete 50 hours every two years, including at least 10 evidence-based-practice hours, or document current BOC certification under WAC 246-916-060(3). Current BOC certification satisfies a continuing-education alternative; the renewal provisions do not demand a certification-exam score.
Course Assessments
A non-BOC-provider multimedia or home-study activity selected under WAC 246-916-060(5)(d)(ii) must have an examination. That unnamed course assessment is a continuing-education condition, not a registered licensure examination.
Declarations
Provide declarations of required continuing education and competency for the entire suspension and other required documentation.
Duration
For suspension longer than three years, comply with profession-specific requirements identified by rule.
Fees
Pay current renewal fee if due, any required monitoring surcharge and the $245 return-from-mandated-suspension fee; standard renewal fees are not required during suspension.
Health Equity
Complete one hour of health-equity continuing education every two years; it counts toward the required hours and is due by the first full reporting period after January 1, 2024 or initial licensure, whichever is later.
Order
Meet all requirements in the mandatory suspension order.
Suicide Prevention
Complete the secretary-approved one-time training of at least six hours in suicide assessment, screening, referral and imminent harm via lethal means by the first full applicable reporting period.

Official no-examination sources

Effective from 2026-06-14.

Return to active status from inactive military related status
No examination is required for this applicant pathway.
Continuing Education
Applicable continuing education resumes during the following renewal.
Discharge Deadline
If discharge prompted return, provide DD214 showing qualifying discharge within the preceding six months and change status within six months; late return is subject to WAC 246-12-040 fees.
Restoration
Pay the current active renewal fee and any required monitoring surcharge; document the service member's current service or discharge status.

Official no-examination sources

Effective from 2026-06-14.

Return to active status from military status
No examination is required for this applicant pathway.
Continuing Education
Continuing education applies after the first post-discharge renewal.
Deadline
Request the change within six months of qualifying discharge; later requests incur WAC 246-12-040 late fees.
Status Change
Submit written notice of service-status change, official discharge papers (DD214), current active renewal fee and any required monitoring surcharge.

Official no-examination sources

Effective from 2025-05-03.

Initial licensure through national BOC certification
BOC Certification Exam
Application
Submit the complete Department application, licensing fee, signed attestation, personal-data responses and required supporting documentation.
Background Check
Complete the Department background check; fingerprint-based national checks may be required at the applicant's expense.
Certification
Hold active BOC certification obtained on or after January 1, 2004, and request official verification directly from BOC.
Discipline
Not subject to denial or conditional licensure; no unprofessional-conduct or impairment disciplinary action during the preceding two years or application pendency; no pending investigation or charges during application.
Documentation Waiver
WAC 246-916-010(2) permits waiver of evidence of education and examination upon verification of qualifying BOC certification and compliance with RCW 18.130.077(3). The BOC leaf is retained because the initial route identifies that currently offered examination; waiver and proof substitution are applicant conditions.
Fitness
Positive personal-data answers require explanations and supporting documents. The Department may require a mental, physical or psychological examination as a fitness assessment; these are applicant conditions, not athletic-training examination leaves.
Implementation Date Wording
The Board page says certification earned "after January 1, 2004"; the rule and application packet say "on or after January 1, 2004". The rule governs inclusion of the date itself.
License History
Disclose all current and previous health-profession credentials and obtain verification directly from each issuing jurisdiction as required.
Other Approved Examination
WAC 246-916-010(1)(c) also accepts its predecessor or another organization approved by the Secretary. No additional current examination is identified by these sources; a predecessor score or an unnamed approved alternative is applicant evidence or a condition, not an invented examination.
Reinstatement following suspension for support or visitation order noncompliance
No examination is required for this applicant pathway.
Release
Provide the Secretary a Department of Social and Health Services release stating compliance with the order.
Remaining Requirements
Continue to satisfy all other reinstatement requirements during suspension and pay any reinstatement fee; the Secretary then automatically reissues the license. This is the express automatic-reissue branch of RCW 18.130.150, not its discretionary disciplinary-reinstatement branch.

Official no-examination sources

Effective from 2026-06-14.

Athletic Trainer Temporary Practice Permit

Temporary permit for an eligible out-of-state license holder pending national background checks or for a qualifying military spouse or registered domestic partner. It grants the full athletic trainer scope for at most 180 days unless it ends earlier under the applicable rule.

Licensing authority: Washington State Department of Health, Secretary of Health · Application information

Temporary practice permit pending fingerprint based national background check
BOC Certification Exam
Background Check
All other licensing requirements must be satisfied; submit the required fingerprint card and written permit request while awaiting the national background check.
Eligibility Limitation
The current Athletic Trainer Licensing Information page says no states have yet been deemed substantially equivalent; this limits applicant eligibility for the permit.
Examination Waiver
The BOC examination identified by initial licensure is retained. Qualifying endorsement applicants have the statutory RCW 18.130.077(1) waiver; qualifying BOC-certified applicants may substitute certification proof under WAC 246-916-010(2). These applicant exemptions do not create a second permit examination.
Good Standing
Not subject to denial or conditional/restricted licensure and no Washington criminal record.
Out Of State License
Hold an unrestricted active athletic trainer license in a substantially equivalent jurisdiction.
Renewal
The permit cannot be renewed, reissued or extended.
Termination
Permit ends when a license is granted, a decision notice is sent unless that notice extends the permit, or 180 days after issuance.
Underlying Licensure
Submit the license application, fees and required documentation; satisfy the athletic-training licensure requirements to the extent the applicable permit rule requires them.
Temporary practice permit for military spouse or registered domestic partner
BOC Certification Exam
Eligibility Limitation
The current Athletic Trainer Licensing Information page says no states have yet been deemed substantially equivalent; this limits applicant eligibility for the permit.
Examination Waiver
The BOC examination identified by initial licensure is retained. Qualifying endorsement applicants have the statutory RCW 18.130.077(1) waiver; qualifying BOC-certified applicants may substitute certification proof under WAC 246-916-010(2). These applicant exemptions do not create a second permit examination.
Good Standing
No pending investigation, charges or disciplinary action by the other jurisdiction's regulatory body.
Military Relationship
Moving to Washington because of the military person's transfer; provide orders and military identification proving relationship, a marriage license or registered domestic-partnership evidence.
Out Of State License
Hold an unrestricted active athletic trainer license in a substantially equivalent jurisdiction.
Remaining Requirements
Meet profession-specific training, education and practice standards; the permit allows completion of additional requirements unrelated to training or practice standards.
Request
Submit a written temporary-permit request, fingerprint card if required and the underlying license documentation.
Termination
Permit ends when a license is granted, a decision notice is sent unless that notice extends the permit, or 180 days after issuance.
Underlying Licensure
Submit the license application, fees and required documentation; satisfy the athletic-training licensure requirements to the extent the applicable permit rule requires them.

BOC Certification Exam

Provider
Board of Certification for the Athletic Trainer (BOC); administered at Meazure Learning testing centers and scored by Meazure Learning
Format
Internet-based exam administered in secure and proctored professional testing centers during 2-week testing windows; stand-alone items (multiple choice, multi-select, drag-and-drop, hot spot) and focused testlets (a scenario followed by key/critical items); each form includes unidentified experimental items that do not count in scoring; multi-select and drag-and-drop items are eligible for partial credit
Exam questions
175 scored and unscored (experimental) items; the PA8 Weighting of Domains table lists 125 items across the five domains (25, 32, 26, 32, 10)
Time limit
Four hours
Passing score
Scaled score of 500 on a 200-800 scale (criterion-referenced, Angoff Modified Technique)
Examination outline
  • Domain I: Risk Reduction, Wellness and Health Literacy — Promoting healthy lifestyle behaviors with effective education and communication to enhance wellness and minimize the risk of injury and illness (20.0% of the exam; 25 items in the PA8 Weighting of Domains table) (20%)
    • Task 0101: Identify risk factors by administering assessment, pre-participation examination and other screening instruments, and reviewing individual and group history and surveillance data. Knowledge of: 1. Disqualifying health-related factors; 2. General health conditions; 3. Risk factors within activities, wellness, and environment; 4. Policies, procedures, and guidelines; 5. Behavioral risks (e.g., nutritional, sexual, substance abuse, sedentary lifestyle, overtraining); 6. Catastrophic risks (e.g., cardiorespiratory, neurological, thermoregulatory, immunological); 7. Biomechanical risks; 8. Indications for referral; 9. Physiological adaptation to exercise; 10. Ergonomic, epidemiological, and etiological factors; 11. Evidence-based principles and practices; 12. Implications of culture for practice; 13. Injury surveillance data and trends; 14. Systematic approach; 15. Applicable screening instruments; 16. Federal, state, and local laws, regulations, rules, and requirements, and professional standards; 17. Mental health risks (e.g., personality, psychosocial, depression, suicide, anxiety, grief, eating disorder); 18. Age-related and lifespans considerations that pertain to conditioning, wellness, and baseline measurement. Skill in: 1. Communicating with appropriate chain of command; 2. Interpreting injury surveillance data; 3. Analyzing examination/screening data; 4. Identifying conditions that may affect participation; 5. Communicating available health resources to patients and/or stakeholders; 6. Administering screenings and examinations; 7. Identifying clinical indications for referral; 8. Communicating with appropriate stakeholders and other healthcare providers; 9. Reviewing information systematically; 10. Exercising clinical judgment consistent with evidence-based principles and practices.
    • Task 0102: Implement plans to aid in risk reduction in accordance with evidence-based practice and applicable guidelines. Knowledge of: 1. Policies, procedures, and guidelines; 2. Principles of strength development, cardiovascular fitness, and functional movement; 3. Health conditions; 4. Proper hygiene practices; 5. Facility cleaning and maintenance; 6. Evidence-based principles and practices; 7. Ergonomics and preventive measures; 8. Risk factors within activities, wellness, and environment; 9. Federal, state, and local laws, regulations, rules, and requirements, and professional standards. Skill in: 1. Communicating inherent risks; 2. Identifying health conditions; 3. Managing health conditions; 4. Interpreting and applying policies and procedures, position statements, and consensus statements; 5. Applying federal, state, and local laws, regulations, rules, and requirements, and professional standards; 6. Educating patients and/or stakeholders on available health resources; 7. Applying preventive measures (e.g., safety rules, accepted biomechanical techniques, ergonomics, nutrition guidelines, injury and disease prevention equipment); 8. Implementing risk-reduction plans.
    • Task 0103: Promote health literacy by educating patients and other stakeholders in order to improve their capacity to obtain, process, and understand basic health information needed to make appropriate health decisions. Knowledge of: 1. Policies, procedures, and guidelines; 2. Federal, state, and local laws, regulations, rules, and requirements, and professional standards; 3. Operation of healthcare systems; 4. Indications for referral; 5. Available resources; 6. Social determinants of health; 7. Cultural diversity and implications for health literacy. Skill in: 1. Communicating effectively; 2. Educating stakeholders on available resources and healthcare procedures; 3. Identifying barriers to optimal health and wellness; 4. Coordinating inter-professional communication; 5. Teaching stakeholders to communicate and advocate effectively with healthcare providers.
    • Task 0104: Optimize wellness (e.g., social, emotional, spiritual, environmental, occupational, intellectual, physical) for individuals and groups. Knowledge of: 1. Risk factors associated with activities, wellness, and environment; 2. Policies, procedures, and guidelines; 3. Principles of strength development, cardiovascular fitness, and functional movement; 4. Screening and baseline assessment tools and their use; 5. Professional resources for stress management, behavior modification, comorbidities, and nutritional conditions; 6. Nutrition and supplements; 7. Human physiology; 8. Considerations for referral; 9. Wellness examinations; 10. Signs and symptoms of social, emotional, mental, and stress-related conditions; 11. Federal, state, and local laws, regulations, rules, and requirements, and professional standards; 12. Pharmacology; 13. Substance use and abuse; 14. Social determinants of health; 15. Cultural diversity and implications for wellness. Skill in: 1. Developing a comprehensive program for optimizing function; 2. Assessing appropriateness of participation in conditioning programs; 3. Correcting or modifying inappropriate, unsafe, or dangerous activities; 4. Accessing information concerning accepted guidelines; 5. Educating individuals and groups on the concepts of wellness; 6. Addressing signs and symptoms of social, emotional, mental, and stress-related conditions; 7. Educating individuals and groups on available wellness resources; 8. Administering and interpreting baseline screening tools; 9. Communicating effectively; 10. Making appropriate referrals.
    • Task 0105: Facilitate individual and group safety by monitoring and responding to environmental conditions (e.g., weather, surfaces, and work setting). Knowledge of: 1. Health conditions; 2. Environmental conditions that create risk; 3. Signs and symptoms of health conditions that result from exposure to environmental conditions; 4. Risk factors associated with activities, wellness, and environments; 5. Methods for reducing risk pertaining to environmental conditions (e.g., activity scheduling, clothing selection, fluid replacement); 6. Policies and procedures for removing participants from environmental risk situations (e.g., heat index, lightning, activity scheduling); 7. Federal, state, and local laws, regulations, rules, and requirements, and professional standards; 8. Ergonomic assessments; 9. Pharmacology; 10. Biomechanics. Skill in: 1. Conducting inspections and recognizing hazards; 2. Using monitoring techniques (e.g., weight charts, fluid intake, body composition); 3. Utilizing weather/environmental monitoring devices; 4. Managing predisposing factors (e.g., environmental conditions, health conditions, ergonomic risks, biomechanical risks); 5. Responding to signs and symptoms of health conditions that result from exposure to environmental conditions; 6. Recommending and implementing appropriate methods for addressing hazards; 7. Communicating risk mitigation procedures and guidelines effectively.
  • Domain II: Assessment, Evaluation and Diagnosis — Implementing systematic, evidence-based assessments and evaluations to formulate valid clinical diagnoses and differential diagnoses to determine a patient’s plan of care (25.6% of the exam; 32 items in the PA8 Weighting of Domains table) (25.6%)
    • Task 0201: Obtain a thorough and individualized history using observation and appropriate interview techniques to identify information relevant to the patient’s current condition. Knowledge of: 1. Psychosocial factors; 2. Evidence-based medicine; 3. Human anatomy and physiology; 4. Neuroscience; 5. Mechanisms of injury and nature of illness; 6. Pathophysiology and pathological conditions; 7. Biomechanical and postural factors and abnormalities; 8. Environmental risk factors; 9. Verbal and non-verbal communication techniques; 10. Epidemiology and etiology of health conditions; 11. Nutrition; 12. Pharmacology; 13. Standard medical terminology; 14. Visual inspection techniques; 15. Health conditions; 16. Health factors (e.g., age and lifespan, sex and gender, race and ethnicity); 17. Cultural diversity and implications for health and assessment; 18. Disablement models; 19. Patient-reported outcome measures. Skill in: 1. Communicating effectively; 2. Asking open-ended questions; 3. Interpreting/using prior medical history and medical records; 4. Documenting observations and history; 5. Identifying anatomical structures; 6. Reviewing and evaluating test results; 7. Recognizing signs and symptoms of health conditions; 8. Recognizing effects of substances; 9. Interpreting results of patient-reported outcome measure; 10. Identifying severity of health condition; 11. Interpreting critical information gathered.
    • Task 0202: Perform a physical examination using appropriate diagnostic techniques. Knowledge of: 1. Normal and abnormal human anatomy and physiology; 2. Mechanics, principles, and techniques of special, specific, and selective tissue tests (e.g., ROM, MMT, orthopedic, neurocognitive, neurological); 3. Normal and pathological clinical findings and physiological measurements; 4. Human biometrics; 5. Palpation techniques and related principles; 6. Mechanism of injury and nature of illness; 7. Immediate and delayed functional and physiological response to health conditions; 8. Signs and symptoms; 9. Standard medical terminology and nomenclature; 10. Clinical trajectories of concussion and traumatic brain injuries; 11. Testing techniques and diagnostic imaging; 12. Exercise physiology and its effects on the healing process; 13. Characteristics of pain; 14. Evidence-based principles and practices; 15. Vital signs; 16. Cultural diversity and implications for health and assessment; 17. General health conditions; 18. Validity and reliability of diagnostic testing and assessment techniques. Skill in: 1. Assessing neurocognitive function; 2. Assessing neurological function and response; 3. Assessing neuromuscular control (e.g., postural control and balance); 4. Identifying anatomical structures; 5. Understanding the severity of signs of health conditions; 6. Palpating appropriate structures to assess the integrity of human anatomical and physiological systems; 7. Interpreting the relationships among signs of pathological health conditions; 8. Assessing range of motion (e.g., AROM, PROM, RROM); 9. Assessing functional movement (e.g., biomechanics, gait analysis); 10. Assessing immediate and delayed physiological responses health conditions; 11. Interpreting the relationships between pre-existing functional/structural abnormalities and health conditions.; 12. Identifying appropriate selective tissue tests; 13. Performing visual inspections; 14. Performing selective tissue tests; 15. Interpreting results of selective tissue tests; 16. Exercising clinical judgement consistent with evidence-based principles and practices; 17. Interpreting diagnostic imaging and testing; 18. Performing manual muscle testing; 19. Obtaining informed consent; 20. Assessing general medical conditions.
    • Task 0203: Formulate a clinical diagnosis by interpreting the information obtained during the history and physical examination. Knowledge of: 1. Health conditions; 2. Clinical indications for referral; 3. Pharmacology; 4. Standard medical terminology and nomenclature; 5. Psychosocial dysfunction and implications associated with health conditions; 6. Evidence-based principles and practices; 7. Normal and abnormal neurocognitive and neurological function; 8. Differential diagnoses. Skill in: 1. Interpreting and integrating evaluation findings; 2. Formulating differential diagnoses; 3. Synthesizing applicable information from the examination and assessment; 4. Using valid and reliable information to assist in decision-making.
    • Task 0204: Establish a plan of care based on the clinical diagnosis and evidence-based practice. Knowledge of: 1. Health conditions and prognosis; 2. Scope of practice of healthcare providers; 3. Guidelines for return to activity or participation; 4. Pharmacology; 5. Therapeutic intervention; 6. Standard medical terminology and nomenclature; 7. Psychosocial factors; 8. Human anatomy and physiology; 9. Cultural diversity and implications for health and assessment; 10. Concepts of healing; 11. Verbal and non-verbal communication; 12. Diagnoses and differential diagnoses; 13. Policies, procedures, and guidelines; 14. Federal, state, and local laws, regulations, rules, and requirements, and professional standards; 15. Clinical trajectories of concussion and traumatic brain injuries; 16. Standard medical documentation procedures. Skill in: 1. Synthesizing information; 2. Identifying appropriates courses of action; 3. Incorporating federal, state, and local laws, regulations, rules, and requirements, and professional standards; 4. Setting appropriate goals; 5. Considering factors that influence level of activity; 6. Collaborating with interdisciplinary healthcare providers; 7. Directing referrals to the appropriate professionals; 8. Using standard medical terminology and nomenclature; 9. Using standard medical documentation procedures.
    • Task 0205: Educate the patient and stakeholders on the clinical diagnosis, prognosis, and plan of care. Knowledge of: 1. Best practices regarding the care and treatment of health conditions; 2. Effective verbal and non-verbal communication techniques; 3. Patient confidentiality guidelines, laws, and regulations; 4. Health conditions prognosis and complications; 5. Standard medical terminology and nomenclature; 6. Motivational techniques; 7. Concepts of healing progression; 8. Psychosocial factors; 9. Cultural diversity and implications for health and assessment. Skill in: 1. Communicating effectively; 2. Maintaining patient confidentiality; 3. Motivating to promote optimal outcomes; 4. Using standard medical terminology and nomenclature; 5. Differentiating between normal and abnormal recovery progression; 6. Using appropriate counseling techniques.
  • Domain III: Critical Incident Management — Integrating best practices in immediate and emergency care for optimal outcomes (20.8% of the exam; 26 items in the PA8 Weighting of Domains table) (20.8%)
    • Task 0301: Implement Emergency Action (Response) Plans for all venues and events to guide appropriate and unified response in order to optimize outcomes. Knowledge of: 1. Components of emergency action plans; 2. Effective communication techniques (e.g., multimedia videos, pamphlets, posters, models, handouts and oral communication); 3. Roles of individual members of the medical management team and appropriate stakeholders; 4. National and state occupational, safety, and health guidelines; 5. Standard protective equipment, removal devices, and procedures; 6. Standard and emergency medical equipment; 7. Pharmacological agents and interventions for immediate and emergent conditions; 8. Personal protective equipment; 9. Organizational and institutional policies and procedures; 10. Legal considerations. Skill in: 1. Communicating effectively; 2. Educating individuals (e.g., facilities, healthcare professionals, patients, guardians, organizational personnel) regarding standard emergency care procedures; 3. Developing, documenting, organizing, and rehearsing emergency action plans.
    • Task 0302: Triage the severity of health conditions. Knowledge of: 1. Epidemiology of catastrophic conditions; 2. Life-threatening medical situations (e.g., respiratory, central nervous, and cardiovascular); 3. Human anatomy and physiology; 4. National and state occupational, safety, and health guidelines; 5. Pharmacological and therapeutic intervention for immediate and emergent conditions; 6. Roles and scopes of practice of relevant healthcare providers; 7. Standard and emergency medical equipment; 8. Triage systems. Skill in: 1. Implementing emergency action plans; 2. Implementing national and state occupational, safety and health guidelines; 3. Using standard and emergency medical equipment; 4. Measuring, interpreting, and monitoring vital signs; 5. Using a primary survey for life-threatening medical situations (e.g., respiratory, central nervous, cardiovascular); 6. Applying pharmacological and therapeutic intervention usage for immediate and emergent conditions; 7. Managing patients in triage systems.
    • Task 0303: Implement appropriate evidence-based emergent care procedures to reduce the risk of morbidity and mortality (e.g., c-spine, airway management, heat illness, pandemics, suicides, other emergent conditions). Knowledge of: 1. Appropriate management techniques for life-threatening conditions and conditions that are not life-threatening; 2. Appropriate use of emergency equipment and techniques (e.g., automated external defibrillator, airway management devices, suction, oxygen); 3. Human anatomy and physiology; 4. Therapeutic intervention for immediate and emergent conditions; 5. National and state occupational, safety, and health guidelines; 6. Roles and scopes of practice of relevant healthcare providers. Skill in: 1. Performing cardiopulmonary resuscitation techniques and procedures; 2. Implementing emergency action plans; 3. Implementing national and state occupational, safety, and health guidelines; 4. Implementing immobilization and transfer techniques; 5. Measuring, interpreting, and monitoring vital signs and patient status; 6. Managing emergency situations and life-threatening conditions; 7. Managing non-life-threatening conditions; 8. Removing protective equipment using appropriate removal devices and/or manual techniques; 9. Using standard and emergency medical equipment; 10. Applying therapeutic interventions for immediate and emergent conditions; 11. Debriefing stakeholders.
    • Task 0304: Assess the scene to identify appropriate courses of action. Knowledge of: 1. Components of emergency action plans; 2. National and state occupational, safety, and health guidelines; 3. Referral strategies for life-threatening conditions and conditions that are not life-threatening; 4. Effective communication; 5. Pertinent administrative practices; 6. Roles and responsibilities of relevant healthcare providers; 7. Triage systems. Skill in: 1. Implementing emergency action plan(s); 2. Measuring, interpreting, and monitoring vital signs and patient status; 3. Documenting and communicating referrals; 4. Directing referrals to appropriate stakeholders.
  • Domain IV: Therapeutic Intervention — Rehabilitating individuals with a health condition (i.e., injury, illness, general medical condition) with the goal of achieving optimal activity and participation levels based on core concepts (i.e., fundamental knowledge and skillsets) using the applications of therapeutic exercise, modality devices, and manual techniques (25.6% of the exam; 32 items in the PA8 Weighting of Domains table) (25.6%)
    • Task 0401: Optimize patient outcomes by developing, evaluating, and updating the plan of care. Knowledge of: 1. Evidence-based principles and practices; 2. Inflammation and healing process; 3. Health conditions; 4. Theories of pain and motor system adaptation (e.g., biopsychosocial model, endogenous descending pain inhibition); 5. Roles and scopes of practice of relevant health care providers; 6. Rehabilitation and/or treatment plan modification; 7. Rehabilitation methods (e.g., therapeutic exercise, manual therapies, modalities and devices); 8. Health factors (e.g., age and lifespan, sex and gender, race and ethnicity, co-morbidities); 9. Indications, contraindications, and precautions; 10. Safety (e.g., patient, environment, equipment, clinician); 11. Pharmacology; 12. Cultural diversity and responses to treatment and rehabilitation; 13. Surgical procedures and precautions; 14. Legal risks and ramifications; 15. Psychosocial implications associated with injuries, illnesses, and conditions; 16. Outcome measurement tools (e.g., patient-centered, clinician-centered); 17. Evaluation findings (e.g., diagnosis, impairments, activity limitations, participation restrictions); 18. Referral sources and procedures; 19. Implications and limitations of provider referrals and standing orders; 20. Periodization. Skill in: 1. Interpreting examinations and assessments; 2. Clinical reasoning; 3. Assessing outcomes; 4. Managing patient care; 5. Communicating effectively; 6. Establishing patient goals; 7. Examining and re-examining health conditions; 8. Assessing and reassessing patient response to therapeutic interventions; 9. Preparing patients for therapeutic intervention; 10. Modifying treatment plans.
    • Task 0402: Educate patients and appropriate stakeholders using pertinent information to optimize patient-centered care and patient engagement throughout the therapeutic intervention process. Knowledge of: 1. Evidence-based principles and practices; 2. Appropriate referral considerations; 3. Anatomy, physiology and kinesiology (e.g., vestibular, pulmonary, visual, cardiovascular, musculoskeletal); 4. Health factors (e.g., age and lifespan, sex and gender, race and ethnicity, co-morbidities; 5. Indications, contraindications, and precautions; 6. Safety (e.g., patient, environment, equipment, clinician); 7. Cultural diversity and responses to treatment and rehabilitation; 8. Surgical procedures and precautions; 9. Legal risks and ramifications (e.g., Scope of practice); 10. Nutrition; 11. Homecare program components; 12. Educational material and methods; 13. Supplemental resources (e.g., psychosocial, community, family, and health care); 14. Psychological aspects related to the therapeutic intervention process; 15. Health conditions; 16. Inflammation and healing processes; 17. Theories of pain, pain control, and motor system adaptation; 18. Principles of rehabilitation process and modification; 19. Pharmacology. Skill in: 1. Communicating effectively (e.g., recovery timeline, expectations, outcomes); 2. Providing guidance for the stakeholders throughout the therapeutic intervention process; 3. Developing homecare programs; 4. Providing appropriate referral; 5. Applying clinical reasoning.
    • Task 0403: Prescribe therapeutic exercises following evidence-based practices to address impairments and enhance activity and participation levels. Knowledge of: 1. Evidence-based principles and practices; 2. Inflammation and healing processes; 3. Health conditions; 4. Theories of pain and motor system adaptation (e.g., biopsychosocial model, endogenous descending pain inhibition); 5. Anatomy, physiology and kinesiology (e.g., vestibular, pulmonary, visual, cardiovascular, musculoskeletal); 6. Health factors (e.g., age and lifespan, sex and gender, race and ethnicity, comorbidities); 7. Indications, contraindications, and precautions; 8. Safety (e.g., patient, environment, equipment, clinician); 9. Pharmacology; 10. Cultural diversity and responses to treatment and rehabilitation; 11. Surgical procedures and precautions; 12. Legal risks and ramifications (e.g., Scope of practice); 13. Equipment and tools; 14. Exercise prescription and modification (e.g., Progression and Regression); 15. Neurological factors; 16. Tissue responses to stimulus; 17. Local and systemic physiologic responses; 18. Principles of resistance training; 19. Principles of functional training; 20. Principles of cardiovascular training; 21. Principles of postural control; 22. Principles of dynamic joint stability; 23. Principles of mobility; 24. Principles of pain control; 25. Principles of swelling management; 26. Principles of return to activity programs; 27. Principles of motor learning; 28. Psychosocial influences; 29. Structure, growth, development, and regeneration of tissue; 30. Physiologic responses to exercise-related modalities and devices; 31. Gait training techniques; 32. Periodization. Skill in: 1. Interpreting examination results; 2. Applying clinical reasoning; 3. Assessing outcomes; 4. Managing patient care (e.g., progressions, regressions, discontinuation); 5. Communicating effectively; 6. Establishing patient goals; 7. Examining and re-examining health conditions; 8. Assessing and reassessing patient’s response to therapeutic interventions; 9. Developing therapeutic exercise programs; 10. Implementing therapeutic exercise programs; 11. Progressing patients through therapeutic exercise programs; 12. Educating patients on proper biomechanics.
    • Task 0404: Administer therapeutic modalities and devices using evidence-based procedures and parameters to address impairments and enhance activity and participation levels. Knowledge of: 1. Evidence-based principles and practices; 2. Inflammation and healing processes; 3. Health conditions; 4. Theories of pain, pain control, and motor system adaptation; 5. Scope of practice and appropriate referral; 6. Principles of rehabilitation process and modification; 7. Health factors (e.g., age and lifespan, sex and gender, race and ethnicity, co-morbidities; 8. Indications, contraindications, and precautions; 9. Safety (e.g., patient, environment, equipment, clinician); 10. Pharmacology; 11. Cultural diversity and responses to treatment and rehabilitation; 12. Surgical procedures and precautions; 13. Legal risks and ramifications; 14. Equipment and tool maintenance; 15. Physiologic responses; 16. Principles of electromagnetic, mechanical, thermal, and acoustical energy; 17. Anatomy, physiology and kinesiology (e.g., vestibular, pulmonary, visual, cardiovascular, musculoskeletal); 18. Principles of taping, bracing and orthotics; 19. Psychosocial influences. Skill in: 1. Interpreting examinations; 2. Applying clinical reasoning; 3. Assessing outcomes; 4. Managing patient care; 5. Communicating effectively; 6. Establishing patient goals; 7. Applying therapeutic devices and modalities; 8. Fabricating orthotic devices appropriately; 9. Using taping techniques and orthotic devices appropriately; 10. Assessing and reassessing patient’s response to therapeutic devices and modalities; 11. Assessing physiological responses related to the application of therapeutic devices and modalities.
    • Task 0405: Administer manual therapy techniques using evidence-based methods to address impairments and enhance activity and participation levels. Knowledge of: 1. Evidence-based principles and practices; 2. Inflammation and healing processes; 3. Health conditions; 4. Theories of pain, pain control, and motor system adaptation; 5. Scope of practice and appropriate referral; 6. Principles of rehabilitation process and modification; 7. Health factors (e.g., age and lifespan, sex and gender, race and ethnicity, co-morbidities; 8. Indications, contraindications, and precautions; 9. Safety (e.g., patient, environment, equipment, clinician); 10. Pharmacology; 11. Cultural diversity and responses to treatment and rehabilitation; 12. Surgical procedures and precautions; 13. Legal risks and ramifications; 14. Adaptations of the cutaneous, nervous, and musculoskeletal systems related to manual techniques; 15. Psychosocial influences; 16. Manual therapy techniques (e.g., joint mobilization, neural mobilization, soft tissue mobilization, positional release); 17. Physiologic responses; 18. Anatomy, physiology and kinesiology (e.g., vestibular, visual, cardiorespiratory, musculoskeletal). Skill in: 1. Interpreting examinations and assessments; 2. Applying clinical reasoning; 3. Assessing outcomes; 4. Managing patient care; 5. Communicating effectively; 6. Establishing patient goals; 7. Examining and re-examining health conditions; 8. Assessing and reassessing patient’s response to therapeutic interventions; 9. Performing manual therapy techniques appropriately.
    • Task 0406: Determine patients’ functional status using appropriate techniques and standards to inform decisions about returning to optimal activity and participation levels. Knowledge of: 1. Evidence-based principles and practices; 2. Inflammation and healing processes; 3. Health conditions; 4. Scope of practice and appropriate referral; 5. Principles of rehabilitation process and plan modification; 6. Health factors (e.g., age and lifespan, sex and gender, race and ethnicity, co-morbidities, nutrition); 7. Indications, contraindications, and precautions; 8. Safety (e.g., patient, environment, equipment, clinician); 9. Cultural diversity and responses to treatment and rehabilitation; 10. Surgical procedures and precautions; 11. Legal risks and ramifications; 12. Anatomy, physiology and kinesiology (e.g., vestibular, pulmonary, visual, cardiovascular, musculoskeletal); 13. Principles of and criteria for functional progression; 14. Gait analysis; 15. Biomechanical and functional assessments; 16. Theories of pain, pain control, and motor system adaptation; 17. Pharmacology; 18. Outcome measurement tools (e.g., patient-centered, clinician-centered); 19. Psychosocial influences; 20. Activity and participation requirements. Skill in: 1. Interpreting examination results; 2. Applying clinical reasoning; 3. Assessing outcomes; 4. Managing patient care; 5. Communicating effectively; 6. Establishing patient goals; 7. Examining and re-examining health conditions; 8. Assessing and reassessing patient’s response to therapeutic interventions; 9. Performing biomechanical and functional analyses; 10. Interpreting biomechanical and functional analyses; 11. Making decisions about functional progressions; 12. Making decisions about return to optimal activity and participation level.
    • Task 0407: Manage general medical conditions to optimize activity and participation levels. Knowledge of: 1. Evidence-based principles and practices; 2. Anatomy, physiology and kinesiology (e.g., vestibular, pulmonary, visual, cardiovascular, musculoskeletal); 3. Health conditions; 4. Inflammation and healing processes; 5. Theories of pain, pain control, and motor system adaptation; 6. Scope of practice and appropriate referral; 7. Principles of rehabilitation process and plan modification; 8. Health factors (e.g., age and lifespan, sex and gender, race and ethnicity, co-morbidities); 9. Indications, contraindications, and precautions; 10. Safety (e.g., patient, environment, equipment, clinician); 11. Pharmacology; 12. Cultural diversity and responses to treatment and rehabilitation; 13. Surgical procedures and precautions; 14. Legal risks and ramifications; 15. Equipment and tools; 16. Neurological factors; 17. Psychosocial influences; 18. Concussion and other traumatic brain injuries; 19. Wound (e.g., chronic, open) management; 20. Pathophysiology of systemic illnesses, communicable diseases, and infections. Skill in: 1. Interpreting examination results; 2. Applying clinical reasoning; 3. Assessing outcomes; 4. Managing patient care; 5. Communicating effectively; 6. Establishing patient goals; 7. Examining and re-examining health conditions; 8. Assessing and reassessing patient’s response to therapeutic interventions; 9. Performing neurocognitive assessments; 10. Incorporating neurocognitive assessments in plans of care; 11. Using personal protective equipment appropriately.
  • Domain V: Healthcare Administration and Professional Responsibility — Integrating best practices in policy construction and implementation, documentation and basic business practices to promote optimal patient care and employee well-being (8.0% of the exam; 10 items in the PA8 Weighting of Domains table, where the domain is listed as 'Health Administration and Professional Responsibility') (8%)
    • Task 0501: Assess organizational and individual outcomes using quality improvement analyses. Knowledge of: 1. Methods of gathering, analyzing, and interpreting qualitative and quantitative data; 2. Benchmarking; 3. Project and program management; 4. Resources available for adapting policies and procedure; 5. Job expectations, personal goals, and priorities (e.g., work-life balance, job satisfaction); 6. Organizational resources available for professional development and personal support; 7. Role of professional collaboration; 8. Leadership and management styles and theories; 9. Evidence-based principles and practices; 10. Post-event assessment techniques; 11. Goal-setting principles and practices; 12. Appropriate software and technologies available. Skill in: 1. Gathering, analyzing, and interpreting data; 2. Conducting a post-event assessment; 3. Formatting and presenting data; 4. Providing data to support the advancement of organizational or personal goals; 5. Synthesizing study results to implement change; 6. Implementing quality improvement (e.g., needs assessment, PDSA cycle, SWOT analysis); 7. Collaborating with stakeholders and other healthcare providers; 8. Educating stakeholders; 9. Applying concepts of evidence-based medicine; 10. Communicating effectively; 11. Providing leadership appropriate to situations and people; 12. Educating the public and stakeholders on the profession of athletic training to ensure patient protection and care across all job settings.
    • Task 0502: Develop policies, procedures, and plans to address organizational needs. Knowledge of: 1. Components of emergency action (response) plans; 2. Human resources; 3. Federal, state, and local laws, regulations, rules, and requirements, and professional standards; 4. Organizational and management styles; 5. Scheduling systems and techniques; 6. Drug testing; 7. Inventory and purchasing; 8. Applicable resource allocation; 9. Legislative and regulatory updates and changes; 10. Basic business principles; 11. Pre-participation examination; 12. Policies, procedures, and guidelines; 13. Budgeting; 14. Equipment and supplies; 15. Insurance and reimbursement; 16. Standard operating procedures; 17. Risk management; 18. Best practices (e.g., position statements); 19. Facility management; 20. Organizational mission and goals. Skill in: 1. Formulating policies and procedures; 2. Collaborating with stakeholders and local first responders; 3. Incorporating technology where appropriate (e.g., computer software, weather monitoring); 4. Implementing human resources policies; 5. Communicating with stakeholders; 6. Implementing policies and procedures; 7. Developing a budget; 8. Interpreting regulatory documents; 9. Understanding job descriptions; 10. Tracking inventory and purchasing; 11. Interpreting applicable and appropriate data (e.g., injury surveillance, usages trends, and risks).
    • Task 0503: Practice within federal, state, and local laws, regulations, rules, requirements, and professional standards. Knowledge of: 1. Standards of professional practice for Athletic Trainers and other healthcare professionals; 2. Professional organization position and consensus statements (NATA, Centers for Disease Control and Prevention); 3. Documentation requirements and procedures; 4. Consent-to-treat requirements and documentation; 5. Standard medical terminology and nomenclature; 6. Federal, state, and local laws, regulations, rules, and requirements, and professional standards; 7. Professional codes of ethics; 8. Process for reporting violations of professional standards and practice acts; 9. Policies, procedures, and guidelines; 10. Requirements for third-party reimbursement; 11. Telehealth and electronic communication restrictions. Skill in: 1. Creating and completing medical documentation; 2. Making ethical decisions that are consistent with professional practice and guidelines; 3. Implementing current position statements, regulatory changes, and legislated requirements; 4. Using standard medical terminology and nomenclature; 5. Accessing professional practice acts and requirements; 6. Communicating effectively; 7. Understanding procedural and diagnostic coding; 8. Protecting the public through the safe and ethical practice of athletic training; 9. Understanding administrative reporting pathways for ethical violations; 10. Applying telehealth and electronic technology.
    • Task 0504: Use standardized documentation procedures to ensure best practices. Knowledge of: 1. Documentation procedures (e.g., SOAP, progress notes, screenings, assessments, examinations); 2. Standard medical terminology and nomenclature; 3. Appropriate documentation requirements (e.g., electronic health record, Centers for Medicare and Medicaid Services, consent); 4. Documentation systems (e.g., software, paper); 5. Appropriate computer software applications; 6. Healthcare coding; 7. Legal considerations and ramifications; 8. Telehealth and electronic communication restrictions. Skill in: 1. Reviewing prescreening participation guidelines; 2. Creating and completing the documentation process; 3. Obtaining, interpreting, evaluating, and applying relevant data; 4. Using computer software applications (e.g., word processing, database spreadsheet, and Internet applications); 5. Reviewing documentation; 6. Interpreting documentation; 7. Updating documentation; 8. Applying telehealth and electronic technology; 9. Communicating effectively.
Examination sources