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Standards for BOC Approved Providers

Purpose of Standards

The BOC Approved Provider Standards (to include all elements of this document: General Standards, Standards, Essential Elements, and Commentary) provide clear requirements for BOC Approved Providers to ensure an educational quality Athletic Trainers can expect from the BOC. BOC Approved Providers must adhere to all outlined standards and guidelines.

Introduction of Terms

General Standards: There are six general Standards expressed in roman numerals I-VI. These are areas that group like-minded Standards together and provide general high-level key points in the development of a program.
Standards: There are 19 Standards. Each Standard is a specific requirement associated with a General Standard.

Essential Elements: These directly relate to a Standard and specify what a certification program must do to fulfill the Standard requirements.

Commentary: These explain the applications of the Standards and their inter-relationships. They also clarify terms, provide examples of practice that help explain a Standard, or offer suggestions regarding evidence that may be provided to demonstrate compliance.

Download Standards for BOC Approved Providers Effective Jan 2022

Development and Structure


All programs must be based on evidence.

Evidence Based Practice (EBP) – The most common definition of EBP is taken from Dr. David Sackett, a pioneer in evidence based practice. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” EBP is the integration of clinical expertise, patient values and the best research evidence into the decision-making process for patient care.

Essential Element A:
Practice Gap: Identify the professional practice gap and/or educational need the content addresses.

The practice gap is the difference between health care processes or outcomes observed in practice, and those potentially achievable on the basis of current professional knowledge. What isn’t the AT doing that they should be doing? What doesn’t the AT know that this program will provide them? What is the patient’s unmet need?

Educational need is the education or learning necessary to address the professional practice gap to enhance knowledge and skills.

Essential Element B:
Objectives: Develop measurable learning objectives that define the knowledge and/or skills the AT is expected to acquire through the completion of the program (e.g. written to most current edition of Bloom’s Taxonomy).

Essential Element C:
Clinical Bottom Line: Provide a clinical bottom line or a summary of the evidence (3-4 sentences) that identifies the clinical recommendation outlined in the learning objectives.

A clinical recommendations or a summary of evidence that addresses one or more of the following aspects of patient care: 1) financial implications 2) equipment needs 3) practicality of implementation 4) applicability to various patient populations.

Content Target:

Programs must be presented at or above the entry-level of a Certified AT and fall within at least one of the five domains of athletic training:

Domain 1: Risk Reduction, Wellness and Health Literacy
Domain 2: Assessment, Evaluation and Diagnosis
Domain 3: Critical Incident Management
Domain 4: Therapeutic Intervention
Domain 5: Health Care Administration and Professional Responsibility

Program Structure:

Structure each program for the transfer of knowledge, application and/or practice based needs of the AT. Content must be based on evidence that is generally accepted by health care professionals.

Examples of types of program structures may include any of the following:

A – Knowledge based: Participants gain factual knowledge
B – Activity based: Participants apply information learned in the allotted time frame
C – Practice based: Participants systematically acquire specific knowledge, skills, attitudes and performance behaviors that expand or enhance practice competencies


The delivery shall be appropriate given the objectives.

Programs can be delivered in a variety of formats:

1- Face to face (F2F) vs Virtual:
A. F2F = delivered in person
B. Virtual = delivered via the internet

2- Asynchronous vs Synchronous:
A. Asynchronous = not at the same time (on demand)
B. Synchronous = at the same time (live)

Program Materials:

Offer educational materials for each program that will enhance participant understanding of the content and foster application to clinical practice.


Participant Assessment:

An assessment must be provided to the participant.

A participant assessment is a tool that allows the participant to demonstrate or confirm their learning relative to stated learning objectives. In addition, assessment allows participants to explain how they plan to incorporate the new skill and/or knowledge into their clinical practice to improve patient outcomes.

Essential Element A:
Alignment: Alignment of learning objective and assessment shall be clearly articulated in writing and documented in participant activity.

Each learning objective must have an appropriate, corresponding strategy for assessment of learning.

Essential Element B:
Formal Measurement: Measure the extent to which learning objectives have been accomplished. The AP must use formal techniques for assessment of learning.

Formal techniques, such as tests and quizzes, and self-reports are typically individualized, written and assessed. Formal data synthesis will be required to complete the annual report.


The AP shall give feedback about the assessment to the participant in an appropriate, timely and constructive manner.

Facilities & Faculty


Ensure the facilities are appropriate for proposed educational programs and that they are conducive to meeting program learning objectives.


Select faculty based on subject matter knowledge; experience and teaching ability; and ability to meet AT educational needs.

Program faculty refers to the instructor, presenter, evaluator or author of a program/activity.

Essential Element A:
Faculty Qualifications: Faculty must have documentation highlighting pertinent education information, professional training and experience, publication and/or presentation history (e.g. curriculum vitae).

Essential Element B:
Ratio of Faculty to Students: For activity based programs, maintain a faculty to participant ratio of a minimum of 1:25 to ensure adequate interaction.

Program Evaluation and Review


APs must develop and conduct evaluations of each program that solicit participant feedback.

A program evaluation is an appraisal tool that enables participants to provide program feedback to help APs determine effectiveness of a program and/or the administration of a program.

Essential Element A:
Target Areas: The evaluation questions shall be solicited in the following areas:

  • Program content was practically useful, appropriate and adequately in-depth
  • Achievement of stated learning objectives
  • Effectiveness of teaching and learning methods
  • Quality and effectiveness of faculty
  • Usefulness of educational materials
  • Appropriateness of participant assessment and the alignment with the learning objectives
  • Perception of bias or commercialism

Program Review and Improvement:

Data collected is thoroughly evaluated and used to make improvements in future activities.

Essential Element A:
Internal Review: An independent or internal review shall be conducted no less than annually to determine program effectiveness. The review should evaluate overall goal achievement of the program, taking into consideration all elements of evaluation results.

Essential Element B:
Faculty Feedback: Program faculty are informed of feedback to improve teaching and learning methods, as well as activity quality and effectiveness.

Professional Conduct


APs are guided by the following principles of professional conduct as they interact with ATs. APs will:
  • Be truthful in statements to the BOC, ATs and the public.
  • Provide equal and fair treatment to all program participants.
  • Comply with the BOC audit system.
  • Uphold and enhance public appreciation and trust for the profession of athletic training.
  • Maintain the confidentiality of all participant information.
  • Fulfill financial obligations for all BOC billable goods and services provided.
  • Use language that does not show personal or professional bias or cultural insensitivity.
  • Ensure that programs are available and accessible to all appropriate participants.
  • Maintain the integrity and copyright of all proprietary BOC documents and materials.
  • Comply with all applicable business, employment and copyright laws within your activities.

Copyright is a form of protection provided by the laws of the United States (title 17, U. S. Code) to the authors of “original works of authorship,” including literary, dramatic, musical, artistic and certain other intellectual works. This protection is available to both published and unpublished works. Visit for more information.

Ensure that copyright permission of materials used by program developers, presenters or others are identified on all program materials, including audio-visual and program related materials. Ownership of the copyright, license or permission must be documented for any protected materials used within a program.
1- Disclose potential and actual conflicts of interest and financial gain associated with any programs, presenters or APs.

A conflict of interest is a situation in which social, professional or financial considerations have the potential to compromise or bias objectivity. An apparent conflict of interest is one in which a reasonable person would think that theAP’s objectivity is likely to be compromised. A conflict of interest exists whether or not decisions are affected by a personal interest; a conflict of interest implies only the potential for bias, not a likelihood.

Annual Renewal:

Renew annually to maintain BOC AP status and continue to provide Category A or EBP programs. Renewal consists of an annual renewal fee and annual report.



Programs must be intended for the credentialed health care and/or wellness providers.

ATs must be included in the target audience. Programs targeted at non-credentialed fitness or wellness professionals and lay persons, such as patients, parents, coaches, administrators or educators, do not meet BOC standards.

Calculate Continuing Education Units (CEUs):

Assign CEUs based on contact hours. A contact hour is the time actually spent in the educational portion of the program. One contact hour equals 1 CEU, rounded to the nearest quarter hour. The number of CEUs that can be offered for each Category A program will be determined by the BOC AP and the BOC will assign CEUs for EBP programs.

Program Directory Updates:

Enter all continuing education (CE) programs offered to ATs into the program directory at least 10 calendar days prior to the event. Programs include all asynchronous/synchronous events and virtual/F2F events.

Operations Manual:

Establish and maintain processes for developing, administering, delivering and documenting programs.

Essential Element A:
Evidence: Incorporate programs that promote the use of current, valid and/or EBP.

Essential Element B:
Environment: Identify and provide a supportive learning environment with the physical, technical and educational materials necessary to support the program.

Provide educational materials to participants in either digital or print format.

Essential Element C:
Record Keeping: Maintain cumulative records, specifically, a roster of all participants who were awarded credit and CEU certificates, for a period of five years.

Essential Element D:
Providership: Develop joint providership agreements that clearly define the working relationship between parties. This includes documentation of the completion and provision of various tasks. Provide an agreement statement to participants.

The providership of a CE program by one or more BOC APs and one or more non-BOC provider. The AP must take responsibility for the CE program’s compliance of the BOC provider standards.

Essential Element E:
Conflicts of Interest: Must declare conflicts of interest.

Ensure that commercial support does not interfere with the independence and objectivity of the activity and/or faculty. The sole purpose of a program cannot be the promotion of goods and services to the participants.

Essential Element F:
Program Content: Document changes in administrator/primary contact for programming and ensure that the new administrator/primary contact understands and is in compliance with all standards.

Essential Element G:
Fees: If a fee is charged for programs, a policy must address cancellations and refunds.

Essential Element H:
Paying Faculty: Develop clearly defined policies on honoraria and expense reimbursement for program faculty.

Promotional Materials:

Provider information prior to registration to allow prospective participants to judge the value and appropriateness of the program. Materials must include:
  • Learning objectives
  • Schedule and format
  • Fee(s)
  • Cancellation/refund policy
  • Program faculty and credentials
  • Number of contact hours/CEUs that will be made available
  • Sponsors
  • Required materials and equipment


Provide each learner, in a timely fashion, with a certificate of completion, in a digital or print format, upon successful completion of the program. Each certificate shall include:
  • Participant’s name
  • Title of the program
  • Completion date
  • BOC AP CE statement that includes the number of CEUs, BOC AP name, number and logo
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