Agentic Denial: How Athletic Teams Sustain Divergent Structures During Concussion Events

2019 ◽  
Vol 51 (3) ◽  
pp. 342-374
Author(s):  
Alaina C. Zanin ◽  
Jessica K. Kamrath ◽  
Steven R. Corman
Keyword(s):  
Ncaa Division I ◽  
National Collegiate Athletic Association ◽  
Athletic Trainers ◽  
Social Systems ◽  
Division I ◽  
Certified Athletic Trainers ◽  
Team Members ◽  
Athletic Teams ◽  
Division I Athletes ◽  
Depth Interviews

This study reveals how athletic health care teams, embedded within large bureaucratic organizations and complex social systems, negotiate and sustain multiple divergent structures. An iterative analysis of 69 in-depth interviews with National Collegiate Athletic Association (NCAA) Division I athletes’ certified athletic trainers (ATCs) and coaches from four high-contact sports (i.e., women’s lacrosse, men’s wrestling, men’s soccer, and men’s football) revealed that team members coconstructed and negotiated multiple conflicting structures during concussion events. The divergent macro-, meso-, and micro-level structures include (a) formal versus hidden authority structures, (b) prevention versus inevitability discourse, (c) assigned versus enacted roles, and (d) authentic versus inauthentic injury performance. The analysis also revealed how a specific speech act, termed agentic denial, enabled members to obscure their agency within concussion events. Theoretical implications and practical recommendations are discussed.

scholarly journals National Collegiate Athletic Association Division I Athletic Trainers' Concussion-Management Practice Patterns

2014 ◽  
Vol 49 (5) ◽  
pp. 665-673 ◽  
Author(s):  
Kassandra C. Kelly ◽  
Erin M. Jordan ◽  
A. Barry Joyner ◽  
G. Trey Burdette ◽  
Thomas A. Buckley
Keyword(s):  
Clinical Examination ◽  
Ncaa Division I ◽  
Sports Medicine ◽  
National Collegiate Athletic Association ◽  
Practice Patterns ◽  
Management Practice ◽  
Athletic Trainers ◽  
Division I ◽  
Concussion Management ◽  
Consensus Statements

Context: A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of athletic trainers' (ATs') practice patterns found limited use of multifaceted protocols; however, these authors typically grouped diverse athletic training settings together. Objective: To (1) describe the concussion-management practice patterns of National Collegiate Athletic Association (NCAA) Division I ATs, (2) compare these practice patterns to earlier studies, and (3) objectively characterize the clinical examination. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: A total of 610 ATs from NCAA Division I institutions, for a response rate of 34.4%. Main Outcome Measure(s): The survey had 3 subsections: demographic questions related to the participant's experiences, concussion-assessment practice patterns, and concussion-recovery and return-to-participation practice patterns. Specific practice-pattern questions addressed balance, cognitive and mental status, neuropsychological testing, and self-reported symptoms. Finally, specific components of the clinical examination were examined. Results: We identified high rates of multifaceted assessments (ie, assessments using at least 3 techniques) during testing at baseline (71.2%), acute concussion assessment (79.2%), and return to participation (66.9%). The specific techniques used are provided along with their adherence with evidence-based practice findings. Respondents endorsed a diverse array of clinical examination techniques that often overlapped objective concussion-assessment protocols or were likely used to rule out associated potential conditions. Respondents were cognizant of the Third International Consensus Statement, the National Athletic Trainers' Association position statement, and the revised NCAA Sports Medicine Handbook recommendations. Conclusions: Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.

scholarly journals National Collegiate Athletic Association Division I Certified Athletic Trainers' Perceptions of the Benefits of Sport Psychology Services

2016 ◽  
Vol 51 (5) ◽  
pp. 398-405 ◽  
Author(s):  
Rebecca A. Zakrajsek ◽  
Scott B. Martin ◽  
Craig A. Wrisberg
Keyword(s):  
Sport Psychology ◽  
National Collegiate Athletic Association ◽  
Rating Scale ◽  
Athletic Trainers ◽  
Division I ◽  
Positive Interactions ◽  
Injury Rehabilitation ◽  
Certified Athletic Trainers ◽  
Rehabilitation Team ◽  
Injured Athletes

Context: Certified athletic trainers (ATs) are responsible for integrating relevant professionals into the rehabilitation team to assist with the holistic care of injured athletes. Objective: To explore National Collegiate Athletic Association Division I (DI) ATs' experience with sport psychology consultants (SPCs), willingness to encourage athletes to use SPCs for injury rehabilitation, and perceptions of the benefits of sport psychology services. Design: Quantitative study. Setting: A Web-based survey was administered to a national sample of DI ATs. Patients or Other Participants: A total of 659 (341 men, 318 women) ATs completed the survey. Main Outcome Measure(s): Athletic trainers' experience with SPCs, willingness to encourage athletes to seek sport psychology services, and perceptions of the benefits of those services in injury-rehabilitation settings were self-reported using a rating scale that ranged from 1 (never or not at all) to 5 (definitely or extremely). Results: Logistic regression revealed that the availability of SPCs, previous encouragement to athletes to seek sport psychology services, and previous positive interactions with SPCs predicted the ATs' willingness to encourage athletes to use these services (P < .0001). The services ATs rated the highest for injury rehabilitation were managing anxiety and emotion, improving coping techniques, and building confidence (ie, confidence in returning to sport and building confidence). Chi-square analyses indicated that female ATs' ratings of perceived benefits were higher (P ≤ .001) than those of male ATs, and the ratings of ATs who were likely to encourage the use of SPCs were higher (P ≤ .001) than those who were unlikely to encourage SPC service use. Conclusions: Athletic trainers in our study who had previous positive SPC experiences were most likely to use SPCs and their services during the injury-rehabilitation process. Possible implications are offered for how ATs interested in sport psychology services might call on SPCs to complement their work with injured athletes.

scholarly journals Associations of Early Sport Specialization and High Training Volume With Injury Rates in National Collegiate Athletic Association Division I Athletes

2020 ◽  
Vol 8 (3) ◽  
pp. 232596712090682 ◽  
Author(s):  
Seth Ahlquist ◽  
Brian M. Cash ◽  
Sharon L. Hame
Keyword(s):  
Ncaa Division I ◽  
Sport Participation ◽  
National Collegiate Athletic Association ◽  
Division I ◽  
Multiple Injuries ◽  
Training Volume ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Time Out ◽  
Division I Athletes

Background: There are 60 million US youth who participate in organized athletics, with large increases in both sport participation and specialization during the past 2 decades. There is some evidence that increased sport specialization and training volumes may be associated with increased injuries in adolescent populations. This study examines these variables in a population of elite college athletes. Hypothesis: Early sport specialization (ESS) and a high training volume are risk factors for injury and/or surgery in National Collegiate Athletic Association (NCAA) Division I athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: All Division I athletes at a single institution were surveyed regarding demographics, scholarship status, reason for specialization, age at specialization, training volume, and injury history. Chi-square and Mann-Whitney U tests were performed to identify significant differences. Results: Athletes who specialized in their eventual varsity sport before age 14 years were more likely to report a history of injuries (86.9% vs 71.4%), multiple injuries (64.6% vs 48.8%), multiple college injuries (17.2% vs 6.0%), a greater number of total injuries (2.0 vs 1.0), and require more time out for an injury (15.2 vs 6.5 weeks) than those who did not. They were also more likely to be recruited (92.9% vs 82.1%) and receive a scholarship (82.8% vs 67.9%). Athletes who trained for greater than 28 hours per week in their eventual varsity sport before high school were more likely to report multiple injuries (90.0% vs 56.3%), multiple college injuries (40.0% vs 12.5%), a surgical injury (60.0% vs 22.9%), multiple surgical injuries (30.0% vs 4.7%), a greater number of total injuries (2.5 vs 2.0), and more time out for an injury (36.5 vs 11.0 weeks) than those who did not (all P < .05). However, these athletes were not more likely to be recruited (90.0% vs 89.8%) or receive a scholarship (80.0% vs 74.5%). Conclusion: NCAA Division I athletes with ESS and/or a high training volume sustained more injuries and missed more time because of an injury, but those with ESS were more likely to be recruited and receive a college scholarship. This knowledge can help inform discussions and decision making among athletes, parents, coaches, trainers, and physicians.

Psychological Skills Training in NCAA Division I Athletics: Are Athletes Ready for Change?

2015 ◽  
Vol 9 (4) ◽  
pp. 317-334 ◽  
Author(s):  
William V. Massey ◽  
Stacy L. Gnacinski ◽  
Barbara B. Meyer
Keyword(s):  
Transtheoretical Model ◽  
Ncaa Division I ◽  
National Collegiate Athletic Association ◽  
Readiness To Change ◽  
Skills Training ◽  
Decisional Balance ◽  
Division I ◽  
Psychological Skills ◽  
Psychological Skills Training ◽  
Division I Athletes

Research has demonstrated the efficacy of psychological skills training (PST), yet many athletes do not appear ready to do whatever it takes to improve the mental aspects of performance. Although the transtheoretical model of behavior change (TTM), generally, and readiness to change, specifically, have received considerable attention in a range of allied health fields, few studies have been conducted to examine this construct in applied sport psychology. The purpose of the current study was to examine National Collegiate Athletic Association (NCAA) Division I athletes’ readiness for PST as it relates to their stage of change, decisional balance, self-efficacy, and use of processes of change. The data trends observed in the current study were consistent with the theoretical underpinnings of the TTM as well as previous research on NCAA Division I athletes. The results of the current study highlight the need to consider readiness to change when designing and implementing PST interventions.

scholarly journals Collegiate Athletic Trainers' Experiences With External Pressures Faced During Decision Making

2020 ◽  
Vol 55 (4) ◽  
pp. 409-415
Author(s):  
Alicia M. Pike Lacy ◽  
Stephanie Mazerolle Singe ◽  
Thomas G. Bowman
Keyword(s):  
Ncaa Division I ◽  
Sports Medicine ◽  
National Collegiate Athletic Association ◽  
Athletic Trainers ◽  
External Pressure ◽  
Division I ◽  
Return To Play ◽  
Major Theme ◽  
Patient Centered ◽  
Medical Decisions

Context Conflict is prevalent between sports medicine professionals and coaching staffs regarding return-to-play decisions for athletes after injury in the National Collegiate Athletic Association (NCAA) Division I setting. The firsthand experiences of athletic trainers (ATs) regarding such conflict have not been fully investigated. Objective To better understand the outside pressures ATs face when making medical decisions regarding patient care and return to play after injury in the NCAA Division I Football Bowl Subdivision (FBS) setting. Design Qualitative study. Setting Semistructured one-on-one telephone interviews. Patients or Other Participants Nine ATs (4 men, 5 women; age = 31 ± 8 years [range = 24–48 years]; years certified = 9 ± 8). Data Collection and Analysis Interviews were audio recorded and later transcribed. Thematic analysis was completed phenomenologically. Researcher triangulation, peer review, and member checks were used to establish trustworthiness. Results Two major themes emerged from the qualitative analysis: (1) pressure is an expected component of the Division I FBS AT role, and (2) strategies can be implemented to mitigate the negative effects of pressure. Three subthemes supported the second major theme: (1) ensuring ongoing and frequent communication with stakeholders about an injured athlete's status and anticipated timeline for return to play, (2) providing a rationale to coaches or administrations to foster an understanding of why specific medical decisions are being made, and (3) establishing positive relationships with coaches, athletes, and administrations. Conclusions External pressure regarding medical decisions was an anticipated occurrence for our sample. Such pressure was described as a natural part of the position, not negative but rather a product of the culture and environment of the Division I FBS setting. Athletic trainers who frequently face pressure from coaches and administration should use the aforementioned strategies to improve the workplace dynamic and foster an environment that focuses on patient-centered care.

scholarly journals Work-Family Conflict, Part I: Antecedents of Work-Family Conflict in National Collegiate Athletic Association Division I-A Certified Athletic Trainers

2008 ◽  
Vol 43 (5) ◽  
pp. 505-512 ◽  
Author(s):  
Stephanie M. Mazerolle ◽  
Jennifer E. Bruening ◽  
Douglas J. Casa
Keyword(s):  
Family Conflict ◽  
National Collegiate Athletic Association ◽  
Athletic Trainers ◽  
Division I ◽  
Work Schedules ◽  
Family Status ◽  
Work Family Conflict ◽  
Certified Athletic Trainers ◽  
Long Work Hours ◽  
Work Family

Abstract Context: Work-family conflict (WFC) involves discord that arises when the demands of work interfere with the demands of family or home life. Long work hours, minimal control over work schedules, and time spent away from home are antecedents to WFC. To date, few authors have examined work-family conflict within the athletic training profession. Objective: To investigate the occurrence of WFC in certified athletic trainers (ATs) and to identify roots and factors leading to quality-of-life issues for ATs working in the National Collegiate Athletic Association Division I-A setting. Design: Survey questionnaire and follow-up, in-depth, in-person interviews. Setting: Division I-A universities sponsoring football. Patients or Other Participants: A total of 587 ATs (324 men, 263 women) responded to the questionnaire. Twelve ATs (6 men, 6 women) participated in the qualitative portion: 2 head ATs, 4 assistant ATs, 4 graduate assistant ATs, and 2 AT program directors. Data Collection and Analysis: Multiple regression analysis was performed to determine whether workload and travel predicted levels of WFC. Analyses of variance were calculated to investigate differences among the factors of sex, marital status, and family status. Interviews were transcribed verbatim and then analyzed using computer software as well as member checks and peer debriefing. The triangulation of the data collection and multiple sources of qualitative analysis were utilized to limit potential researcher prejudices. Results: Regression analyses revealed that long work hours and travel directly contributed to WFC. In addition to long hours and travel, inflexible work schedules and staffing patterns were discussed by the interview participants as antecedents to WFC. Regardless of sex (P  =  .142), marital status (P  =  .687), family status (P  =  .055), or age of children (P  =  .633), WFC affected Division I-A ATs. Conclusions: No matter their marital or family status, ATs employed at the Division I-A level experienced difficulties balancing their work and home lives. Sources of conflict primarily stemmed from the consuming nature of the profession, travel, inflexible work schedules, and lack of full-time staff members.

scholarly journals Retention and Attrition Factors for Female Certified Athletic Trainers in the National Collegiate Athletic Association Division I Football Bowl Subdivision Setting

2010 ◽  
Vol 45 (3) ◽  
pp. 287-298 ◽  
Author(s):  
Ashley Goodman ◽  
James M. Mensch ◽  
Michelle Jay ◽  
Karen E. French ◽  
Murray F. Mitchell ◽  
...  
Keyword(s):  
National Collegiate Athletic Association ◽  
Athletic Trainers ◽  
Division I ◽  
Role Overload ◽  
Full Time ◽  
Football Bowl Subdivision ◽  
Certified Athletic Trainers ◽  
Southeastern Conference ◽  
Division I Football ◽  
Main Factor

Abstract Context: Organizational effectiveness and the continuity of patient care can be affected by certain levels of attrition. However, little is known about the retention and attrition of female certified athletic trainers (ATs) in certain settings. Objective: To gain insight and understanding into the factors and circumstances affecting female ATs' decisions to persist in or leave the National Collegiate Athletic Association Division I Football Bowl Subdivision (NCAA D-I FBS) setting. Design: Qualitative study. Setting: The 12 NCAA D-I FBS institutions within the Southeastern Conference. Patients or Other Participants: A total of 23 women who were current full-time ATs (n  =  12) or former full-time ATs (n  =  11) at Southeastern Conference institutions participated. Data Collection and Analysis: Data were collected via in-depth, semistructured interviews, transcribed verbatim, and analyzed via a grounded theory approach. Peer review and member checking methods were performed to establish trustworthiness. Results: The decision to persist involved 4 main factors: (1) increased autonomy, (2) increased social support, (3) enjoyment of job/fitting the NCAA D-I mold, and (4) kinship responsibility. Two subfactors of persistence, the NCAA D-I atmosphere and positive athlete dynamics, emerged under the main factor of enjoyment of job/fitting the NCAA D-I mold. The decision to leave included 3 main factors: (1) life balance issues, (2) role conflict and role overload, and (3) kinship responsibility. Two subfactors of leaving, supervisory/coach conflict and decreased autonomy, emerged under the main factor of role conflict and role overload. Conclusions: A female AT's decision to persist in or leave the NCAA D-I FBS setting can involve several factors. In order to retain capable ATs long term in the NCAA D-I setting, an individual's attributes and obligations, the setting's cultural issues, and an organization's social support paradigm should be considered.

scholarly journals Preliminary Scale of Reference Values for Evaluating Reactive Strength Index-Modified in Male and Female NCAA Division I Athletes

Sports ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 133 ◽  
Author(s):  
Christopher Sole ◽  
Timothy Suchomel ◽  
Michael Stone
Keyword(s):  
Reference Values ◽  
Ncaa Division I ◽  
National Collegiate Athletic Association ◽  
Collegiate Athletes ◽  
Division I ◽  
Strength Index ◽  
Male And Female ◽  
Significant Difference ◽  
Males And Females ◽  
Division I Athletes

The purpose of this analysis was to construct a preliminary scale of reference values for reactive strength index-modified (RSImod). Countermovement jump data from 151 National Collegiate Athletic Association (NCAA) Division I collegiate athletes (male n = 76; female n = 75) were analyzed. Using percentiles, scales for both male and female samples were constructed. For further analysis, athletes were separated into four performance groups based on RSImod and comparisons of jump height (JH), and time to takeoff (TTT) were performed. RSImod values ranged from 0.208 to 0.704 and 0.135 to 0.553 in males and females, respectively. Males had greater RSImod (p < 0.001, d = 1.15) and JH (p < 0.001, d = 1.41) as compared to females. No statistically significant difference was observed for TTT between males and females (p = 0.909, d = 0.02). Only JH was found to be statistically different between all performance groups. For TTT no statistical differences were observed when comparing the top two and middle two groups for males and top two, bottom two, and middle two groups for females. Similarities in TTT between sexes and across performance groups suggests JH is a primary factor contributing to differences in RSImod. The results of this analysis provide practitioners with additional insight as well as a scale of reference values for evaluating RSImod scores in collegiate athletes.

scholarly journals Estimation of Prepractice Hydration Status of National Collegiate Athletic Association Division I Athletes

2009 ◽  
Vol 44 (6) ◽  
pp. 624-629 ◽  
Author(s):  
Stella L. Volpe ◽  
Kristen A. Poule ◽  
Erica G. Bland
Keyword(s):  
Menstrual Cycle ◽  
Specific Gravity ◽  
Ncaa Division I ◽  
National Collegiate Athletic Association ◽  
Division I ◽  
Urine Specific Gravity ◽  
Cycle Phase ◽  
Hydration Status ◽  
Menstrual Cycle Phase ◽  
Division I Athletes

Abstract Context: To our knowledge, no one has compared the prepractice hydration status of male and female National Collegiate Athletic Association (NCAA) Division I athletes or has studied the effects of the menstrual cycle phase on women's prepractice hydration status. Objective: To report prepractice hydration status of collegiate athletes and determine the factors that might influence that status. Design: Cross-sectional, descriptive study. Setting: University sports team practices. Patients or Other Participants: Participants included 138 male and 125 female athletes (age  =  19.9 ± 1.3 years, height  =  165.8 ± 42.9 cm, mass  =  77.4 ± 17.5 kg) from an NCAA Division I New England university. Intervention(s): One spontaneously voided (spot) urine sample was collected from each participant before his or her team practice and was measured 2 times. Main Outcome Measure(s): A refractometer was used to analyze the amount of light that passed through a small drop of urine and assess urine specific gravity. Fluid intake and menstrual history for women were also collected. Three hydration-status groups were defined based on the American College of Sports Medicine and National Athletic Trainers' Association criteria: (1) euhydrated, which was urine specific gravity less than 1.020; (2) hypohydrated, from 1.020 to 1.029; and (3) significantly hypohydrated, equal to or more than 1.030. Results: Thirteen percent of student-athletes appeared significantly hypohydrated, with a mean urine specific gravity of 1.031 ± 0.002 (χ2  =  12.12, P &lt; .05); 53% appeared hypohydrated, with a mean urine specific gravity of 1.024 ± 0.003 (χ2  =  12.12, P &lt; .05); and 34% appeared euhydrated, with a mean urine specific gravity of 1.012 ± 0.005 (χ2  =  0.03, P &gt; .05). A greater percentage of men (47%) than women (28%) were hypohydrated (χ2  =  8.33, P &lt; .05). In women, no difference was evident between the luteal and follicular phases of their menstrual cycles (χ2  =  0.02, P &gt; .05). Conclusions: Before activity, athletes were hypohydrated at different levels. A greater percentage of men than women were hypohydrated. Menstrual cycle phase did not appear to affect hydration in women.

scholarly journals Work-Family Conflict, Part II: Job and Life Satisfaction in National Collegiate Athletic Association Division I-A Certified Athletic Trainers

2008 ◽  
Vol 43 (5) ◽  
pp. 513-522 ◽  
Author(s):  
Stephanie M. Mazerolle ◽  
Jennifer E. Bruening ◽  
Douglas J. Casa ◽  
Laura J. Burton
Keyword(s):  
Job Satisfaction ◽  
Life Satisfaction ◽  
National Collegiate Athletic Association ◽  
Athletic Trainers ◽  
Intention To Leave ◽  
Job Burnout ◽  
Division I ◽  
Work Family Conflict ◽  
Certified Athletic Trainers ◽  
Work Family

Abstract Context: Previous researchers have shown that work-family conflict (WFC) affects the level of a person's job satisfaction, life satisfaction, and job burnout and intentions to leave the profession. However, WFC and its consequences have not yet been fully investigated among certified athletic trainers. Objective: To investigate the relationship between WFC and various outcome variables among certified athletic trainers working in National Collegiate Athletic Association Division I-A settings. Design: A mixed-methods design using a 53-item survey questionnaire and follow-up in-depth interviews was used to examine the prevalence of WFC. Setting: Division I-A universities sponsoring football. Patients or Other Participants: A total of 587 athletic trainers (324 men, 263 women) responded to the questionnaire, and 12 (6 men, 6 women) participated in the qualitative portion of the mixed-methods study. Data Collection and Analysis: We calculated Pearson correlations to determine the relationship between WFC and job satisfaction, life satisfaction, and job burnout. Regression analyses were run to determine whether WFC was a predictor of job satisfaction, job burnout, or intention to leave the profession. Interviews were transcribed verbatim and then analyzed using the computer program N6 as well as member checks and peer debriefing. Results: Negative relationships were found between WFC and job satisfaction (r  =  −.52, P &lt; .001). Positive were noted between WFC and job burnout (r  =  .63, P &lt; .001) and intention to leave the profession (r  =  .46, P &lt; .001). Regression analyses revealed that WFC directly contributed to job satisfaction (P &lt; .001), job burnout (P &lt; .001), and intention to leave the profession (P &lt; .001). Conclusions: Overall, our findings concur with those of previous researchers on WFC and its negative relationships to job satisfaction and life satisfaction and positive relationship to job burnout and intention to leave an organization. Sources of WFC, such as time, inflexible work schedules, and inadequate staffing, were also related to job burnout and job dissatisfaction in this population.

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