scholarly journals Benefits of and Barriers to Using Patient-Rated Outcome Measures in Athletic Training

2014 ◽  
Vol 49 (5) ◽  
pp. 674-683 ◽  
Author(s):  
Alison R. Snyder Valier ◽  
Amy L. Jennings ◽  
John T. Parsons ◽  
Luzita I. Vela
Keyword(s):  
Athletic Training ◽  
Outcome Measures ◽  
Health Care Professionals ◽  
Treatment Effectiveness ◽  
Athletic Trainers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Web Based ◽  
Occupational Setting ◽  
E Mail

Context: Patient-rated outcome measures (PROMs) are important for driving treatment decisions and determining treatment effectiveness. However, athletic trainers (ATs) rarely use them; understanding why may facilitate strategies for collection of these outcomes. Objective: To identify the benefits of and barriers to using PROMs in athletic training. Design: Cross-sectional study. Setting: Web-based survey. Patients or Other Participants: A total of 1469 randomly sampled ATs (age = 36.8 ± 9.8 years; 48% female) working in the college/university, 2-year institution, secondary school, clinic, hospital, or industrial/occupational setting. Intervention(s): An e-mail was sent to ATs inviting them to complete a survey regarding the use, benefits, and barriers of PROMs. Athletic trainers who indicated they used PROMs (AT-PRs) completed 65 questions about the benefits of and barriers to their use. Athletic trainers who indicated no use of PROMs (AT-NONs) completed 21 questions about barriers of use. Main Outcome Measure(s): Dependent variables were the endorsements for the benefits of and barriers to the use of PROMs. Results: A total of 458 ATs initiated the survey and 421 (AT-PR = 26%, AT-NON = 74%) completed it (response rate = 28.7%). The most frequently endorsed benefits by AT-PRs were enhancing communication with patients (90%) and other health care professionals (80%), directing patient care (87%), and increasing examination efficiency (80%). The most frequently endorsed barriers by AT-PRs were that PROMs are time consuming (44%), difficult (36%), and confusing (31%) for patients and time consuming for clinicians to score and interpret (29%). The most frequently endorsed problems by AT-NONs were that PROMs are time consuming for clinicians to score and interpret (31%), time consuming (46%) and irrelevant to patients (28%), and lacking a support structure for clinicians (29%). Conclusions: These results suggest that, although benefits to using PROMs exist, there are also barriers. Barriers are similar for AT-PRs and AT-NONs. Strategies to decrease barriers and facilitate the use of PROMs warrant investigation.

scholarly journals Prevalence and Predictors of Burnout in Athletic Training Students: A Comparison of Undergraduate and Graduate Students

2021 ◽  
Vol 16 (2) ◽  
pp. 101-111
Author(s):  
Ashlyne Paige Vineyard ◽  
Andrew Gallucci ◽  
Kathleen Adair ◽  
Leslie Oglesby ◽  
Kristina White ◽  
...  
Keyword(s):  
Graduate Students ◽  
Athletic Training ◽  
Social Stress ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Personal Accomplishment ◽  
Athletic Training Students ◽  
Cross Sectional ◽  
Web Based ◽  
Survey Responses

Context Burnout is a psychological syndrome consisting of increased emotional exhaustion (EE), depersonalization (DP), and decreased personal accomplishment (PA). To date, examinations of burnout among athletic training students (ATS) is limited. Objective To determine prevalence and antecedents of burnout among ATS. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants Students enrolled in athletic training programs (ATP). Intervention(s) A survey assessed demographics, stressors, and burnout measured by the Maslach Burnout Inventory–Human Services Survey. Main Outcome Measure(s) Multiple regression analyses were used to determine relationships between variables. Results A total of 725 students participated. Most respondents were undergraduates (n = 582, 80%), female (n = 518, 71%), Caucasian (n = 564, 78%), and single (n = 422, 58%). Mean burnout scores for EE, DP, and PA were 33 ± 10, 17 ± 4.5, and 39 ± 5.8, respectively. Survey responses showed that 70.8% of undergraduate and 62.9% of graduate students reported high EE. All the students (100%) in both samples reported high DP. Undergraduates pursuing internships or residencies (b = −7.69, P < .001) and who were currently enrolled in non–Division I institutions (b = −2.90, P < .01) had decreased EE. Increased stress revealed increased EE (overall stress: b = 3.11, P < .001; social stress: b = 1.32, P < .05; class stress: b = 1.45, P < .05). Increases in clinical hours also related to increased EE (b = 1.49, P < .001). Those pursuing internships or residencies (b = −2.10, P < .05) and who were female (b = −2.10, P < .05) reported decreased DP. Being married (b = 2.87, P < .01), increased clinical hours (b = 0.77, P < .001), and social stress (b = 0.59, P < .05) resulted in increased DP. Increased PA was seen in students intending to pursue graduate education (b = 1.76, P < .05) and female students (b = 1.17, P < .05). Graduate students' stress levels revealed increased EE (b = 6.57, P < .01) and DP (b = 0.98, P < .05). Conclusions Differences exist between undergraduate and graduate burnout scores and associated predictors. Further research is needed to identify student responses to burnout.

scholarly journals Athletic Trainers' Attitudes Toward Lesbian, Gay, and Bisexual National Collegiate Athletic Association Student-Athletes

2011 ◽  
Vol 46 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Kristine A. Ensign ◽  
Athena Yiamouyiannis ◽  
Kristi M. White ◽  
B. David Ridpath
Keyword(s):  
Family Member ◽  
Athletic Training ◽  
Student Athletes ◽  
National Collegiate Athletic Association ◽  
Athletic Trainers ◽  
Pearson Correlation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Attitudes ◽  
And Bisexual

Abstract Context: Researchers have investigated heterosexuals' attitudes toward homosexuals, focusing on factors such as sex, race, religion, education, and contact experiences. However, in the context of sport, this research is deficient. We found no published literature investigating athletic trainers (ATs') attitudes toward lesbian, gay, and bisexual student-athletes (LGB). Objective: To determine heterosexual ATs' attitudes toward LGB student-athletes in the National Collegiate Athletic Association. Design: Cross-sectional study Setting: E-mailed survey. Patients or Other Participants: A total of 964 ATs employed at member institutions. Main Outcome Measure(s): We measured attitudes using the Attitudes Toward Lesbian, Gay Men, and Bisexuals (ATLGB) Scale. To determine the extent to which sex, religion, and whether having an LGB friend or family member had an effect on ATs' attitudes, we performed analysis of variance. To establish the effect of age on ATs' attitudes, we calculated a Pearson correlation. We used an independent t test to identify differences between ATs who reported working with LGB student-athletes and ATs who did not. Results: With ATLGB score as the dependent factor, a main effect was noted for sex, religion, and having an LGB friend or family member (P < .01 for all comparisons). Age and total score were related (P < .01). A difference was seen in the ATLGB scores between ATs who were aware of LGB student-athletes on their teams and ATs who were not (P < .001). Conclusions: Many ATs hold positive attitudes toward LGB student-athletes, especially females, those who have an LGB friend or family member, and those who are aware of LGB student-athletes. Still, it is important to provide an open environment in the athletic training room for all student-athletes.

scholarly journals COVID-19 Fear Among Health Care Workers (HCW) and Non-HCW in IGMC, Shimla: An Online Questionnaire-Based Prospective Study

2021 ◽  
Vol 7 (4) ◽  
pp. 1-7
Author(s):  
Girish K Sharma ◽  
Pamposh Raina ◽  
Kailash C Barwal ◽  
Manjeet Kumar ◽  
Vineet Kumar ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Web Based ◽  
Care Workers ◽  
Fear And Anxiety

The unremitting COVID-19 pandemic is evoking anxiety, fear, panic, and socio-occupational stress among human population all around the globe. This cross-sectional study was planned to assess the fear and anxiety because of COVID-19 pandemic among health care professionals, patients, and general public in IGMC, Shimla. A cross-sectional, web-based survey was conducted in month of December 2020. COVID-19 fear questionnaire was used to assess fear among participants. A total of 162 responses were received. Ninety-five (41.35%) respondents were males and 67(58.64%) were females. Average total score of COVID-19 fear based on questionnaire was 17.71 among the participants. The majority of respondents 67(41.4%) were afraid of COVID-19, 53(32.7%) were neutral, whereas 42 (25.9%) were not afraid of COVID-19. Sixty-two (38.3%) responders were uncomfortable thinking about COVID-19, whereas, 67(41.4%) were not uncomfortable. Only 22 (13.6%) participants felt their hands clammy when they thought of COVID-19, 78 (48.15%) respondents were afraid of losing their life, 78 (48.15%) respondents disagreed with the question of being nervous or anxious to hear news and stories of COVID-19. Thirteen (8%) participants were informed of sleeplessness, and 22 (13.5%) reported palpitations due to COVID-19 fear. COVID-19 fear was evident in 65.15% of all males and 55.8% of all females’ respondents, respectively. Seventy percent of participants of age more than 40 years were afraid of COVID-19, whereas only 54.83% participants of less than 40 years had COVID-19 fear. COVID-19 fear was more evident among non-HCW (74.42%) as compared to HCW in whom it was seen in 53.03% participants. Rampaging Pandemic has ingrained fear and anxiety among non-HCW as well as health care workers. But undeterred by COVID-19 fear, majority of participants didn’t fear death and didn’t have other effects of fear. Despite (can be used) surging pandemic when fear of COVID-19 is soaring, HCW and non-HCW could work, think, and live.

scholarly journals Development of an Instrument to Assess Athletic Trainers' Attitudes Toward Transgender Patients

2018 ◽  
Vol 53 (4) ◽  
pp. 431-436 ◽  
Author(s):  
Kristine A. Ensign ◽  
Brian M. Dodge ◽  
Debra Herbenick ◽  
Carrie L. Docherty
Keyword(s):  
Athletic Training ◽  
Response Rate ◽  
Athletic Trainers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Item Reduction ◽  
Gender Minorities ◽  
Semistructured Interviews ◽  
National Athletic Trainers Association ◽  
And Gender

Context:  The unique contexts in which athletic trainers (ATs) work require specific tools in order to understand their attitudes toward diverse patient populations, including sexual and gender minorities. Objective:  To develop and validate the Attitudes Toward Transgender Patients (ATTP) instrument for ATs. Design:  Cross-sectional study. Setting:  Semistructured interviews, paper-based questionnaire, and electronic questionnaire. Patients or Other Participants:  Six ATs completed semistructured interviews to develop themes regarding transgender patients. Additionally, 39 students in professional and postprofessional athletic training programs answered questionnaires designed to elicit statements regarding transgender patients. For item reduction, a sample of 3000 ATs were e-mailed (response rate = 17%), and for validation, another sample of 3000 ATs were e-mailed (response rate = 13%). Athletic trainers' e-mail addresses were obtained from the National Athletic Trainers' Association. Data Collection and Analysis:  The 3 phases were (1) exploratory interviews, (2) construct validity and item reduction, and (3) criterion validity. Items were created based on interviews and questionnaires. Principal axis factoring was used for item reduction, and Pearson correlations were used for validation. Results:  Thirty-six statements pertaining to transgender patients were developed from the interview and questionnaire data. After item reduction, 10 items remained to form the ATTP (α = .834). For validation, the ATTP and Transphobia Scale were significantly correlated (r = .723; P < .001). Conclusions:  The ability to assess attitudes toward transgender patients will allow clinicians to identify needed areas of focus for training and education. The ATTP assesses affective and cognitive attitudes and behavioral intentions toward transgender patients in common clinical settings.

scholarly journals The Level of Medical Services and Secondary School-Aged Athletes

2012 ◽  
Vol 47 (1) ◽  
pp. 91-95 ◽  
Author(s):  
Terry L. DeWitt ◽  
Scott A. Unruh ◽  
Srivatsa Seshadri
Keyword(s):  
Secondary School ◽  
Secondary Schools ◽  
American Academy ◽  
Athletic Training ◽  
Athletic Trainers ◽  
Cross Sectional Study ◽  
Medical Services ◽  
Athletic Programs ◽  
Cross Sectional ◽  
American Academy Of Pediatrics

Context: Medical organizations have recommended that administrators, parents, and community leaders explore every opportunity to make interscholastic athletic programs safe for participation, including employing athletic trainers at practices and competitive events. Objective: To determine the overall level of medical services provided for secondary school-aged athletes at high school athletic events in a rural southern state, to evaluate the employment of athletic trainers in the provision of medical services in secondary schools, and to compare athletic training medical services provided at athletic events among schools of various sizes. Design: Cross-sectional study. Setting: Questionnaires were sent to administrators at 199 secondary schools. Patients or Other Participants: A total of 144 administrators, including interscholastic athletic directors and school principals, from 199 secondary schools participated (72% response rate). Main Outcome Measure(s): Participants completed the Self-Appraisal Checklist for Health Supervision in Scholastic Athletic Programs from the American Academy of Pediatrics, which has been demonstrated to be valid and reliable. The Kruskal-Wallis and Mann-Whitney tests were used to measure differences in groups. Results: We found differences in cumulative scores when measuring between institutional classifications (P≤.05). Cumulative scores for the Event Coverage section of the instrument ranged from 80.5 to 109.6 out of a total possible score of 126. We also found differences in several factors identified in the Event Coverage section (P≤.05). Conclusions: The number of coaching staff certified in cardiopulmonary resuscitation or first aid was minimal. Most schools did not have a plan for providing minimal emergency equipment, ice, or water for visiting teams. We found that 88% (n = 7) of the 8 essential Event Coverage components that the American Academy of Pediatrics deems important were not addressed by schools represented in our study.

scholarly journals Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 1: Perceived Importance, Knowledge, and Confidence

2013 ◽  
Vol 48 (3) ◽  
pp. 394-404 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Cailee W. McCarty ◽  
Eric J. Newton ◽  
Stacy E. Walker ◽  
...  
Keyword(s):  
Athletic Training ◽  
Online Survey ◽  
Evidence Based Practice ◽  
Athletic Trainers ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Cross Sectional ◽  
Master's Degrees ◽  
Athletic Training Educators ◽  
Perceived Importance

Context: Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown. Objective: To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%. Main Outcome Measure(s): Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables. Results: Athletic trainers demonstrated low knowledge scores (64.2% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P < .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P < .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P < .001). Conclusions: Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.

scholarly journals Experiences With Workplace Bullying Among Athletic Trainers in the Collegiate Setting

2014 ◽  
Vol 49 (5) ◽  
pp. 696-705 ◽  
Author(s):  
Celest Weuve ◽  
William A. Pitney ◽  
Malissa Martin ◽  
Stephanie M. Mazerolle
Keyword(s):  
Athletic Training ◽  
Workplace Bullying ◽  
Athletic Trainers ◽  
Cross Sectional Study ◽  
Training Environment ◽  
Chi Square ◽  
Cross Sectional ◽  
Academic Degree ◽  
Work Settings ◽  
National Athletic Trainers Association

Context: Workplace bullying (WPB) is a series of persistent negative interactions that affect a clinician's ability to perform his or her role. Although WPB has been studied in other health professions, to date, no information exists pertaining to WPB in athletic training. Objective: To determine the prevalence of WPB in the collegiate setting and examine factors that influence its occurrence. Design: Cross-sectional study. Setting: Collegiate setting. Patients or Other Participants: There were 723 (329 female, 394 male) athletic trainers (ATs) aged 37.5 ± 10.4 years. Main Outcome Measure(s): We collected data via the validated and reliable online Athletic Training Environment Survey. Descriptive statistics were obtained to determine a bullying score for each AT and examine the prevalence of WPB. Chi-square analyses were performed to examine the differences between (1) sex, (2) academic degree level, (3) employment title, and (4) National Athletic Trainers' Association district. Results: A total of 106 participants (14.7%) had a score of 2 or higher, indicating they were bullied in the athletic training setting. Of those bullied, 47 (44.3%) were women and 59 (55.7%) were men. There was no difference between women and men with respect to having experienced bullying (χ21 = 0.068, P = .794). Moreover, no difference existed in the prevalence of bullying among ATs holding various degrees (χ23 = 6.73, P = .081) or among ATs holding various titles within an organization (χ25 = 3.55, P = .616). More (χ21 = 23.77, P = < .001) perpetrators were male (74.2%, n = 75) than female (25.8%, n = 26); of these, 38.2% (n = 39) were coaches, 17.6% (n = 18) were supervisory ATs, and 8.8% (n = 9) were coworker ATs. Conclusions: Bullying was experienced by both male and female ATs in the collegiate setting, and a higher number of bullies were male. More research is necessary to explore WPB in other work settings.

scholarly journals The Relationships of Age and Years of Experience to Professional Development for Athletic Trainers Employed in the Collegiate Setting

2020 ◽  
Vol 15 (3) ◽  
pp. 194-200
Author(s):  
Christianne M. Eason ◽  
Jessica L. Barrett ◽  
Stephanie H. Clines
Keyword(s):  
Professional Development ◽  
Professional Identity ◽  
Athletic Training ◽  
Online Survey ◽  
Athletic Trainers ◽  
Years Of Experience ◽  
Demographic Information ◽  
Cross Sectional ◽  
Web Based ◽  
Pearson Correlations

Context Professional identity is a process in which individuals forms a self-concept in the context of their profession, and includes an ability to articulate a professional philosophy. Professional identity relates to many aspects of a profession, including practices, ethics, and the requirements for success. Professional development is a component of professional identity and represents the growth of professionals as they acquire skills and confidence in autonomous practice. Currently, little is known in regard to the role age and years of experience play in the professional development of athletic trainers (ATs). Objective To determine the relationships of age and years of experience to professional development. Design Cross-sectional online survey. Setting Collegiate athletic training clinical setting. Patients or Other Participants Four hundred twenty-three (193 men, 230 women) ATs. Intervention(s) Data were collected via a Web-based survey instrument consisting of demographic and Likert-scale questions relating to professional development. Main Outcome Measure(s) Likert responses were summed, and demographic information was analyzed for frequency and distribution. Pearson correlations were run to evaluate the relationships between variables and linear regression was used to determine if age or years of experience could predict professional development scores. Results A positive relationship exists between professional development scores and both age and years of experience. Both age (R2 = 0.066) and years of experience (R2 = 0.075) were statistically significant predictors of variance in overall professional development scores. Conclusions Although age and years of experiences were both positively correlated with, and predicted variance in, overall professional development scores, the predicted variance of both variables was relatively small. Although we can say that both age and years of experience are prognostic in the professional development of collegiate ATs, their impact is statistically minimal.

scholarly journals Athletic Trainers' Practice Patterns Regarding Medical Documentation

2019 ◽  
Vol 54 (7) ◽  
pp. 822-830 ◽  
Author(s):  
Lindsey E. Eberman ◽  
Elizabeth R. Neil ◽  
Sara L. Nottingham ◽  
Tricia M. Kasamatsu ◽  
Cailee E. Welch Bacon
Keyword(s):  
Athletic Trainers ◽  
School Setting ◽  
Legal Protection ◽  
Cross Sectional Study ◽  
Medical Documentation ◽  
Documentation System ◽  
Cross Sectional ◽  
Web Based ◽  
Health Care Professions ◽  
National Athletic Trainers Association

Context Medical documentation is a required component of patient care in all health care professions. Objective To evaluate athletic trainers' perceived behaviors toward, barriers to, and confidence in their medical documentation. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants We purchased a list of randomly selected e-mails from the National Athletic Trainers' Association. Of the 9578 participants, 1150 accessed our questionnaire (12.0% access rate), 1053 completed at least 1 portion, and 904 completed the questionnaire in its entirety (85.8% completion rate). Of the participants, 60.1% (n = 569/947) were female, 66.6% (n = 632/949) held a master's degree, 39.3% (n = 414/1053) worked in a collegiate or university setting, and 36.1% (n = 381/1053) worked in a secondary school setting. Main Outcome Measure(s) We used a 31-item questionnaire with demographics (12 items), medical documentation behaviors (16 items), barriers (2 items), and perceptions (1 multipart item) sections. The questionnaire explored athletic trainers' behaviors as well as confidence in, comfort with, and concerns about their documentation practices (Cronbach α = 0.887). We used descriptive statistics to identify characteristics of central tendency (mean, standard deviation, mode, frequency). Results Participants always (45.7%, n = 478/1046) or very frequently (39.0%, n = 408/1046) used a double documentation system consisting of electronic and paper records (50.4%, n = 523/1038). They most often documented to provide legal protection (86.8%, n = 914/1053), because it is a legal obligation (79.1%, n = 833/1053), or to track patient progress (83.9%, n = 883/1053). The most frequently cited barriers to medical documentation were time (76.5%, n = 806/1053), managing too many patients (51.9%, n = 547/1053), technological concerns (17.2%, n = 181/1053), and software limitations (17.2%, n = 181/1053). Respondents believed they were competent, comfortable, and confident in their documentation practices. Conclusions We were able to evaluate the generalizability of previous research while adding to the understanding of the behaviors toward, barriers to, and perceptions about medical documentation. We confirmed that time and patient load affected the ability to perform high-quality medical documentation.

scholarly journals Pressure on Sports Medicine Clinicians to Prematurely Return Collegiate Athletes to Play After Concussion

2015 ◽  
Vol 50 (9) ◽  
pp. 944-951 ◽  
Author(s):  
Emily Kroshus ◽  
Christine M. Baugh ◽  
Daniel H. Daneshvar ◽  
Julie M. Stamm ◽  
R. Mark Laursen ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Athletic Trainers ◽  
Collegiate Athletes ◽  
Cross Sectional Study ◽  
Athletic Department ◽  
Collegiate Sports ◽  
Cross Sectional ◽  
Web Based ◽  
Medicine Department ◽  
Concussion Recovery

Context  Anecdotal and qualitative evidence has suggested that some clinicians face pressure from coaches and other personnel in the athletic environment to prematurely return athletes to participation after a concussion. This type of pressure potentially can result in compromised patient care. Objective  To quantify the extent to which clinicians in the collegiate sports medicine environment experience pressure when caring for concussed athletes and whether this pressure varies by the supervisory structure of the institution's sports medicine department, the clinician's sex, and other factors. Design  Cross-sectional study. Setting  Web-based survey of National College Athletic Association member institutions. Patients or Other Participants  A total of 789 athletic trainers and 111 team physicians from 530 institutions. Main Outcome Measure(s)  We asked participants whether they had experienced pressure from 3 stakeholder populations (other clinicians, coaches, athletes) to prematurely return athletes to participation after a concussion. Modifying variables that we assessed were the position (athletic trainer, physician) and sex of the clinicians, the supervisory structure of their institutions' sports medicine departments, and the division of competition in which their institutions participate. Results  We observed that 64.4% (n = 580) of responding clinicians reported having experienced pressure from athletes to prematurely clear them to return to participation after a concussion, and 53.7% (n = 483) reported having experienced this pressure from coaches. Only 6.6% (n = 59) reported having experienced pressure from other clinicians to prematurely clear an athlete to return to participation after a concussion. Clinicians reported greater pressure from coaches when their departments were under the supervisory purview of the athletic department rather than a medical institution. Female clinicians reported greater pressure from coaches than male clinicians did. Conclusions  Most clinicians reported experiencing pressure to prematurely return athletes to participation after a concussion. Identifying factors that are associated with variability in pressure on clinicians during concussion recovery can inform potential future strategies to reduce these pressures.

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