Athletic Trainers' Roles and Responsibilities Regarding Academic Adjustments as Part of the Concussion-Management Process in the Secondary School Setting

Context: Athletic trainers (ATs) play a vital role in managing the care of student-athletes after a sport-related concussion, yet little is known about their specific involvement in the implementation of academic adjustments as part of the concussion-management plan. Objective: To explore ATs' perceived roles and responsibilities regarding the implementation of academic adjustments for concussed student-athletes. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Sixteen ATs employed in the secondary school setting (8 women, 8 men; age = 39.6 ± 7.9 years; athletic training experience = 15.1 ± 5.6 years), representing 12 states, were interviewed. Data Collection and Analysis: One telephone interview was conducted with each participant. After the interviews were transcribed, the data were analyzed and coded into themes and categories, which were determined via consensus of a 4-person research team. To decrease researcher bias, triangulation occurred through participant member checking, the inclusion of multiple researchers, and an internal auditor. Results: Several categories related to participants' perceptions regarding their roles and responsibilities within the academic-adjustments process emerged from data analysis: (1) understanding of academic adjustments, (2) perceptions of their roles in academic adjustments, (3) initiation of academic adjustments, (4) facilitation of academic adjustments, and (5) lack of a role in the academic-adjustments process. Although most ATs perceived that they had a role in the initiation and facilitation of academic adjustments for concussed student-athletes, some reported they did not want a role in the process. Regardless, participants frequently suggested the need for further education. Conclusions: These findings highlight that ATs either wanted to be involved in the implementation of academic adjustments but felt further education was needed or they did not want to be involved because they felt that it was not in their area of expertise. To create a cohesive concussion-management team, it is vital that ATs understand their individual and collaborative roles in the secondary school setting.

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Athletic Trainers' Familiarity With and Perceptions of Academic Accommodations in Secondary School Athletes After Sport-Related Concussion

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.81 ◽

2015 ◽

Vol 50 (3) ◽

pp. 262-269 ◽

Cited By ~ 33

Author(s):

Richelle M. Williams ◽

Cailee E. Welch ◽

John T. Parsons ◽

Tamara C. Valovich McLeod

Keyword(s):

Secondary School ◽

Employment Status ◽

Student Athletes ◽

Athletic Trainers ◽

School Setting ◽

Full Time ◽

Years Of Experience ◽

Academic Accommodations ◽

Cognitive Rest ◽

Perceived Familiarity

Context: Sport-related concussion can affect athletes' sport participation and academic success. With the recent emphasis on cognitive rest, student-athletes may benefit from academic accommodations (AA) in the classroom; however, athletic trainers' (ATs') perceived familiarity with, and use of, AA is unknown. Objective: To assess secondary school ATs' perceived familiarity with, attitudes and beliefs about, and incorporation of AA for student-athletes after sport-related concussion. A secondary purpose was to determine whether employment status altered familiarity and use of AA. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: Of 3286 possible respondents, 851 secondary school ATs accessed the survey (response rate = 25.9%; 308 men [36.2%], 376 women [44.2%], 167 respondents [19.6%] with sex information missing; age = 37.3 ± 10.1 years). Main Outcome Measure(s): Participants were solicited via e-mail to complete the Beliefs, Attitudes and Knowledge Following Pediatric Athlete Concussion among Athletic Trainers employed in the secondary school setting (BAKPAC-AT) survey. The BAKPAC-AT assessed ATs' perceived familiarity, perceptions, and roles regarding 504 plans, Individualized Education Programs (IEPs), and returning student-athletes to the classroom. Independent variables were employment status (full time versus part time), employment model (direct versus outreach), years certified, and years of experience in the secondary school setting. The dependent variables were participants' responses to the AA questions. Spearman rank-correlation coefficients were used to assess relationships and Mann-Whitney U and χ2 tests (P < .05) were used to identify differences. Results: Respondents reported that approximately 41% of the student-athletes whose sport-related concussions they managed received AA. Respondents employed directly by the school were more familiar with 504 plans (P < .001) and IEPs (P < .001) and had a greater belief that ATs should have a role in AA. Both the number of years certified and the years of experience at the secondary school were significantly correlated with perceived familiarity regarding 504 plans and IEPs. Conclusions: The ATs employed directly by secondary schools and those with more experience as secondary school ATs were more familiar with AA. Understanding AA is important for all ATs because cognitive rest and “return to learn” are becoming more widely recommended in concussion management.

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Athletic Trainers’ Perceived Challenges Toward Comprehensive Concussion Management in the Secondary School Setting

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2017-0043 ◽

2018 ◽

Vol 23 (1) ◽

pp. 33-41 ◽

Cited By ~ 2

Author(s):

Cailee E. Welch Bacon ◽

Gary W. Cohen ◽

Melissa C. Kay ◽

Dayna K. Tierney ◽

Tamara C. Valovich McLeod

Keyword(s):

Qualitative Study ◽

Best Practices ◽

Secondary School ◽

Athletic Trainers ◽

School Setting ◽

Community Resources ◽

Concussion Management ◽

Policies And Procedures ◽

Management Procedures ◽

Education Levels

Available financial and personnel resources often dictate the specifics of concussion policies and procedures in the secondary school setting. The purpose of this qualitative study was to explore athletic trainers’ perceived challenges toward comprehensive concussion management in the secondary school setting. The findings indicate several challenges exist toward concussion management in the secondary school, including facility, personnel, and community resources, education levels of various stakeholders, and general perceptions of concussion and athletic trainers. It is important to identify challenges athletic trainers may face in order to develop strategies to align current concussion management procedures with current best practices.

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Methods and Descriptive Epidemiology of Services Provided by Athletic Trainers in High Schools: The National Athletic Treatment, Injury and Outcomes Network Study

Journal of Athletic Training ◽

10.4085/1062-6050-51.1.08 ◽

2015 ◽

Vol 50 (12) ◽

pp. 1310-1318 ◽

Cited By ~ 16

Author(s):

Zachary Y. Kerr ◽

Thomas P. Dompier ◽

Sara L. Dalton ◽

Sayers John Miller ◽

Ross Hayden ◽

...

Keyword(s):

High School ◽

High Schools ◽

Athletic Training ◽

High School Student ◽

Student Athletes ◽

Athletic Trainers ◽

School Setting ◽

Descriptive Epidemiology ◽

Time Loss ◽

School Sports

Context Research is limited on the extent and nature of the care provided by athletic trainers (ATs) to student-athletes in the high school setting. Objective To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) project and provide the descriptive epidemiology of AT services for injury care in 27 high school sports. Design Descriptive epidemiology study. Setting Athletic training room (ATR) visits and AT services data collected in 147 high schools from 26 states. Patients or Other Participants High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011−2012 through 2013−2014 academic years. Main Outcome Measure(s) The number of ATR visits and individual AT services, as well as the mean number of ATR visits (per injury) and AT services (per injury and ATR visit) were calculated by sport and for time-loss (TL) and non–time-loss (NTL) injuries. Results Over the 3-year period, 210 773 ATR visits and 557 381 AT services were reported for 50 604 injuries. Most ATR visits (70%) were for NTL injuries. Common AT services were therapeutic activities or exercise (45.4%), modalities (18.6%), and AT evaluation and reevaluation (15.9%), with an average of 4.17 ± 6.52 ATR visits and 11.01 ± 22.86 AT services per injury. Compared with NTL injuries, patients with TL injuries accrued more ATR visits (7.76 versus 3.47; P < .001) and AT services (18.60 versus 9.56; P < .001) per injury. An average of 2.24 ± 1.33 AT services were reported per ATR visit. Compared with TL injuries, NTL injuries had a larger average number of AT services per ATR visit (2.28 versus 2.05; P < .001). Conclusions These findings highlight the broad spectrum of care provided by ATs to high school student-athletes and demonstrate that patients with NTL injuries require substantial amounts of AT services.

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Work-Family Guilt: The Perspective of Secondary School Athletic Trainers with Children

Journal of Athletic Training ◽

10.4085/152-20 ◽

2020 ◽

Author(s):

Christianne M Eason ◽

Kelsey M Rynkiewicz ◽

Stephanie M. Mazerolle Singe

Keyword(s):

Secondary School ◽

Athletic Training ◽

Family Life ◽

Athletic Trainers ◽

School Setting ◽

Work Environments ◽

Certified Athletic Trainers ◽

Data Collection And Analysis ◽

Work Family ◽

Study Setting

Abstract Context: Literature in athletic training has consistently demonstrated evidence of work-family-life conflict and the potential consequences of that conflict among athletic trainers employed in the clinical setting. Parental responsibilities, have been suggested to increase the conflict between work-family-life. The emotions that occur as a result of the conflict have received little attention and warrant further investigation. Objective: To investigate perceptions of and antecedents of work-family guilt among athletic trainers with children working in the secondary school setting. Design: Phemenological qualitative study Setting: Athletic Trainers currently employed in the secondary school setting who self-identify as parents. Patients or Other Participants: Twenty (13 women, 7 men) athletic trainers employed in the secondary school setting with children (range 1–3). All but three were married (n=17) at the time of the study. The average age of our participants was 37 ± 11 and they were certified athletic trainers for 14 ± 11 years. Data Collection and Analysis: Participants completed a one-on-one semi structured phone interview. Multiple analyst triangulation and peer review were included as steps to establish data credibility. Results: General inductive analysis revealed that men and women participants are experiencing feelings of work-family guilt despite having supportive work environments. The guilt for both sexes stemmed from work interfering with family and an altruistic mindset. Women indicated that they felt pressure from their husbands that contributed to feelings of guilt. Conclusions: Secondary school athletic trainers are experiencing work family guilt. Trying to balance parental and athletic training duties can cause an emotional response and athletic trainers' giving and caring nature may be a precursor to guilt.

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Experiences With and Perceptions of Workplace Bullying Among Athletic Trainers in the Secondary School Setting

Journal of Athletic Training ◽

10.4085/1062-6050-51.10.14 ◽

2016 ◽

Vol 51 (9) ◽

pp. 709-716 ◽

Cited By ~ 6

Author(s):

William A. Pitney ◽

Celest Weuve ◽

Stephanie M. Mazerolle

Keyword(s):

Secondary School ◽

Athletic Training ◽

Sleep Disturbances ◽

Workplace Bullying ◽

Online Survey ◽

Athletic Trainers ◽

School Setting ◽

Years Of Experience ◽

Administrator Support ◽

Data Collection And Analysis

Context: Workplace bullying (WPB) has recently received much attention in society. Research on WPB in athletic training practice settings is limited. Objective: To determine the prevalence of WPB in the secondary school setting and explore the factors related to it. Design: Mixed-methods study. Setting: Secondary school. Patients or Other Participants: A total of 567 athletic trainers (women = 322 [56.8%], men = 245 [43.2%]), aged 36.5 ± 11.1 years with 11.9 ± 9.5 years of experience took part in phase I. Ten participants (7 women and 3 men), aged 39.3 ± 10.1 years with 14.3 ± 8.3 years of experience, took part in phase II. Data Collection and Analysis: For the online survey, we used the previously validated and reliable (Cronbach α = .84) Athletic Training Workplace Environment Survey, which included the Negative Acts Questionnaire-Revised. The prevalence of WPB was measured with descriptive statistics, and χ2 analyses were used to compare differences between groups (ie, females and males, perpetrators' titles). The interview data were examined using an inductive content analysis. Results: Of the participants, 44 (7.8%) were empirically identified as targets of bullying, though a higher percentage (12.4%, n = 70) self-identified as bullying targets. Men and women did not differ with respect to having experienced WPB, but more perpetrators were male (71.6%, n = 48) than female (28.4%, n = 19; χ21 = 12.55, P = <.001). We also observed a difference in perpetrators' titles, with the vast majority of bullies being coaches or administrators (χ26 = 33.82, P = <.001). Lack of administrator support and discrimination were antecedents of bullying. Stress, depression, and sleep disturbances were reported consequences. Participants coped with bullying by avoidance and role refocusing. Conclusions: Bullying was experienced by a small percentage of athletic trainers in the secondary school setting, a contrast to the findings in the collegiate practice setting.

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The National Sports Safety in Secondary Schools Benchmark (N4SB) Study: Defining Athletic Training Practice Characteristics

Journal of Athletic Training ◽

10.4085/1062-6050-48.4.04 ◽

2013 ◽

Vol 48 (4) ◽

pp. 483-492 ◽

Cited By ~ 17

Author(s):

Tamara C. Valovich McLeod ◽

Kellie C. Huxel Bliven ◽

Kenneth C. Lam ◽

R. Curtis Bay ◽

Alison R. Snyder Valier ◽

...

Keyword(s):

Secondary School ◽

Secondary Schools ◽

Medical Care ◽

Athletic Training ◽

Athletic Trainers ◽

School Setting ◽

Practice Setting ◽

Web Based ◽

Practice Characteristics ◽

Training Practice

Context: Increased rates of sport participation and sport-related injury have led to greater emphasis on and attention to medical care of student-athletes in the secondary school setting. Access to athletic training services is seen as a critical factor for delivering adequate injury prevention and medical care to student-athletes. However, few data are available regarding practice characteristics of athletic trainers (ATs) in this setting. Objective: To characterize the practices of secondary school athletic trainers (ATs). Design: Descriptive study. Setting: Web-based survey. Patients or Other Participants: A total of 17 558 ATs with current National Athletic Trainers' Association membership were identified for survey distribution. Of these, 4232 ATs indicated that they practiced in the secondary school setting, and 4045 completed some part of the survey. Main Outcome Measure(s): A Web-based survey was used to obtain demographic information about ATs and their secondary schools and characteristics of athletic training practice. Descriptive data regarding the athletic trainer's personal characteristics, secondary school characteristics, and practice patterns are reported as percentages and frequencies. Results: Most respondents were in the early stages of their careers and relatively new to the secondary school practice setting. Nearly two-thirds (62.4%; n = 2522) of respondents had 10 or fewer years of experience as secondary school ATs, 52% (n = 2132) had been certified for 10 or fewer years, and 53.4% (n = 2164) had 10 or fewer years of experience in any practice setting. The majority of respondents (85%) worked in public schools with enrollment of 1000 to 1999 (35.5%) and with football (95.5%). More than half of respondents were employed directly by their school. Most respondents (50.6%) reported an athletic training budget of less than $4000. The majority of ATs performed evaluations (87.5%) on-site all of the time, with a smaller percentage providing treatments (73.3%) or rehabilitation (47.4%) services all of the time. Conclusions: This is the first study to describe secondary school athletic training that reflects national practice trends. To improve the quality of athletic training care and to support and improve current working conditions, the profession must examine how its members practice on a day-to-day basis.

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Athletic Trainers' Perceptions of and Barriers to Patient Care Documentation: A Report From the Athletic Training Practice-Based Research Network

Journal of Athletic Training ◽

10.4085/1062-6050-52.3.15 ◽

2017 ◽

Vol 52 (7) ◽

pp. 667-675 ◽

Cited By ~ 14

Author(s):

Cailee E. Welch Bacon ◽

Bradly L. Eppelheimer ◽

Tricia M. Kasamatsu ◽

Kenneth C. Lam ◽

Sara L. Nottingham

Keyword(s):

Secondary School ◽

Patient Care ◽

Athletic Training ◽

Athletic Trainers ◽

School Setting ◽

Research Network ◽

High Quality ◽

Quality Patient Care ◽

Practice Based Research ◽

Training Practice

Context: For the practice characteristics of the services athletic trainers (ATs) provide to be identified, all ATs must complete high-quality patient care documentation. However, little is known about ATs' perceptions of patient care documentation or the potential barriers they may encounter while trying to ensure high-quality documentation. Objective: To explore ATs' perceptions of and barriers to patient care documentation via the Clinical Outcomes Research Education for Athletic Trainers (CORE-AT) electronic medical record system in the secondary school setting. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: We interviewed 10 ATs (4 men, 6 women; age = 32.6 ± 11.4 years, athletic training experience = 7.1 ± 7.8 years) who were members of the Athletic Training Practice-Based Research Network (AT-PBRN) and employed in the secondary school setting. Data Collection and Analysis: We conducted an individual interview with each participant. After transcription of the interviews, the data were analyzed into common themes and categories following the consensual qualitative research tradition. Data triangulation occurred through member checking and multiple researchers to ensure accuracy during data analysis. Results: Participants revealed several perceptions of patient care documentation, consisting of quality, expectations and accountability, priority, incentive, and culture of the secondary school setting. In addition, we identified barriers to quality patient care documentation: lack of time, lack of accountability for documenting patient care, inadequate facility resources, and lack of personnel. Participants discussed the volume of patients as a unique challenge in the secondary school setting. Conclusions: Whereas ATs perceived patient care documentation as important, several practical barriers may inhibit their ability to complete high-quality documentation of the services they provide. Effective strategies to improve the quality of patient care documentation among ATs are needed to ensure that their value, particularly in the secondary school setting, is accurately characterized.

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A Qualitative Examination of Professional Role Commitment Among Athletic Trainers Working in the Secondary School Setting

Journal of Athletic Training ◽

10.4085/1062-6050-45.2.198 ◽

2010 ◽

Vol 45 (2) ◽

pp. 198-204 ◽

Cited By ~ 41

Author(s):

William A. Pitney

Keyword(s):

Secondary School ◽

Athletic Training ◽

Athletic Trainers ◽

School Setting ◽

Professional Role ◽

Professional Responsibility ◽

Strong Sense ◽

Athletic Trainer ◽

Professional Commitment ◽

Role Commitment

Abstract Context: Work-related demands can challenge an athletic trainer's professional role commitment for an extended period throughout one's career. Objective: To explore how athletic trainers perceive the phenomenon of professional commitment and maintain this commitment while working in a professionally challenging environment. Design: Basic, interpretive qualitative study. Setting: Secondary school. Patients or Other Participants: A criterion sample was used. Each participant had a minimum of 10 years of experience as an athletic trainer and self-identified as having maintained his or her professional commitment. Seventeen individuals (14 men, 3 women) with a mean age of 44.3 ± 6.8 years and 19.0 ± 6.7 years of experience in the secondary school setting participated in the study. Data Collection and Analysis: Seventeen total interviews were conducted. Interviews were transcribed and an inductive analysis was performed. A peer debriefing and member checks with 7 participants were completed to enhance the trustworthiness of the findings. Results: Four themes emerged from the findings: 1) professional responsibility, 2) rewards, 3) respect, and 4) rejuvenation. Participants explained that a strong sense of responsibility to their patients was a prominent feature of maintaining their commitment. Their professional commitment was influenced by both intrinsic and extrinsic rewards and respect from others. The last emergent theme, rejuvenation, explained the necessity of having appropriate time away from the athletic training role to interact with peers and address personal needs. Conclusions: A strong sense of professional responsibility to both patients and the athletic training discipline is a central feature of professional commitment. Organizations, such as high school athletic programs, can play an influential role in helping an athletic trainer to maintain professional commitment by examining the intrinsic and extrinsic reward systems, assessing the work structure to ensure time to address personal needs, fostering effective communication, and addressing continuing education needs to maintain competence.

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Future Strategies to Enhance Patient Care Documentation Among Athletic Trainers: A Report From the Athletic Training Practice-Based Research Network

Journal of Athletic Training ◽

10.4085/1062-6050-298-17 ◽

2018 ◽

Vol 53 (6) ◽

pp. 619-626 ◽

Cited By ~ 8

Author(s):

Cailee E. Welch Bacon ◽

Tricia M. Kasamatsu ◽

Kenneth C. Lam ◽

Sara L. Nottingham

Keyword(s):

Patient Care ◽

Athletic Training ◽

Athletic Trainers ◽

School Setting ◽

Research Network ◽

High Quality ◽

Quality Patient Care ◽

Quality Of Patient Care ◽

Practice Based Research ◽

Enhance Patient Care

Context: High-quality patient care documentation is an essential component of any health care professional's daily practice. Whereas athletic trainers (ATs) recognize the importance of patient care documentation, several barriers may prevent them from producing high-quality patient care documentation. Objective: To explore beneficial strategies and techniques that ATs perceived would enhance the quality of patient care documentation in the secondary school setting. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Ten ATs who were members of the Athletic Training Practice-Based Research Network and employed in the secondary school setting were interviewed (4 men, 6 women with 7.1 ± 7.8 years of athletic training experience). Data Collection and Analysis: An individual telephone interview was conducted with each participant. Once transcribed, data were analyzed into common themes and categories per the consensual qualitative research tradition. Trustworthiness of the data was achieved through triangulation strategies: (1) the inclusion of multiple researchers to ensure accuracy and representativeness of the data and (2) participant member checking. Results: Participants identified several documentation strategies they perceived would be helpful to improve the quality of patient care documentation, including mode and consistency of documentation and the need for a standardized process as well as the need for system standardization. In addition, participants discussed the need for more education on patient care documentation. Specifically, they identified ways of learning and strategies for future education to enhance patient care documentation across the profession. Conclusions: As athletic training continues to evolve, it is crucial that ATs are well educated on how to produce high-quality patient care documentation as a part of routine practice. Continuing professional development opportunities are needed to promote lifelong learning in the area of patient care documentation.

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

Journal of Athletic Training ◽

10.4085/1062-6050-46.1.69 ◽

2011 ◽

Vol 46 (1) ◽

pp. 69-75 ◽

Cited By ~ 13

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.

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