The Athletic Identity of Collegiate Athletic Trainers: A Descriptive Study

Context: Empirical and anecdotal evidence suggest that many athletic trainers were former athletes and select the profession due to its affiliation with sport. Qualitative research has indicated that collegiate athletic trainers may have a strong athletic identity, but the concept of athletic identity has not been quantified in this population. Objective: To quantitatively asses the athletic identity of collegiate athletic trainers and determine if group differences exist. Design: Cross-sectional observational study. Setting: Collegiate clinical setting. Patients and Other Participants: A total of 257 (n = 93 (37%) males, n = 162 (63%) females) athletic trainers employed in the collegiate setting were included in data analysis. Main Outcome Measure(s): Data were collected via a web-based survey platform which was designed to measure athletic identity. Demographic information was analyzed for frequency and distribution. Mann-Whitney U tests and Kruskal-Wallis tests were calculated to determine if group differences existed. Results: The large majority of participants (90%) self-identified as having participated in organized sport yet scored moderately on the athletic identity measurement scale (22.9 ± 7.9). There were no sex differences in overall athletic identity (p = .446), but females did have higher levels of negative affectivity (p = .045) than males. Testing also revealed group differences based on current employment setting for social identity (p = .020), with NCAA Division I scores less than Division II, III, and NAIA. NCAA Division III exclusivity (p = .030) was lower than NCAA Division II and NAIA. Conclusions: It appears that components of athletic identity vary based on the employment setting of collegiate athletic trainers and may have a relationship to the number of hours worked in the summer. The moderate athletic identity scores of collegiate athletic trainers are comparable to former athletes who selected career paths outside of sport. This may indicate adaptive career decision processes.

The Relationship Between Spiritual Well-Being and Burnout in Collegiate Athletic Trainers

Context Spiritual well-being is the expression of one's spirituality as measured in the dimensions of existential and religious well-being. The Smith Cognitive Affective Model of Athletic Burnout suggests that personality factors such as spiritual well-being and the use of religious coping methods may affect burnout as well as its causes and outcomes. This has not been examined in collegiate athletic trainers (ATs). Objective To investigate the relationship between spiritual well-being and burnout in collegiate ATs. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants A total of 783 certified ATs employed full time in the collegiate setting participated. Part-time employees (eg, graduate assistants, interns) were excluded. Main Outcome Measure(s) A 100-item online questionnaire was created for this study. It used items from previously developed scales, including the Spiritual Well-Being Scale, the Brief RCOPE, the Maslach Burnout Inventory, and substance-use questions from the Monitoring the Future study. Participants were able to complete the survey in approximately 10–15 minutes. Multiple regression analyses were used to analyze survey data. We mapped all independent (existential well-being, religious well-being, positive and negative religious coping) and dependent variables (situational variables, Maslach Burnout Inventory burnout subscales, substance use, and intention to leave) onto the Smith Cognitive-Affective Model of Athletic Burnout to determine which variables altered burnout levels, substance use, and intention to leave. Tests of mediation or moderation were conducted when appropriate. Results Existential well-being was a significant positive predictor of social support and a significant negative predictor of work-family conflict, decreased sense of personal accomplishment, emotional exhaustion, depersonalization, intention to leave the profession, and binge drinking. Existential well-being also served as a mediator or moderator in several components of the model. Conclusions Existential well-being was a protective factor against burnout as well as some of the causes and effects of burnout in collegiate ATs.

Collegiate Athletic Trainers' Experiences with Work-family Conflict and Work-family Guilt Based Upon Organizational Factors

Context: The collegiate athletic setting has been described as having high workloads and working demands. The extensive time commitment required of athletic trainers working in this setting has been identified as a precursor to work-family conflict (WFC) and work-family guilt (WFG). Though individualized, experiences in the work-life interface can largely be impacted by organizational factors (i.e., elements specific to the workplace). While staff size and patient load may influence the athletic trainer's feelings of WFC and WFG, these factors have not been directly studied. Objective: Our purpose was to examine organizational factors and experiences of WFC and WFG among collegiate athletic trainers. Design: Cross-sectional study. Setting: Collegiate setting. Participants: 615 (female=391, gender variant/non-conforming=1, male=222, preferred not to answer=1) athletic trainers responded to an online survey. The average age of participants was 33 ± 9 years, and they were BOC certified for 10 ± 8 years. 352 participants (57.2%) worked in the DI setting, 99 in DII (16.1%), and 164 in DIII (26.7%). Main Outcome Measure(s): Participants responded to demographic and workplace characteristic questions (organizational infrastructure, staff size, and number of varsity-level athletic teams). Individuals completed WFC and WFG scales that have been previously validated and used in the athletic trainer population. Results: Work-family conflict and WFG were universally experienced among our participants with WFC scores predicting WFG scores. Participants reported higher time-based conflict than strain or behavior-based conflict. No significant differences in WFC and WFG scores were found between organizational infrastructures. Weak positive correlations were found between staff size and WFC scores and WFG scores. The number of athletic teams was not associated with WFC or WFG scores. Conclusions: Organizational factors are an important component of the work-life interface. From an organizational perspective, focusing on improving work-life balance for the athletic trainer can help mitigate experiences with WFC and WFG.

Work–Family Guilt of Collegiate Athletic Trainers: A Descriptive Study

Work–family guilt (WFG) is a measure used to assess guilt related to work interference with family and family interference with work. While work–family conflict (WFC) has been studied in the athletic trainer (AT) population, WFG has not. The purpose of this study was to gather descriptive data on WFG and to determine if WFC can predict WFG. There were significant positive associations between WFG and hours worked, but no sex differences in WFG or WFC exist. WFG was predicted by WFC. Results indicate higher levels of WFG and WFC are associated with a greater number of hours worked. Because guilt can negatively impact overall health, steps should be taken to mitigate WFC and WFG.

The Effect of the Model of Organizational Infrastructure on Collegiate Athletic Trainer Job Satisfaction: A Critically Appraised Topic

Clinical Question: Does the medical model of organizational structure compared to either the academic or traditional models have a greater influence on job satisfaction and quality of life in collegiate athletic trainers? Clinical Bottom Line: Based on the quality of the person-oriented evidence available, the recommendation to adopt the medical model for athletic training staff would receive a Strength of Recommendation Taxonomy (SORT) grade of B.

Challenges Faced by Collegiate Athletic Trainers, Part II: Treating Concussed Student-Athletes

Context Conflict between athletic trainers (ATs) and other stakeholders can occur because of competing interests over medical decisions regarding concussion. However, we are unaware of any studies specifically exploring these situations across various collegiate athletic affiliations. Objective To investigate the challenges faced by ATs when treating concussed student-athletes. Design Qualitative study. Setting Online questionnaire. Patients or Other Participants A total of 434 ATs (267 women, 166 men, 1 missing data; age = 27.73 ± 3.24 years, experience = 5.17 ± 2.67 years) completed the questionnaire (response rate = 14.47%). Our participants represented multiple employment settings within intercollegiate athletics. Data Collection and Analysis We sent an online questionnaire to 3000 ATs working in the collegiate and university setting across the United States. A survey expert verified face, content, and construct validity of the questionnaire in 2 rounds of review, and 3 ATs completed a content-validity tool before we finalized the survey. We analyzed the qualitative data using a general inductive approach and ensured trustworthiness through multiple-analyst triangulation and peer review. Results When we examined the responses from our participants regarding their work with student-athletes who had sustained concussions, we found 2 major themes, each with subthemes. First, educational efforts appeared to be only modestly effective because of a lack of honesty, noncompliant actions, and coach interference. Second, return to learn was challenging because of a lack of communication among stakeholders, athletes being anxious about needing accommodations, and difficulty convincing faculty to provide reasonable accommodations. Conclusions Based on our findings, we recommend continued efforts to improve the culture surrounding concussion in collegiate athletes. Athletic trainers should include key stakeholders such as coaches, student-athletes, parents, faculty, and other educational administrators in their educational efforts to improve the policies and culture surrounding concussion treatment.