Organizational-Professional Conflict in the Collegiate and Secondary School Practice Settings: A Sequential, Mixed-Methods Study.

CONTEXT: Athletic trainers (ATs) are employed in various settings, which may use 1 of 3 organizational infrastructure models: (1) the sport/athletic model, (2) the medical model, and (3) the academic model. These different settings and organizational infrastructure models may result in varying levels of organizational-professional conflict (OPC). However, how OPC may differ across infrastructure models and practice settings is not known. OBJECTIVE: To examine the prevalence of OPC among ATs in various organizational infrastructures and explore ATs' perceptions of OPC, including its precipitating and mitigating factors. DESIGN: Sequential explanatory mixed-methods study with equal emphasis on quantitative and qualitative components. SETTING: Collegiate and secondary school institutions. PATIENTS OR OTHER PARTICIPANTS: Five hundred ninety-four ATs from collegiate and secondary schools. DATA COLLECTION AND ANALYSIS: We conducted a national cross-sectional survey using a validated scale to assess OPC. We then followed the quantitative survey with individual interviews. Trustworthiness was established with multiple-analyst triangulation and peer debriefing. RESULTS: Athletic trainers experienced low to moderate degrees of OPC with no differences across practice settings or infrastructure models. Poor communication, others' unfamiliarity with the AT's scope of practice, and lack of medical knowledge were precipitating factors for OPC. Organizational relationships founded on trust and respect for one another; administrative support in that ATs were listened to, decisions were endorsed, and appropriate resources provided; and autonomy given to the AT were key components to preventing OPC. CONCLUSIONS: Most ATs experienced primarily low to moderate OPC. However, OPC continues to permeate professional practice to some extent in collegiate and secondary school settings, regardless of the infrastructure model used. The findings of this study highlight the role of administrative support that allows for autonomous AT practice as well as effective communication that is direct, open, and professional to decrease OPC.

National Athletic Trainers' Association Position Statement: Facilitating Work-Life Balance in Athletic Training Practice Settings.

OBJECTIVE:: To illustrate the concept of work-life balance and those factors that influence it and to provide recommendations to facilitate work-life balance in athletic training practice settings. To present the athletic trainer with information regarding work-life balance, including those factors that negatively and positively affect it within the profession. BACKGROUND:: Concerns for work-life balance have been growing within the health care sector, especially in athletic training, as it is continuously linked to professional commitment, burnout, job satisfaction, and career longevity. The term work-life balance reflects those practices used to facilitate the successful fulfillment of the responsibilities associated with all roles one may assume, including those of a parent, spouse, partner, friend, and employee. A host of organizational and individual factors (eg, hours worked, travel demands, flexibility of work schedules, relationship status, family values) negatively influence the fulfillment of work-life balance for the athletic trainer, but practical strategies are available to help improve work-life balance, regardless of the practice setting. RECOMMENDATIONS:: This position statement is charged with distributing information on work-life balance for athletic trainers working in a variety of employment settings. Recommendations include a blend of organizational and personal strategies designed to promote work-life balance. Establishing work-life balance requires organizations to have formal policies that are supported at the departmental and personal level, in addition to informal policies that reflect the organizational climate of the workplace. Individuals are also encouraged to consider their needs and responsibilities in order to determine which personal strategies will aid them in attaining work-life balance.

Initial Validation of a Multilevel Model of Job Satisfaction and Career Intentions Among Collegiate Athletic Trainers.

CONTEXT: The constructs of job satisfaction and career intentions in athletic training have been examined predominantly via unilevel assessment. The work-life interface is complex, and with troubling data regarding attrition, job satisfaction and career intentions should be examined via a multilevel model. Currently, no known multilevel model of career intentions and job satisfaction exists within athletic training. OBJECTIVE: To validate a multilevel model of career intentions and job satisfaction among a collegiate athletic trainer population. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: Athletic trainers employed in National Collegiate Athletic Association Division I, II, or III or a National Association of Intercollegiate Athletics college or university (N = 299; 56.5% female, 43.5% male). The average age of participants was 34 ± 8.0 years, and average experience as an athletic trainer was 10.0 ± 8 years. MAIN OUTCOME MEASURE(S): A demographic questionnaire and 7 Likert-scale survey instruments were administered. Variables were responses related to work-family conflict, work-family enrichment, work-time control, perceived organizational family support, perceived supervisor family support, professional identity and values, and attitude toward women. RESULTS: Exploratory factor analysis confirmed 3 subscales: (1) individual factors, (2) organizational factors, and (3) sociocultural factors. The scale was reduced from 88 to 62 items. A Cronbach α of 0.92 indicated excellent internal consistency. CONCLUSIONS: A multilevel examination highlighting individual, organizational, and sociocultural factors is a valid and reliable measure of job satisfaction and career identity among athletic trainers employed in the collegiate setting.

Role Strain, Part 2: Perceptions Among Athletic Trainers Employed in the Professional Practice Setting.

CONTEXT: Athletic trainers (ATs) employed in the professional sport setting (ATPSSs) demonstrate moderate to high degrees of role strain. The experiences and perceptions of these ATs provide insight regarding the sources of role strain as well as ways to reduce it. OBJECTIVE: To investigate the perceptions of ATPSSs regarding role strain. DESIGN: Qualitative study. PATIENTS OR OTHER PARTICIPANTS: From a purposeful sampling of 389 ATs employed in the 5 major sport leagues (Major League Baseball, Major League Soccer, National Basketball Association, National Football League, and National Hockey League), we identified 34 participants willing to participate in phone interviews. Data Collection and Procedures: Semistructured phone interviews. Inductive data analysis was based on a grounded theory approach. Credibility was addressed with member checks and a peer debriefing. RESULTS: Three first-order emergent themes materialized from the data: (1) sources of role strain, (2) consequences of role strain, and (3) strategies to alleviate role strain in ATPSSs. Participants described the antecedents of role strain as emerging from the competing expectations of the professional athlete, the organization, and the sport league. Consequences of role strain included effects on direct patient care and work-life imbalance. Improving organizational factors such as inadequate staffing and poor communication within the organization were strategies described by participants for decreasing role strain in the professional sports setting. CONCLUSIONS: Our participants discussed experiencing role strain, which was facilitated by trying to meet the competing demands placed on them with limited time and often with an inadequate support staff. Participant role strain affected health care and contributed to work-life imbalance. Participants described changing the organizational factors that contributed to role strain as a strategy to alleviate the perceived stress.

Role Strain, Part 1: Experiences of Athletic Trainers Employed in the Professional Sports Setting.

CONTEXT: The demands and expectations of athletic trainers employed in professional sports settings (ATPSSs) have increased over the years. Meeting these demands and expectations may predispose the athletic trainer to workplace stress and ultimately role strain. OBJECTIVE: To investigate the concept of role strain among ATPSSs. DESIGN: Sequential, explanatory mixed-methods study consisting of 2 phases: (1) population role-strain survey and (2) personal interviews. PATIENTS OR OTHER PARTICIPANTS: From a purposeful sampling of 389 athletic trainers employed in the 5 major sports leagues (Major League Baseball, Major League Soccer, National Basketball Association, National Football League, and National Hockey League), 152 individuals provided usable data (39% response rate). MAIN OUTCOME MEASURE(S): A previously validated and reliable role-strain survey using a 5-point Likert scale (1 = never, 5 = nearly all the time) was administered. Measures of central tendency were used to identify the presence and degree of role strain; inferential statistics were calculated using analysis of variance to determine group differences in overall role strain and its subcomponents. RESULTS: More than half of the participants (53.9%) experienced a moderate to high degree of role strain. Interrole conflict (2.99 ± 0.77) and role overload (2.91 ± 0.75) represented the most prominent components of role strain. Differences existed by sport leagues and employment. CONCLUSIONS: Role strain existed at moderate to high levels (mean Role Strain Score > 2.70) among ATPSSs. Interrole conflict and role overload contributed the most to overall role strain. The ATPSSs experienced role strain to a higher degree than reported in other settings.

Multilevel Examination of Job Satisfaction and Career Intentions of Collegiate Athletic Trainers: A Quantitative Approach.

CONTEXT: Recent employment data from collegiate athletic training settings have demonstrated departure trends among men and women. These trends have been hypothesized to be related to work-life balance. However, work-life balance is only 1 aspect of a myriad of factors. Due to the complex nature of the work-life interface, a multilevel examination is needed to better understand the precipitators of departure. OBJECTIVE: To quantitatively examine factors that may influence collegiate athletic trainers' (ATs') job satisfaction and career intentions via a multilevel examination of the work-life interface. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: Athletic trainers employed in National Collegiate Athletic Association Division I, II, or III or National Association of Intercollegiate Athletics colleges or universities (N = 299: 56.5% female, 43.5% male). The average age of participants was 33.6 ± 8.3 years, and their average experience was 10.3 ± 7.6 years. DATA COLLECTION AND ANALYSIS: Participants responded to an online questionnaire consisting of demographic questions, 9 Likert-scale surveys, and open-ended questions. Job-satisfaction Scores (JSSs) and intention-to-leave scores (ITLSs) served as the dependent variables and factors from individual, organizational, and sociocultural levels were the independent variables. Hierarchical regression analysis was run to determine the predictability of factors. RESULTS: No sex differences in ITLS or JSS were found in our sample. Independent variables explained 68.5% of the variance in JSS and 28.8% of the variance in ITLS. Additions of factor levels increased the percentage of explained variance in both scores. CONCLUSIONS: A combination of individual-, organizational-, and sociocultural-level factors was able to best predict JSS and ITLS among collegiate ATs.

Examining the Environmental Effects of Athletic Training: Perceptions of Waste and the Use of Green Techniques.

CONTEXT: Environmental sustainability is a critical concern in health care. Similar to other professions, the practice of athletic training necessitates the use of a large quantity of natural and manufactured resources. OBJECTIVE: To examine the perceptions of the waste produced by the practice of athletic training and the green practices currently used by athletic trainers (ATs) to combat this waste. DESIGN: Mixed-methods study. SETTING: Field setting. PATIENTS OR OTHER PARTICIPANTS: A total of 442 ATs completed the study. Sixteen individuals participated in the qualitative portion. MAIN OUTCOME MEASURE(S): Data from sections 2 and 3 of the Athletic Training Environmental Impact Survey were analyzed. Focus groups and individual interviews were used to determine participants' views of waste and the efforts used to combat waste. Descriptive statistics were used to examine types of waste. Independent t tests, χ2 tests, and 1-way analyses of variance were calculated to identify any differences between the knowledge and use of green techniques. Interviews and focus groups were transcribed verbatim and analyzed inductively. RESULTS: Participants reported moderate knowledge of green techniques (3.18 ± 0.53 on a 5-point Likert scale). Fifty-eight percent (n = 260) of survey participants perceived that a substantial amount of waste was produced by the practice of athletic training. Ninety-two percent (n = 408) admitted they thought about the waste produced in their daily practice. The types of waste reported most frequently were plastics (n = 111, 29%), water (n = 88, 23%), and paper for administrative use (n = 81, 21%). Fifty-two percent (n = 234) agreed this waste directly affected the environment. The qualitative aspect of the study reinforced recognition of the large amount of waste produced by the practice of athletic training. Types of conservation practices used by ATs were also explored. CONCLUSIONS: Participants reported concern regarding the waste produced by athletic training. The amount of waste varies depending on practice size and setting. Future researchers should use direct measures to determine the amount of waste created by the practice of athletic training.

Athletic Trainers' Attitudes and Perceptions of Environmental Sustainability.

CONTEXT: Environmental sustainability efforts are becoming a critical concern in health care. However, little is known regarding how athletic trainers feel about the environment or what can be done to reduce the environmental impact of the practice of athletic training. OBJECTIVE: To examine athletic trainers' attitudes toward and perceptions of factors related to environmental sustainability. DESIGN: Sequential, mixed methods using a survey, focus groups, and personal interviews. SETTING: Field study. PATIENTS OR OTHER PARTICIPANTS: Four hundred forty-two individuals completed the survey. Sixteen participated in the qualitative portion. MAIN OUTCOME MEASURE(S): Quantitative results from the Athletic Training Environmental Impact Survey included data from a 5-point Likert scale (1 = lowest rating and 5 = highest rating). Descriptive statistics and 1-way analyses of variance were used to describe perceptions and determine differences in mean opinion, National Athletic Trainers' Association district, and use of green techniques. Qualitative data were transcribed verbatim and analyzed inductively. RESULTS: The mean score for opinion of the environment was 3.30 ± 0.52. A difference was found between opinion and National Athletic Trainers' Association district ( F9, 429 = 2.43, P = .01). A Bonferroni post hoc analysis identified this difference ( P = .03) between members of District 2 (Delaware, New Jersey, New York, Pennsylvania) and District 9 (Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, Tennessee). An inductive analysis resulted in 3 emergent themes: (1) barriers to using green techniques, (2) motivators for using green techniques, and (3) solutions to overcoming the barriers. The information gleaned from participants in the qualitative portion of the study can be useful for clinicians wishing to implement basic conservation efforts in their practice settings and may guide future sustainability projects. CONCLUSIONS: Overall, participants reported a positive opinion of environmental sustainability topics related to athletic training. However, many barriers to practicing green techniques were identified.

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

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.

Implementing Health and Safety Policy Changes at the High School Level From a Leadership Perspective.

CONTEXT: Although consensus statements and recommendations from professional organizations aim to reduce the incidence of injury or sudden death in sport, nothing is mandated at the high school level. This allows states the freedom to create and implement individual policies. An example of a recommended policy is heat acclimatization. Despite its efficacy in reducing sudden death related to heat stroke, very few states follow the recommended guidelines. OBJECTIVE: To retroactively examine why and how 3 states were able to facilitate the successful creation and adoption of heat-acclimatization guidelines. DESIGN: Qualitative study. SETTING: High school athletic associations in Arkansas, Georgia, and New Jersey. PATIENTS OR OTHER PARTICIPANTS: Eight men and 3 women (n = 11; 6 athletic trainers; 2 members of high school athletic associations; 2 parents; 1 physician) participated. Participant recruitment ceased when data saturation was reached. DATA COLLECTION AND ANALYSIS: All phone interviews were digitally recorded and transcribed verbatim. A grounded-theory approach guided analysis and multiple analysts and peer review were used to establish credibility. RESULTS: Each state had a different catalyst to change (student-athlete death, empirical data, proactivity). Recommendations from national governing bodies guided the policy creation. Once the decision to implement change was made, the states displayed 2 similarities: shared leadership and open communication between medical professionals and members of the high school athletic association helped overcome barriers. CONCLUSIONS: The initiating factor that spurred the change varied, yet shared leadership and communication fundamentally allowed for successful adoption of the policy. Our participants were influenced by the recommendations from national governing bodies, which align with the institutional change theory. As more states begin to examine and improve their health and safety policies, this information could serve as a valuable resource for athletic trainers in other states and for future health and safety initiatives.

Perceptions of Support Networks During the Graduate-Assistant Athletic Trainer Experience.

CONTEXT: The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously. OBJECTIVE: To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships. DESIGN: Semistructured phone interviews. SETTING: Graduate-assistant ATs in various clinical settings. PATIENTS OR OTHER PARTICIPANTS: Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non-athletic training-based curriculum = 6). Median age was 24 years. DATA COLLECTION AND ANALYSIS: Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability. RESULTS: Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support. CONCLUSIONS: Our results confirm the literature regarding the GAAT's pursuit of continued formal mentoring. The GAATs perceived less support from full-time AT staff members due to limited availability. Therefore, GAATs leaned on their peers for support during the graduate experience.

Sex and Employment-Setting Differences in Work-Family Conflict in Athletic Training.

CONTEXT: Work-family conflict (WFC) has received much attention in athletic training, yet several factors related to this phenomenon have not been examined, specifically a practitioner's sex, occupational setting, willingness to leave the profession, and willingness to use work-leave benefits. OBJECTIVE: To examine how sex and occupational differences in athletic training affect WFC and to examine willingness to leave the profession and use work-leave benefits. DESIGN: Cross-sectional study. SETTING: Multiple occupational settings, including clinic/outreach, education, collegiate, industrial, professional sports, secondary school, and sales. PATIENTS OR OTHER PARTICIPANTS: A total of 246 athletic trainers (ATs) (men = 110, women = 136) participated. Of these, 61.4% (n = 151) were between 20 and 39 years old. MAIN OUTCOME MEASURES(S): Participants responded to a previously validated and reliable WFC instrument. We created and validated a 3-item instrument that assessed willingness to use work-leave benefits, which demonstrated good internal consistency (Cronbach α = 0.88), as well as a single question about willingness to leave the profession. RESULTS: The mean (± SD) WFC score was 16.88 ± 4.4 (range = 5 [least amount of conflict] to 25 [highest amount of conflict]). Men scored 17.01 ± 4.5, and women scored 16.76 ± 4.36, indicating above-average WFC. We observed no difference between men and women based on conflict scores (t244 = 0.492, P = .95) or their willingness to leave the profession (t244 = -1.27, P = .21). We noted differences among ATs in different practice settings (F8,245 = 5.015, P <.001); those in collegiate and secondary school settings had higher reported WFC scores. A negative relationship existed between WFC score and comfort using work-leave benefits (2-tailed r = -0.533, P < .001). Comfort with using work-leave benefits was different among practice settings (F8,245 = 3.01, P = .003). CONCLUSIONS: The ATs employed in traditional practice settings reported higher levels of WFC. Male and female ATs had comparable experiences of WFC and willingness to leave the profession.

Student-Retention and Career-Placement Rates Between Bachelor's and Master's Degree Professional Athletic Training Programs.

CONTEXT: The debate over what the entry-level degree should be for athletic training has heightened. A comparison of retention and career-placement rates between bachelor's and master's degree professional athletic training programs may inform the debate. OBJECTIVE: To compare the retention rates and career-placement rates of students in bachelor's and master's degree professional programs. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 192 program directors (PDs) from bachelor's degree (n = 177) and master's degree (n = 15) professional programs. INTERVENTION(S): The PDs completed a Web-based survey. MAIN OUTCOME MEASURE(S): We instructed the PDs to provide a retention rate and career-placement rate for the students in the programs they lead for each of the past 5 years. We also asked the PDs if they thought retention of students was a problem currently facing athletic training education. We used independent t tests to compare the responses between bachelor's and master's degree professional programs. RESULTS: We found a higher retention rate for professional master's degree students (88.70% ± 9.02%, 95% confidence interval [CI] = 83.71, 93.69) than bachelor's degree students (80.98% ± 17.86%, 95% CI = 78.30, 83.66) (t25 = -2.86, P = .008, d = 0.55). Similarly, PDs from professional master's degree programs reported higher career-placement percentages (88.50% ± 10.68%, 95% CI = 82.33, 94.67) than bachelor's degree professional PDs (71.32% ± 18.47%, 95% CI = 68.54, 74.10) (t20 = -5.40, P < .001, d = 1.14). Finally, we observed no difference between groups regarding whether retention is a problem facing athletic training (χ(2)1 = 0.720, P = .40, Φ = .061). CONCLUSIONS: Professional master's degree education appears to facilitate higher retention rates and greater career-placement rates in athletic training than bachelor's degree education. Professional socialization, program selectivity, and student commitment and motivation levels may help to explain the differences noted.

Multistakeholder Perspectives on the Transition to a Graduate-Level Athletic Training Educational Model.

CONTEXT: The decision has been made to move away from the traditional bachelor's degree professional program to a master's degree professional program. Little is known about the perceptions about this transition from those involved with education. OBJECTIVE: To examine multiple stakeholders' perspectives within athletic training education on the effect that a change to graduate-level education could have on the profession and the educational and professional development of the athletic trainer. DESIGN: Qualitative study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 18 athletic training students (6 men, 12 women; age = 24 ± 5 years), 17 athletic training faculty (6 men, 9 women, 2 unspecified; 7 program directors, 5 faculty members, 3 clinical coordinators, 2 unidentified; age = 45 ± 8 years), and 15 preceptors (7 men, 7 women, 1 unspecified; age = 34 ± 7 years) completed the study. DATA COLLECTION AND ANALYSIS: Participants completed a structured Web-based questionnaire. Each cohort responded to questions matching their roles within an athletic training program. Data were analyzed following a general inductive process. Member checks, multiple-analyst triangulation, and peer review established credibility. RESULTS: Thirty-one (62%) participants supported the transition, 14 (28%) were opposed, and 5 (10%) were neutral or undecided. Advantages of and support for transitioning and disadvantages of and against transitioning emerged. The first higher-order theme, advantages, revealed 4 benefits: (1) alignment of athletic training with other health care professions, (2) advanced coursework and curriculum delivery, (3) improved student and professional retention, and (4) student maturity. The second higher-order theme, disadvantages, was defined by 3 factors: (1) limited time for autonomous practice, (2) financial concerns, and (3) lack of evidence for the transition. CONCLUSIONS: Athletic training students, faculty, and preceptors demonstrated moderate support for a transition to the graduate-level model. Factors supporting the move were comparable with those detailed in a recent document on professional education in athletic training presented to the National Athletic Trainers' Association Board of Directors. The concerns about and reasons against a move have been discussed by those in the profession.

Exploring the Athletic Trainer's Role in Assisting Student-Athletes Presenting With Alcohol-Related Unintentional Injuries.

Compared with their nonathlete peers, collegiate athletes consume higher quantities of alcohol, drink with greater frequency, and exhibit an increased propensity to engage in heavy episodic drinking (ie, binge drinking), which often may result in alcohol-related consequences. Moreover, collegiate athletes are also more likely to engage in other maladaptive lifestyle behaviors, such as participating in physical fights and riding with an intoxicated driver, and less likely to engage in protective behaviors, such as wearing a helmet while operating a motorcycle, moped, or bicycle. Taken together, these behaviors clearly pose a health risk for student-athletes and increase the likelihood that they will experience an alcohol-related unintentional injury (ARUI). An ARUI represents a risk not only to the health and well-being of collegiate athletes but also to their athletic performances, collegiate careers, and potential professional opportunities. Therefore, athletic trainers need to be equipped with the knowledge and skills to provide face-to-face brief interventions to student-athletes presenting with ARUIs and to evaluate the effect of their involvement. We address potential action items for implementation by athletic trainers.

Experiences of Work-Life Conflict for the Athletic Trainer Employed Outside the National Collegiate Athletic Association Division I Clinical Setting.

CONTEXT: The intercollegiate setting receives much of the scholarly attention related to work-life conflict (WLC). However research has been focused on the National Collegiate Athletic Association Division I setting. Multiple factors can lead to WLC for the athletic trainer (AT), including hours, travel, and lack of flexibility in work schedules. OBJECTIVE: To investigate the experiences of WLC among ATs working in the non-Division I collegiate setting and to identify factors that contribute to fulfillment of work-life balance in this setting. DESIGN: Qualitative study. SETTING: Institutions in the National Collegiate Athletic Association Divisions II and III, the National Association of Intercollegiate Athletics, and the National Junior College Athletic Association. PATIENTS OR OTHER PARTICIPANTS: A total of 244 ATs (128 women, 114 men; age = 37.5 ± 13.3 years, experience = 14 ± 12 years) completed phase I. Thirteen participants (8 women, 5 men; age = 38 ± 13 years, experience = 13.1 ± 11.4 years) completed phase II. DATA COLLECTION AND ANALYSIS: For phase I, participants completed a previously validated and reliable (Cronbach α > .90) Web-based survey measuring their levels of WLC and work-family conflict (WFC). This phase included 2 WFC scales defining family; scale 1 defined family as having a partner or spouse with or without children, and scale 2 defined family as those individuals, including parents, siblings, grandparents, and any other close relatives, involved in one's life. Phase II consisted of an interview. Qualitative data were evaluated using content analysis. Data source and multiple-analyst triangulation secured credibility. RESULTS: The WFC scores were 26.33 ± 7.37 for scale 1 and 20.46 ± 10.14 for scale 2, indicating a moderate level of WFC for scale 1 and a low level of WFC for scale 2. Qualitative analyses revealed that organizational dimensions, such as job demands and staffing issues, can negatively affect WLC, whereas a combination of organizational and personal dimensions can positively affect WLC. CONCLUSIONS: Overload continues to be a prevalent factor in negatively influencing WLC and WFC. Supervisor and peer support, personal networks, and time away from the role positively influenced work-life balance and WFC. Athletic trainers are encouraged to support one another in the workplace, especially when providing flexibility in scheduling.

Athletic trainers' barriers to maintaining professional commitment in the collegiate setting.

CONTEXT: Professional commitment simply describes one's obligation to his or her work. For athletic trainers (ATs), the demanding work environment and job expectations may affect their characterization of professional commitment. Our breadth of knowledge regarding professional commitment within athletic training is narrow. OBJECTIVE: To evaluate the professional commitment of ATs in the collegiate setting. DESIGN: Qualitative study. SETTING: Collegiate. PATIENTS OR OTHER PARTICIPANTS: Thirty-three Board of Certification-certified ATs employed in the collegiate setting (National Collegiate Athletic Association Division I = 11, Division II = 9, Division III = 13) with an average of 10 ± 8 years of clinical experience volunteered. Data saturation guided the total number of participants. DATA COLLECTION AND ANALYSIS: Online journaling via QuestionPro was completed by all participants. Multiple-analyst triangulation and peer review were conducted for data credibility. Analysis followed a general inductive method. RESULTS: Four themes speak to the factors that negatively affect ATs' professional enthusiasm and commitment: (1) life stage, (2) work overload, (3) organizational climate, and (4) human resources. The latter 3 speak to the effect the workplace can have on ATs' professional commitment, and the first speaks to the effect outside responsibilities can have. CONCLUSIONS: Our results suggest that several of the factors that negatively influence the professional commitment of collegiate ATs are modifiable organizational components. Developing resiliency strategies at the individual and organizational levels may help to facilitate improved professional commitment for the AT.

The professional socialization of the graduate assistant athletic trainer.

CONTEXT: The graduate assistant athletic trainer (AT) position often serves as one's first experience working independently as an AT and is also an important aspect of the professional socialization process. The socialization experiences of graduate assistant ATs have yet to be fully explored. OBJECTIVE: To understand the socialization process for graduate assistant ATs during their graduate experience. DESIGN: Qualitative study. SETTING: We conducted phone interviews with all participants. PATIENTS OR OTHER PARTICIPANTS: A total of 25 graduate assistant ATs (20 women, 5 men) studying in 1 of 3 academic tracks: (1) accredited postprofessional athletic training program (n = 8), (2) postprofessional athletic training program (n = 11), or (3) a nonathletic training degree program (n = 6). The average age was 25 ± 5 years, and the median age was 24 years. Participants were certified by the Board of Certification for an average of 2 ± 0.4 years. DATA COLLECTION AND ANALYSIS: We analyzed the data using a general inductive approach. Peer review, field notes, and intercoder reliability established trustworthiness. Data saturation guided participant recruitment. RESULTS: The ability to gain clinical independence as a practitioner was an important socialization process. Having the chance to develop a relationship with a mentor, who provided support, guidance, and more of a hierarchical relationship, was an important socializing agent for the graduate assistant AT. Participants used the orientation session as a means to understand the expectations and role of the graduate-assistant position. Academic coursework was a way to achieve better inductance into the role via the opportunity to apply classroom skills during their clinical practice. CONCLUSIONS: Socializing the graduate assistant blends formal and informal processes. Transition to practice is a critical aspect of the profession; thus, supporting autonomous practice with directed mentoring can promote professional maturity.

Athletic trainers' facilitators of professional commitment in the collegiate setting.

CONTEXT: Professional responsibility, rewards and respect, and time for rejuvenation are factors supporting professional commitment for athletic trainers (ATs) in the high school setting. The inherent complexities of an occupational setting can mitigate perceptions of professional commitment. Thus far, evidence is lacking regarding professional commitment for ATs in other occupational settings. OBJECTIVE: To extend the literature on professional commitment of the AT to the collegiate setting. DESIGN: Qualitative study. SETTING: Collegiate. PATIENTS OR OTHER PARTICIPANTS: Thirty-three Board of Certification-certified ATs employed in the collegiate setting (National Collegiate Athletic Association Division I = 11, Division II = 9, Division III = 13) with an average of 10 ± 8 years of clinical experience volunteered. Data saturation guided the total number of participants. DATA COLLECTION AND ANALYSIS: Online journaling via QuestionPro was used to collect data from all participants. Two strategies, multiple-analyst triangulation and peer review, were completed to satisfy data credibility. Data were evaluated using a general inductive approach. RESULTS: Likert-scale data revealed no differences regarding levels of professional commitment across divisions. Two themes emerged from the inductive-content analysis: (1) professional responsibility and (2) coworker support. The emergent theme of professional responsibility contained 4 subthemes: (1) dedication to advancing the athletic training profession, (2) ardor for job responsibilities, (3) dedication to the student-athlete, and (4) commitment to education. Our participants were able to better maintain their own professional commitment when they felt their coworkers were also committed to the profession. CONCLUSIONS: The collegiate ATs investigated in this study, regardless of division, demonstrated professional commitment propelled by their aspiration to advance the profession, as well as their dedication to student-athletes and athletic training students. Maintaining commitment was influenced by a strong sense of coworker support.