Landing Technique Improvements After an Aquatic-Based Neuromuscular Training Program in Physically Active Women.

CONTEXT: Neuromuscular training programs (NTPs) improve landing technique and decrease vertical ground-reaction forces (VGRFs), resulting in injury-risk reduction. NTPs in an aquatic environment may elicit the same improvements as land-based programs with reduced joint stress. OBJECTIVE: To examine the effects of an aquatic NTP on landing technique as measured by the Landing Error Scoring System (LESS) and VGRFs, immediately and 4 mo after the intervention. DESIGN AND SETTING: Repeated measures, pool and laboratory. PARTICIPANTS: Fifteen healthy, recreationally active women (age 21 ± 2 y, mass 62.02 ± 8.18 kg, height 164.74 ± 5.97 cm) who demonstrated poor landing technique (LESS-Real Time > 4). INTERVENTIONS: All participants completed an aquatic NTP 3 times/wk for 6 wk. MAIN OUTCOME MEASURES: Participants' landing technique was evaluated using a jump-landing task immediately before (PRE), immediately after (POST), and 4 mo after (RET) the intervention period. A single rater, blinded to time point, graded all videos using the LESS, which is a valid and reliable movement-screening tool. Peak VGRFs were measured during the stance phase of the jump-landing test. Repeated-measure analyses of variance with planned comparisons were performed to explore differences between time points. RESULTS: LESS scores were lower at POST (4.46 ± 1.69 errors) and at RET (4.2 ± 1.72 errors) than at PRE (6.30 ± 1.78 errors) (P < .01). No significant differences were observed between POST and RET (P > .05). Participants also landed with significantly lower peak VGRFs (P < .01) from PRE (2.69 ± .72 N) to POST (2.23 ± .66 N). CONCLUSIONS: The findings introduce evidence that an aquatic NTP improves landing technique and suggest that improvements are retained over time. These results show promise of using an aquatic NTP when there is a desire to reduce joint loading, such as early stages of rehabilitation, to improve biomechanics and reduce injury risk.

An Exertional Heat Stroke Survivor's Return to Running: An Integrated Approach on the Treatment, Recovery, and Return to Activity.

CONTEXT: Evidence-based best practices for the recognition and treatment of exertional heat stroke (EHS) indicate that rectal thermometry and immediate, aggressive cooling via cold-water immersion ensure survival from this medical condition. However, little is known about the recovery, medical follow-up, and return to activity after an athlete has suffered EHS. OBJECTIVE: To highlight the transfer of evidenced-based research into clinical practice by chronicling the treatment, recovery, and return to activity of a runner who suffered an EHS during a warm-weather road race. DESIGN: Case study. SETTING: Warm-weather road race. PARTICIPANT: 53-y-old recreationally active man. INTERVENTION: A runner's treatment, recovery, and return to activity from EHS and 2014 Falmouth Road Race performance. MAIN OUTCOMES: Runner's perceptions and experiences with EHS, body temperature, heart rate, hydration status, exercise intensity. RESULTS: The runner successfully completed the 2014 Falmouth Road Race without incident of EHS. Four dominant themes emerged from the data: predisposing factors, ideal treatment, lack of medical follow-up, and patient education. The first theme identified 3 predisposing factors that contributed to the runner's EHS: hydration, sleep loss, and lack of heat acclimatization. The runner received ideal treatment using evidence-based best practices. A lack of long-term medical care following the EHS with no guidance on the runner's return to full activity was observed. The runner knew very little about EHS before the 2013 race, which drove him to seek knowledge as to why he suffered EHS. Using this newly learned information, he successfully completed the 2014 Falmouth Road Race without incident. CONCLUSIONS: This case supports prior literature examining the factors that predispose individuals to EHS. Although evidence-based best practices regarding prompt recognition and treatment of EHS ensure survival, this case highlights the lack of medical follow-up and physician-guided return to activity after EHS.

Junior Athletic Training Faculty Members' Perceptions of Doctoral Education on Their Role Transition.

AIMS: Faculty members in healthcare professions have an important role in developing future clinicians, and preparation for their responsibilities is important. The purpose of this study was to examine junior athletic training faculty members' perceptions of doctoral preparation using a qualitative, phenomenological design. METHODS: We included 20 athletic training faculty members (14 women, 6 men) who were 32±3 yrs of age and averaged 2±2 yrs as full-time faculty members in accredited athletic training programs. We audio-recorded and transcribed verbatim semi-structured telephone interviews designed to gain participants' perspectives on their doctoral education and transition to their faculty role. Two investigators analyzed data using a phenomenological approach, and saturation was obtained. Trustworthiness was established with the use of member checking, multiple analyst triangulation, and peer review. RESULTS: Perceptions of doctoral preparation emerged into three themes: 1) doctoral preparation emphasizes research preparation, 2) teaching experience is important, and 3) faculty desire more preparation for faculty life and administrative responsibilities. Generally, participants felt highly prepared to do research, somewhat prepared to teach, and inadequately prepared for faculty life and administrative duties. CONCLUSIONS: Doctoral program advisors and administrators should consider diversifying doctoral education to more holistically prepare faculty members.

Analysis of States' Barriers to and Progress Toward Implementation of Health and Safety Policies for Secondary School Athletics.

CONTEXT: Implementation of health and safety best practices for the leading causes of sudden death and catastrophic injury has been shown to mitigate risk. However, to our knowledge, no authors have examined progress toward health and safety policy implementation at the state level. OBJECTIVE: To investigate the progress made by state secondary school leaders in developing and implementing health and safety policies (ie, exertional heat stroke, sudden cardiac arrest, concussion, emergency action plans) and to explore perceived barriers to and strategies for implementation. DESIGN: Mixed-methods study. SETTING: State high school athletics associations and sports medicine advisory committees. PATIENTS OR OTHER PARTICIPANTS: Collaborative Solutions for Safety in Sport meeting attendees participated in this study. Thirty-five state leaders (current role experience = 8 ± 6 years) completed the survey. Ten of the 35 participated in follow-up interviews. DATA COLLECTION AND ANALYSIS: A survey assessing progress on health and safety policy implementation was administered. Respondents indicated whether their state had implemented a policy, made progress without implementation, or made no progress. We conducted follow-up telephone interviews so they could expand on the survey responses. The data were analyzed using descriptive statistics and the general inductive approach. RESULTS: A total of 89% of respondents reported their states made progress on or implemented health and safety policies during the 2015-2016 academic year. Barriers to policy implementation included cost, a lack of understanding regarding policies versus recommendations, the content and value of policy change, and a false sense of security. Strategies for implementation included varying approaches to change, education of all constituents, and collaborative relationships among key stakeholders. CONCLUSIONS: Although a majority of respondents reported progress in implementing health and safety policies in their states, perceived barriers pointed to the need for the continued education of state leaders in charge of developing and implementing health and safety policies. Despite these barriers, collaboration among key stakeholders is crucial to successful implementation of best-practice policies in secondary school athletics.

Application of a Preventive Training Program Implementation Framework to Youth Soccer and Basketball Organizations.

CONTEXT: Preventive training programs (PTPs) can reduce injury rates and improve neuromuscular control and sport performance. However, PTPs must be implemented correctly and consistently over time for athletes to benefit. Coaches represent the best long-term option for implementing PTPs. Youth athletes are at the optimal age for developing good habits before maturation. Although frameworks have been proposed to guide implementation efforts, little is known regarding the feasibility and real-world context of PTP implementation at the youth sport level. OBJECTIVE: To evaluate the application of the 7-Step framework for promoting implementation of a preseason PTP workshop. DESIGN: Descriptive epidemiology study. SETTING: Youth soccer and basketball organizations. PATIENTS OR OTHER PARTICIPANTS: Organizations with at least 1 team of athletes aged 8 to 14 years were invited to participate in a free preseason coaches' education workshop on PTP implementation. INTERVENTION(S): The 7-Step framework was used to guide PTP education and implementation for each organization. Personnel at organizations that agreed to participate attended a single preseason workshop for coaches. Research staff were available as a resource throughout the season but did not actively implement or monitor the PTPs. MAIN OUTCOME MEASURE(S): Retrospective evaluation of each organization's completion of steps 1 through 5 of the 7-Step framework. RESULTS: A total of 62 youth soccer (n = 40) and basketball (n = 22) organizations were invited to participate. Twelve organizations completed steps 1 through 4 and steps 5a through 5d. The highest drop-off rate occurred during step 1, "Establishing Administrative Support." No organization completed all components of steps 1 through 5. CONCLUSIONS: To better understand how to successfully promote PTP adoption, we must identify the implementation steps that may present the most challenges. Because the highest drop-off rate was seen during the initial step, establishing administrative support and strengthening initial engagement are necessary to improve PTP implementation.

The Organizational Climate in Collegiate Athletics: An Athletic Trainer's Perspective.

CONTEXT: An organizational climate is largely based on an employee's perceptions of the working conditions in which he or she engages regularly. A multifaceted concept, the organizational climate is often formed by perceptions of employee welfare, rewards, and support. Achieving work-life balance is also a part of the climate. OBJECTIVE: To learn collegiate athletic trainers' perceptions of organizational climate and specifically how it may pertain to their work-life balance. DESIGN: Phenomenologic study. SETTING: Collegiate practice setting. PATIENTS OR OTHER PARTICIPANTS: Thirty athletic trainers working in the collegiate athletics setting took part in 1-on-1 phone interviews. The participants were 30.5 (interquartile range [IQR] = 7.75) years old and had been certified for 7 (IQR = 5) years and at their current position for 4 (IQR = 3) years. DATA COLLECTION AND ANALYSIS: Participants completed a phone interview that followed a semistructured framework. All transcribed interviews were analyzed using a phenomenologic approach. Researcher triangulation, expert review, and data saturation were used to establish credibility. RESULTS: Athletic trainers working in the collegiate athletics setting who had positive perceptions of their work-life balance described their organizational climate as family friendly. Our participants' supervisors allowed for autonomy related to work scheduling, which provided opportunities for work-life balance. These athletic trainers believed that they worked in a climate that was collegial, which was helpful for work-life balance. In addition, the importance of placing family first was part of the climate. CONCLUSIONS: The perceptions of our participants revealed a climate of family friendliness, supervisor support, and collegiality among staff members, which facilitated the positive climate for work-life balance. The mindset embraced the importance of family and recognized that work did not always have to supersede personal priorities.

An Examination of Relationships Among Resiliency, Hardiness, Affectivity, and Work-Life Balance in Collegiate Athletic Trainers.

CONTEXT:: A multilevel model has been used to describe the complex nature of work-life balance in sport organizations. Organizational aspects such as work scheduling, hours worked, job demands, and decreased perceived value have been reported as factors that can positively or negatively affect work-life balance. However, the individual factors that contribute to this balance have not been well studied. OBJECTIVE:: To better understand the individual factors (emotional stability and coping) that may facilitate or inhibit work-life balance among athletic trainers (ATs). DESIGN:: Cross-sectional online survey. SETTING:: National Collegiate Athletic Association athletic training setting. PATIENTS OR OTHER PARTICIPANTS:: A total of 423 (193 men, 230 women) ATs employed in the National Collegiate Athletic Association setting. MAIN OUTCOME MEASURE(S):: Data were collected via a Web-based survey instrument consisting of demographic and Likert-scale questions related to resiliency, hardiness, affectivity, work-family conflict (WFC), and work-family enrichment (WFE). Likert responses were summed and demographic information was analyzed for frequency and distribution. Independent t tests, analysis of variance, and Spearman correlations were calculated to evaluate the relationships among variables. RESULTS:: Participants exhibited moderate hardiness scores of 3.9 ± 4.0 (range, -9 to 15). Positive affectivity was weakly negatively correlated with WFC ( r = -0.212, P < .001) and moderately positively correlated with WFE ( r = 0.448, P < .001). Resiliency was weakly negatively correlated with WFC ( r = -0.25, P < .001) and weakly positively correlated with WFE ( r = 0.228, P < .001). Additionally, individuals with less than 10 years of experience had lower positive affectivity scores than those with more than 10 years of experience. Men scored higher than women only in resiliency. CONCLUSIONS:: Collegiate ATs demonstrated moderate levels of coping behaviors that allow them to manage their personal and professional lives. Athletic trainers with more years of experience displayed a more positive affect.

A Narrative Analysis: Examining the Transition to Practice for the Full-Time Secondary School Athletic Trainer.

CONTEXT: The transition to clinical practice is an important topic in athletic training because it is viewed as a stressful time that is accompanied by self-doubt. Mentorship and previous experience support the transition to practice, but little information is available on the organizational entry of the athletic trainer (AT) who is employed full time in the secondary school setting. OBJECTIVE: To understand the experiences of newly credentialed ATs in full-time positions in the secondary school setting. DESIGN: Qualitative study. SETTING: Secondary schools. PATIENTS OR OTHER PARTICIPANTS: Seventeen ATs (4 men, 13 women; age = 25 ± 4 years) were employed full time in the secondary school setting. On average, the full-time ATs worked 40 ± 10 hours per week. DATA COLLECTION AND ANALYSIS: All participants completed a semistructured telephone interview with 1 researcher. Data were analyzed using a narrative analysis, and credibility was established by peer review and researcher triangulation. The narrative research paradigm guided our protocol and supported the rigor of the study. RESULTS: Our analyses revealed that transition to practice was organic, such that the newly credentialed AT gained awareness by engaging in the role daily. Additionally, the transition process was facilitated by previous experience in the setting, mostly from educational training. Ongoing communication with various stakeholders (athletic directors, team physicians, and peer ATs) in the setting also assisted in the process of transitioning. Finally, mentorship from previous preceptors provided support during the transition process. CONCLUSIONS: Transitioning into full-time clinical practice in the secondary school setting was informal and supported by professional relationships and past experiences. Past experiences allowed for awareness but also the development of mentoring relationships that continued beyond the clinical education experience. Communication also assisted the newly credentialed AT, as it provided feedback for legitimation by multiple stakeholders.

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.

Transition to Practice for Graduate Assistant Athletic Trainers Providing Medical Care in the Secondary School Setting.

CONTEXT: Transition to clinical practice can be challenging for newly credentialed athletic trainers (ATs), who are expected to immediately step into their roles as autonomous clinicians. For those providing care in the secondary school setting, this transition may be complicated by the fact that many practice in isolation from other health care providers. OBJECTIVE: To explore the transition to practice of newly credentialed graduate assistant ATs providing medical care in the secondary school. DESIGN: Phenomenologic qualitative study. SETTING: Secondary school. PATIENTS OR OTHER PARTICIPANTS: The 14 participants (2 men, 12 women; age = 23.3 ± 2.0 years) were employed in the secondary school setting through graduate assistantships, had been credentialed for less than 1 year, and had completed professional bachelor's degree programs. DATA COLLECTION AND ANALYSIS: We completed 14 semistructured phone interviews. Interviews were recorded and transcribed verbatim. A general inductive approach was used for data analysis. Trustworthiness was established through multiple-analyst triangulation, peer review, and member checks. RESULTS: A period of uncertainty referred to a time during which participants were anxious as they began practicing independently. Legitimation through role engagement signified that as the period of uncertainty passed, participants developed more confidence in themselves and legitimation by engaging in their role. Acclimation through physician communication and professional relationships highlighted the importance of developing a relationship with the team physician, which provided a source of feedback and support for continued growth and confidence. CONCLUSIONS: To prepare for this period of uncertainty, educators and preceptors should encourage students to interact with members of the health care team and communicate with parents and coaches. Employers should implement initiatives to orient newly credentialed ATs to their roles, provide clear job expectations, and assign or assist with identifying mentors. Newly credentialed ATs should seek support from many different individuals, including the team physician, who can provide support, feedback, and encouragement.

Maintaining Professional Commitment as a Newly Credentialed Athletic Trainer in the Secondary School Setting.

CONTEXT: Professional commitment, or one's affinity and loyalty to a career, has become a topic of interest in athletic training. The expanding research on the topic, however, has omitted newly credentialed athletic trainers (ATs). For an impressionable group of practitioners, transitioning to clinical practice can be stressful. OBJECTIVE: To explore the professional commitment of newly credentialed ATs in the secondary school setting. SETTING: Secondary school. DESIGN: Qualitative study. PATIENTS OR OTHER PARTICIPANTS: A total of 31 newly credentialed ATs (6 men, 25 women; mean age = 24 ± 3 years) participated. Of these, 17 ATs (4 men, 13 women; mean age = 25 ± 4 years) were employed full time in the secondary school setting, and 14 ATs (2 men, 12 women; mean age = 23.0 ± 2.0 years) were graduate assistant students in the secondary school setting. DATA COLLECTION AND ANALYSIS: All participants completed semistructured interviews, which focused on their experiences in the secondary school setting and transitioning into the role and setting. Transcripts were analyzed using the phenomenologic approach. Creditability was established by peer review, member checks, and researcher triangulation. RESULTS: Four main findings related to the professional commitment of newly credentialed ATs in the secondary school setting were identified. Work-life balance, professional relationships formed with the student-athletes, enjoyment gained from working in the secondary school setting, and professional responsibility emerged as factors facilitating commitment. CONCLUSIONS: Affective commitment is a primary facilitator of professional commitment. Newly credentialed ATs who enjoy their jobs and have time to engage in nonwork roles are able to maintain a positive professional commitment. Our findings align with the previous literature and help strengthen our understanding that rejuvenation and passion are important to professional commitment.

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.

Validation of the Professional Identity and Values Scale Among an Athletic Trainer Population.

CONTEXT: Forming a professional identity is a process by which an individual achieves an awareness of his or her own self-concept in the context of the profession. Identity in relation to an individual's profession includes the ability to articulate one's role as a professional and professional philosophy. Professional identity has been studied extensively in other fields, but currently no professional identity scales have been validated within the athletic training profession. OBJECTIVE: To validate the Professional Identity and Values Scale (PIVS) among an 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, III, or National Association of Intercollegiate Athletics colleges or universities (n = 299, 56.5% female, 43.5% male). The average age of the participants was 33.6 ± 8.3 years, and they had 10.3 ± 7.6 years of experience. MAIN OUTCOME MEASURE(S): Participants were asked to complete a demographic questionnaire and the 32-item PIVS. The variables included demographics and the PIVS (Professional Orientation and Values subscale [18 items] and the Professional Development subscale [14 items]). RESULTS: Exploratory factor analysis reduced the survey from 32 to 20 items and revealed 6 factors. Three factors emerged from the Professional Development subscale and emphasized professional insecurities during the early career stages, the importance of mentors during the intermediate stages, and self-confidence and awareness during the later stages of professional development. An additional 3 factors emerged from the Professional Orientation and Values subscale: (1) patient care and advocacy, (2) professional engagement and collaboration, and (3) personal wellness and values. A Cronbach α of 0.80 indicated good internal consistency. CONCLUSIONS: A modified PIVS is a valid and reliable measure of professional identity among athletic trainers employed in the collegiate setting.

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.

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.

Gaining Access to Providing Medical Care to Male Sport Teams: The Female Athletic Trainer Perspective.

CONTEXT: Female athletic trainers (ATs) can face barriers to employment within the profession. Although there is evidence for an increasing percentage of women in athletic training, the portion providing medical care to male sport teams within the professional sport and collegiate settings continues to be small. OBJECTIVE: To investigate the experiences of female ATs when seeking employment with male sport teams within the Division I setting. DESIGN: Qualitative study. SETTING: National Collegiate Athletic Association (NCAA) Division I. PATIENTS OR OTHER PARTICIPANTS: A total of 15 NCAA Division I female ATs providing medical care to a male sport team participated in our study. Their mean age was 33 ± 9 years, and they had a mean of 11 ± 9 years of overall clinical experience. DATA COLLECTION AND ANALYSIS: All participants completed one-on-one phone interviews, which were recorded and transcribed. Analysis of the data followed thematic analysis using a phenomenologic approach. Credibility was established through credibility checks, peer review, and researcher triangulation. RESULTS: Factors that played a role in women gaining employment with male sport teams were (1) preexisting professional relationships, (2) prior experience with a male sport, and (3) perseverance. Participants in our study were most attracted to their current positions because of (1) the environment of the collegiate setting and (2) the location of the university. CONCLUSIONS: Job access for female ATs in this study was not viewed as a challenge. Familiarity through previous connections with the university and staff and commitment to career goals helped these women obtain the positions they held. The desire to work in male sports was not a primary contributing factor to the decision-making process. Progress continues for women in athletic training, as evidenced by the reported ease of job access with male sport teams.

The Doctor of Philosophy Experience of Athletic Trainers: Facilitators and Barriers to Anticipatory Faculty Socialization.

CONTEXT: It is important to understand the process whereby athletic trainers learn about their future roles, particularly when the roles can be complex and demanding. Little is known about the experiences of athletic training doctoral students, including facilitators and barriers to socialization as aspiring faculty members. OBJECTIVE: To investigate factors influencing the anticipatory socialization of athletic training doctoral students into future faculty roles. DESIGN: Qualitative study. SETTING: Universities with athletic training doctoral students. PATIENTS OR OTHER PARTICIPANTS: We recruited 28 students (19 women, 9 men, age = 28 ± 3 years) with a minimum of 1 year of doctoral coursework completed and participating in an assistantship at the time of the study to reach data saturation. Participants were certified for 6 ± 3 years and represented 5 National Athletic Trainers' Association districts and 9 institutions. DATA COLLECTION AND ANALYSIS: We completed semistructured, 1-on-1 telephone interviews with participants. We transcribed each interview verbatim and analyzed the data using an inductive approach. Peer review, multiple-analyst triangulation, and member checks ensured trustworthiness. RESULTS: We uncovered 4 themes from our analysis related to facilitators and barriers to professional socialization. Participants described comprehensive autonomous experiences in research that allowed them to feel confident they could sustain a scholarly agenda. Independent experiences and lack of pedagogy training yielded mixed preparedness relative to teaching responsibilities. Limited formal experience led to incomplete role understanding related to the service component of the professoriate. Finally, with regard to the administrative duties associated with athletic training faculty positions, participants noted a lack of direct exposure to common responsibilities. CONCLUSIONS: Role occupation in various aspects of the professoriate helped doctoral students prepare as future faculty members, although full role understanding was limited. Intentional exposure to research, teaching, service, and administrative expectations during doctoral experiences may facilitate the socialization of future athletic training faculty into academic roles.

Perceptions of Work-Life Balance Practices Offered in the Collegiate Practice Setting.

CONTEXT: Organizational factors have been identified as barriers to finding work-life balance (WLB) in athletic training. Despite the existence of organizational policies to address WLB, little is known about athletic trainers' (ATs') awareness of these policies that could assist them. OBJECTIVE: To better understand the perceptions of ATs regarding the workplace practices available to them, which may help them achieve WLB. DESIGN: Phenomenologic study. SETTING: Collegiate practice setting. PATIENTS OR OTHER PARTICIPANTS: Twenty-one ATs (women = 10, men = 11) employed at the collegiate level (National Collegiate Athletic Association Division I = 12, Division II = 5, Division III = 4) volunteered for our study. The average age of the participants was 33 ± 9 years. Saturation of the data was met at n = 21. DATA COLLECTION AND ANALYSIS: Participants completed an in-depth, 1-on-1 phone interview, which was then transcribed verbatim. Data were analyzed using a phenomenologic approach. Credibility was determined by member checks, peer review, and researcher triangulation. RESULTS: Our analyses revealed that participants (1) had a limited awareness of formal policies that were offered within their university or collegiate infrastructure; (2) used informal policies to manage their personal, family, and work obligations; and (3) thought that more formal policies, such as adherence to adequate staffing patterns and work schedules, could help establish WLB within collegiate athletic training settings. CONCLUSIONS: Informal workplace policies were more commonly used by our participants and were viewed as a means of creating a supportive atmosphere. Administrators and supervisors should consider creating or endorsing more formal policies specific to the demands of an AT in the collegiate setting to help with WLB.

Organizational Infrastructure in the Collegiate Athletic Training Setting, Part II: Benefits of and Barriers in the Athletics Model.

CONTEXT: The athletics model, in which athletic training clinical programs are part of the athletics department, is the predominant model in the collegiate athletic training setting. Little is known about athletic trainers' (ATs') perceptions of this model, particularly as it relates to organizational hierarchy. OBJECTIVE: To explore the perceived benefits of and barriers in the athletics model. DESIGN: Qualitative study. SETTING: National Collegiate Athletic Association Divisions I and III. PATIENTS OR OTHER PARTICIPANTS: Eight full-time ATs (5 men, 3 women; age = 41 ± 13 years, time employed at the current institution = 14 ± 14 years, experience as a certified AT = 18 ± 13 years) working in the collegiate setting using the athletics model. DATA COLLECTION AND ANALYSIS: We conducted semistructured interviews via telephone or in person and used a general inductive approach to analyze the qualitative data. Multiple-analyst triangulation and peer review established trustworthiness. RESULTS: Two benefits and 3 barriers emerged from the data. Role identity emerged as a benefit that occurred with role clarity, validation, and acceptance of the collegiate AT personality. Role congruence emerged as a benefit of the athletics model that occurred with 2 lower-order themes: relationship building and physician alignment and support. Role strain, staffing concerns, and work-life conflict emerged as barriers in the athletics model. Role strain occurred with 2 primary lower-order themes: role incongruity and role conflict. CONCLUSIONS: The athletics model is the most common infrastructure for employing ATs in collegiate athletics. Participants expressed positive experiences via character identity, support, trust relationships, and longevity. However, common barriers remain. To reduce role strain, misaligning values, and work-life conflict, ATs working in the athletics model are encouraged to evaluate their relationships with coaches and their supervisor and consider team physician alignment. Moreover, measures to increase quality athletic training staff from a care rather than a coverage standpoint should be considered.