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Context: Professional identity is a process in which individuals forms a self-concept in the context of their profession, and includes an ability to articulate a professional philosophy. Professional identity relates to many aspects of a profession, including practices, ethics, and the requirements for success. Professional development is a component of professional identity and represents the growth of professionals as they acquire skills and confidence in autonomous practice. Currently, little is known in regard to the role age and years of experience play in the professional development of athletic trainers (ATs). Objective: To determine the relationships of age and years of experience to professional development. Design: Cross-sectional online survey. Setting: Collegiate athletic training clinical setting. Patients or Other Participants: Four hundred twenty-three (193 men, 230 women) ATs. Intervention(s): Data were collected via a Web-based survey instrument consisting of demographic and Likert-scale questions relating to professional development. Main Outcome Measure(s): Likert responses were summed, and demographic information was analyzed for frequency and distribution. Pearson correlations were run to evaluate the relationships between variables and linear regression was used to determine if age or years of experience could predict professional development scores. Results: A positive relationship exists between professional development scores and both age and years of experience. Both age (R[superscript 2] = 0.066) and years of experience (R[superscript 2] = 0.075) were statistically significant predictors of variance in overall professional development scores. Conclusions: Although age and years of experiences were both positively correlated with, and predicted variance in, overall professional development scores, the predicted variance of both variables was relatively small. Although we can say that both age and years of experience are prognostic in the professional development of collegiate ATs, their impact is statistically minimal.

Geographic disparities exist in trauma care (ie, "trauma center desert") within the United States. An athletic trainer (AT) on site at secondary schools (SSs) may help enhance collaboration with emergency medical systems and potentially lead to better outcomes after catastrophic injuries. However, access to AT services relative to the location of level I or II (ie, tertiary) trauma centers remains unknown. To visualize and describe the distance between SSs and trauma centers and compare access to AT services across the United States. Cross-sectional study. Public and private SSs with interscholastic athletics programs in the United States. Survey data obtained through the Athletic Training Locations and Services (ATLAS) project database between September 2019 and April 2023. The minimum distance from each SS to a tertiary trauma center was calculated on Tableau Desktop by geocoding with longitude and latitude. The status and level of AT employment were obtained from the ATLAS project database. The odds and percentages of access to AT services were examined by distance ranges. A total of 18 244 SSs were included in the analyses. Of these, 75% (n = 13 613) were located within 50 miles (81 km) of a tertiary trauma center. The odds of access to AT services were 2.74 (95% CI = 2.56, 2.93) times greater in SSs situated within 50 miles of a tertiary trauma center (P <.001). Additionally, SSs located more than 60 miles (97 km) from a tertiary trauma center had decreased access to AT services (R2 = 0.9192). This study highlighted the geographic disparities in distance to trauma care for SSs in the United States. Those SSs located more than 60 miles from trauma centers had reduced odds of access to AT services. Identification of geographic trends of AT services relative to the location of tertiary trauma centers is a critical first step in preventing fatal consequences of catastrophic injuries. [ABSTRACT FROM AUTHOR]

Given rising temperatures, globally, heat exposures and catastrophic heat illnesses are a major concern in laborer and industrial sectors. The purpose of this study was to evaluate the perceptions of females laboring in the heat regarding challenges and barriers encountered in their respective industries while working in the heat. A consensual qualitative research (CQR) design was employed to gain information related to participant occupational and job characteristics, feelings while working in the heat, adjustments made by employers when they work in the heat, and their experience working in the heat specific to their identified sex. Females were eligible to participate if they were currently employed in an environment that required them to work in the heat. Twelve females participated in a single, 45-60 min one-on-one semi-structured interview. Participants reported working in the manufacturing, agriculture, tourism, and railroad industries. Upon completion of data analysis, one primary theme was identified: heat stress mitigation strategies, which were further broken down into two subthemes of formal strategies provided by the employer and informal strategies driven by the employees. Participants indicated there was a lack of heat stress prevention strategies implemented by their employers, which resulted in employees creating their own strategies to protect themselves and their coworkers from heat stress. Results indicated there are limited heat stress prevention strategies that are provided in industries that include females working in the heat. Unique considerations should be made to protect this population from the dangers of heat stress and must go beyond workers protecting themselves. [ABSTRACT FROM AUTHOR]

Written health and safety policies mitigate catastrophic outcomes resulting from sport injuries. The purpose of this project was to evaluate athletic trainers' proficiency in evaluating catastrophic policies and procedures alignment with best practices. This study found athletic trainers were not able to identify the majority of policy and procedure components based on evidence-based best practice documents. Furthermore, athletic trainers tended to focus more on aesthetics and feasibility versus alignment with current best practices. Results support the need to enhance education specific to policy and procedure development, evaluation, and implementation in order to improve proficiency of clinicians. [ABSTRACT FROM AUTHOR]

The athletic training research agenda identifies a need for exploration on strategies for improved work–life balance. One unexplored area is self-care practices used to maintain work–life balance. Fourteen (six males, eight females) athletic trainers employed in the secondary school setting participated in a qualitative research study. All interviews were recorded, transcribed, and analyzed using an inductive approach as prescribed by phenomenological approach. Data saturation guided recruitment and peer review and intercoder reliability was used for credibility. Secondary school athletic trainers are engaging in self-care practices regularly and connect those activities to their work–life balance. Self-care practices are designed to create "me time" and are geared toward physical and social self-care activities. In addition, our results address the interchangeable thoughts of self-care practices, stress relief, and work–life balance. [ABSTRACT FROM AUTHOR]

Context: The professional socialization process enables athletic training students (ATSs) to gain insights into behaviors, values, and attitudes that characterize their chosen profession. However, the process often focuses on skill development over professional issues. ATSs may be exposed to burnout and work-life conflict, which may impact their professional perceptions. Objective: Examine the cumulative impact of professional socialization on the ATS regarding their perceptions of burnout and work-life balance. Design: Qualitative research. Setting: Semistructured interviews with 6 individuals and 4 focus groups. Patients or Other Participants: Twenty-three ATSs enrolled in their final semester of Commission on Accreditation of Athletic Training Education-accredited programs at 5 universities (9 male, 14 female; average age = 22 years). Main Outcome Measure(s): Data collection occurred from 2 cohorts over a 2-year period. Participants completed focus group or individual interviews following the same interview guide. Interviews were transcribed verbatim. A general inductive analysis was used to evaluate the data. Themes were enumerated by counting the frequency with which a viewpoint was mentioned. Not all students answered each question. Member checks and a peer review established data credibility. Results: Three major themes emerged from our analysis, where ATSs reported (1) perceiving burnout, (2) recognizing burnout in their preceptors and professors, and (3) that work-life imbalance may be a challenge in the future. Athletic training students described experiencing feelings they attributed to burnout while recognizing similar signs in classmates and preceptors or professors, and acknowledged that having a family could be difficult in the future. Conclusions: Despite these seemingly negative findings, this group of ATSs was not influenced to leave the profession. Observing their preceptors use strategies and positive behaviors gave them hope for the future. Professionals must understand the importance of appropriate socialization when students are exposed to potentially negative situations so they remain optimistic about entering the field.

Context: Mentorship is a developmental process whereby a novice individual, as he/she becomes inducted into his/her area of expertise, is guided by a more experienced person. Speculation exists that years of experience can impact this relationship. Objective: To determine the impact mentoring can have on athletic training student development and evaluate if experience as a preceptor is viewed as influential on the mentor experience. Design: Mixed-methods study. Setting: Commission on Accreditation of Athletic Training Education accredited programs. Patients or Other Participants: We recruited 17 (14 females, 3 males) athletic training students to participate in our study. On average, our participants were 21 ± 1 years old and represented varying levels of academic standing (1 sophomore, 9 juniors, 7 seniors). All participants indicated they currently had a mentor when asked directly. Main Outcome Measure(s): Participants responded to the Athletic Training Perceptions of Effective Mentoring survey and 14 open-ended interview questions regarding their perceptions of mentoring. An inductive approach was used to identify themes and supporting categories. Trustworthiness was established by using multiple-analyst triangulation, peer review and piloting of the instruments, and triangulation of data using a mixed-methods approach. Results: Athletic training students perceive their mentoring experiences as those that provide support and understanding, advance their clinical practice, and allow for the development of career goals. Age and experience did not appear to impact the overall experience of the student but rather facilitates the type of mentoring relationship developed. Conclusions: Mentoring was perceived to be an advantageous aspect of the socialization process for the athletic training student. It provided support and understanding during times of increased stress, allowed for the development of clinical skills, and provided the chance to cultivate a professional identity.

Context: Mentorship has been identified as a contributor to the socialization of athletic training preceptors. Understanding how mentorship occurs and contributes to preceptor development may help athletic training educators facilitate effective mentorship within their athletic training programs. Objective: Examine preceptors' perceptions of mentoring as part of their socialization into this role. Design: Qualitative study. Setting: Commission on Accreditation of Athletic Training Education programs. Patients or Other Participants: Twelve athletic trainers representing 4 National Athletic Trainers' Association districts, including 5 men and 7 women, average age = 32 ± 10.5 years, and average of 5 ± 5.0 years' experience as a preceptor. Main Outcome Measure(s): Participants responded to 14 interview questions regarding their perceptions of mentoring. Two researchers analyzed data using an inductive approach to identify themes and supporting categories. Trustworthiness was established by piloting the interview, using multiple analyst triangulation, and peer review. Results: Four themes emerged from the data: (1) characteristics, (2) processes, (3) mentoring by emulating, and (4) roles of mentoring. Participants identified that communication and commitment are characteristics of effective mentorship. Preceptors learn to mentor by emulating other preceptors, and mentoring relationships develop through both formal and informal processes. Mentoring serves multiple roles for preceptors, including providing a support system and facilitating reciprocal learning for both mentors and protégés. Conclusions: Participants perceive mentoring as beneficial to their initial and ongoing development as preceptors. Preceptors learn to mentor by emulating current and past mentors, emphasizing the importance of modeling for both preceptors and students. Clinical education coordinators can facilitate the mentoring of preceptors by educating them on the benefits of engaging in it as well as connecting experienced preceptors with newer preceptors.

Burnout and work–family conflict (WFC) are stressors faced by secondary school athletic trainers, however, the concept of perceived stress and its relationship to burnout or WFC is not well understood. The purpose of this study was to investigate perceived stress' relationship with burnout and WFC. Participants reported a WFC score of 40.36 (±15.63), low burnout (40.1 ± 16.28), and moderate stress (15.99 ± 7.02). Perceived stress predicted WFC, but not burnout (b = 1.13, t572 = 14.132, p ≤.001). One's level of perceived stress impacts WFC, which indicates higher stress will equal greater work–family conflict. [ABSTRACT FROM AUTHOR]

Work-life balance continues to be a focal point of athletic training research, particularly due to the job challenges and demands of health care providers. Despite a large body of literature, much is still unexplored, especially in the area of family role performance (FRP). To examine the relationships between work-family conflict (WFC), FRP, and various demographic variables among athletic trainers employed in the collegiate setting. Cross-sectional online survey. Collegiate setting. A total of 586 collegiate athletic trainers (females = 374, males = 210, sex variant or nonconforming = 1, preferred not to answer = 1). Data were collected through an online survey (Qualtrics) in which participants responded to demographic questions and previously validated WFC and FRP scales. Demographic data were reported and analyzed for descriptive information and frequencies. Mann-Whitney U tests were performed to identify differences among groups. Participants' mean scores were 28.19 ± 6.01 and 45.86 ± 11.55 for the FRP and WFC scales, respectively. Mann-Whitney U tests revealed differences between men and women for WFC scores (U = 344 667, P =.021). The FRP score was moderately negatively correlated with the WFC total score (rs[584] = −0.497, P <.001) and predicted the WFC score (b = 72.02, t582 = −13.30, P =.001). The Mann-Whitney U test demonstrated that married athletic trainers (47.20 ± 11.92) had higher WFC scores than those who were not married (43.48 ± 11.78; U = 19847.00, P =.003). Mann-Whitney U analysis (U = 32 096.00, P =.001) also revealed a difference between collegiate athletic trainers with children (48.16 ± 12.44) and those without children (44.68 ± 10.90). Collegiate athletic trainers experienced more WFC with marriage and having children. We propose that the time required to raise a family and build relationships may cause WFC due to time incongruencies. Athletic trainers want to be able to spend time with their families; however, when such time is highly limited, then WFC increases. [ABSTRACT FROM AUTHOR]

Parents have unique roles in advocating for their child's health and safety. Such advocacy can improve student-athletes' access to athletic trainers (ATs), yet few researchers have investigated the perceptions of student-athletes' parents regarding athletic training. To explore parents' perceptions of athletic training and evaluate their knowledge regarding the AT's role. Concurrent mixed-methods study. Web-based questionnaire. Parents affiliated with USA Football representing 36 states (n = 316: men = 53.5%, women = 46.1%; average age = 45.6 ± 6.2 years [age provided = 291]) were included. An online questionnaire was developed and distributed via Qualtrics. The questionnaire contained demographic questions, quantitative items assessing perceived value and knowledge of athletic training, and open-ended questions to provide opportunities for expansion. Descriptive statistics were calculated for the demographic data. Quantitative measures were presented as count and percentage responses. Open-ended responses were analyzed using the general inductive approach, and overall perceptions were supported with participant quotes. Of 10 763 parents, 390 completed the questionnaire (3.6% response rate, 74.8% completion rate). Of the 390, 316 had a child in high school. Approximately 67% (n = 213) of respondents considered an AT a trusted source of medical information and "extremely valuable" to student-athletes' health and safety. The questionnaire response injury prevention was frequently recognized (n = 307, 97.2%) as a skill ATs perform, followed by first aid/wound care (91.8%) and therapeutic interventions (82.3%). Parents highlighted the AT's role in immediate care and attributed peace of mind and feelings of comfort to having a health care professional readily available for their children. When asked directly and when discussing their effect on student-athlete health and safety, parents valued ATs. Though various qualifications of ATs were recognized, parents emphasized the importance of having someone immediately available to provide care if and when needed. Educational efforts should focus on ATs as the most qualified health care professionals to provide comprehensive medical care to student-athletes in both urgent and nonurgent situations. [ABSTRACT FROM AUTHOR]

Coaches play a role in streamlining care, especially by directing student-athletes in need of further medical attention to the athletic trainer (AT). The AT-coach relationship holds great potential for incorporating collaborative care, and yet, little is known about coaches' perceptions and knowledge of ATs. To investigate coaches' perceptions of athletic training and their knowledge regarding the roles and responsibilities of ATs in secondary schools. Concurrent mixed-methods study. Cross-sectional online questionnaire. Secondary school athletic coaches from 10 sports with the highest participation rates during the 2017–2018 season (n = 1097). Most respondents were male (n = 795, 72.4%), and their average age was 44.7 ± 11.4 years. Participants completed a web-based questionnaire containing demographics and quantitative measures assessing their perceived value and knowledge of ATs, as well as open-ended questions. Descriptive statistics summarized the demographic data. Counts and percentage responses for quantitative measures were reported. Open-ended responses were analyzed using the general inductive approach. Approximately 93% of respondents considered an AT a trusted source of medical information and a key member of the sports medicine team. Most respondents selected injury prevention (98.9%), first aid and wound care (97%), therapeutic interventions (89.9%), and emergency care (85.8%) as skills ATs are qualified to perform. Forty-six percent of respondents were willing to coach without an AT employed. Coaches trusted ATs as part of the "athletic team" and as gatekeepers, referring student-athletes for advanced care when warranted. Regarding the AT role, coaches emphasized the treatment of minor injuries and the idea of "coverage versus care." Secondary school coaches valued the athletic training profession and were knowledgeable regarding various roles and responsibilities ATs frequently perform. However, they may view ATs as luxuries instead of necessities, as evidenced by the fact that just under half of responding coaches were willing to coach without an AT employed at the school. [ABSTRACT FROM AUTHOR]

The work-life interface continues to be a central focus for those working in sport; yet despite the growth in understanding the complexities of balancing work, life, and home roles much is yet to be explored. The aim of this study was to better understand the athletic trainer’s experiences of work-family conflict and guilt while working for the National Collegiate Athletics Association (NCAA) member institutions as it pertained specifically to years of experience, age, and level within the NCAA. We used an online cross-sectional survey (Qualtrics, Provo, UT) to collect demographics, scales, and supporting questions. Results indicate that age and years of experience are variables that are associated with experiences of work-family conflict and guilt. Athletic trainers working in the collegiate setting are experiencing work-family guilt. Marriage and family are contributing factors for collegiate athletic trainers to experience work-family conflict, and feel work-family guilt. Our findings also imply that working in the Division I setting for the athletic trainer increases experiences of work-family conflict. [ABSTRACT FROM AUTHOR]

Empirical and anecdotal evidence suggests that many athletic trainers (ATs) are former athletes and selected the profession because of its affiliation with sport. Qualitative research has indicated that collegiate ATs may have a strong athletic identity, but the concept of athletic identity has not been quantified in this population. To quantitatively assess the athletic identity of collegiate ATs and determine if group differences exist. Cross-sectional observational study. Collegiate clinical setting. A total of 255 (n = 93 men [36%], n = 162 women [63%]; n = 2 did not indicate sex [1%]) ATs employed in the collegiate setting. Data were collected via a web-based survey platform that 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. The large majority of respondents (90%) self-identified as having participated in organized sport and yet scored moderately on the Athletic Identity Measurement Scale (22.9 ± 7.9). No sex differences were present in overall athletic identity (P =.446), but women had higher levels of negative affectivity (P =.045) than men. Testing also revealed group differences based on current employment setting for social identity (P =.020), with scores for those in National Collegiate Athletic Association (NCAA) Division I less than those in Division II, Division III, and the National Association of Intercollegiate Athletics. Exclusivity in NCAA Division III was lower (P =.030) than that in NCAA Division II and National Association of Intercollegiate Athletics ATs. Components of athletic identity appeared to vary based on the employment setting of collegiate ATs and may be related to the number of hours worked in the summer. The moderate athletic identity scores of collegiate ATs were comparable with those of former athletes who selected career paths outside of sport. This may indicate adaptive career decision processes. [ABSTRACT FROM AUTHOR]

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). Although individualized, experiences in the work-life interface can largely be affected by organizational factors (ie, elements specific to the workplace). Staff size and patient load may influence the athletic trainer's feelings of WFC and WFG, yet these factors have not been directly studied. To examine organizational factors and experiences of WFC and WFG among collegiate athletic trainers. Cross-sectional study. Collegiate setting. A total of 615 (females = 391, gender variant or nonconforming = 1, males = 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 Board of Certification certified for 10 ± 8 years. A total of 352 participants (57.2%) worked in National Collegiate Athletic Association Division I, 99 in Division II (16.1%), and 164 in Division III (26.7%). Participants responded to demographic and workplace characteristic questions (organizational infrastructure, staff size, and number of varsity-level athletic teams). They completed WFC and WFG scales that have been previously validated and used in the athletic trainer population. Work-family conflict and WFG were universally experienced among our participants, with WFC scores predicting WFG scores. Participants reported more time-based conflict than strain- or behavior-based conflict. No differences in WFC and WFG scores were found among organizational infrastructures. Weak positive correlations were present between staff size and WFC scores and WFG scores. The number of athletic teams was not associated with WFC or WFG scores. 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. [ABSTRACT FROM AUTHOR]