{"id":6824,"date":"2020-01-31T06:30:00","date_gmt":"2020-01-31T12:30:00","guid":{"rendered":"http:\/\/thesportjournal.org\/?p=6824"},"modified":"2020-06-02T13:43:24","modified_gmt":"2020-06-02T18:43:24","slug":"the-workplace-experiences-of-athletic-trainers-in-the-professional-sports-setting","status":"publish","type":"post","link":"https:\/\/thesportjournal.org\/article\/the-workplace-experiences-of-athletic-trainers-in-the-professional-sports-setting\/","title":{"rendered":"The Workplace Experiences of Athletic Trainers in the Professional Sports Setting"},"content":{"rendered":"\n

Authors:<\/strong><\/p>\n\n\n\n

Katelyn A. Zweigle DAT, LAT, ATC<\/strong>
Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory Department of Applied Medicine and Rehabilitation
Indiana State University
Terre Haute, IN
E-mail: kzweigle@sycamores.indstate.edu<\/a><\/p>\n\n\n\n

Stephanie M. Mazerolle Singe PhD, ATC, FNATA<\/strong>
Department of Kinesiology
University of Connecticut
Storrs, CT
E-mail: Stephanie.mazerolle@uconn.edu<\/a><\/p>\n\n\n\n

Zachary K. Winkelmann PhD, SCAT, ATC<\/strong>
Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory Department of Applied Medicine and Rehabilitation
Indiana State University
Terre Haute, IN
E-mail: zwinkelmann@indstate.edu<\/a><\/p>\n\n\n\n

Elizabeth R. Neil PhD, LAT, ATC<\/strong>
Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory Department of Applied Medicine and Rehabilitation
Indiana State University
Terre Haute, IN
E-mail: eneil@sycamores.indstate.edu<\/a><\/p>\n\n\n\n

Nicholas J. Spangler DAT, LAT, ATC<\/strong>
Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory Department of Applied Medicine and Rehabilitation
Indiana State University
Terre Haute, IN
E-mail: nspangler@sycamores.indstate.edu<\/a><\/p>\n\n\n\n

Lindsey E. Eberman PhD, LAT, ATC*<\/strong>
Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory Department of Applied Medicine and Rehabilitation
Indiana State University
Terre Haute, IN
E-mail: lindsey.eberman@indstate.edu<\/a><\/p>\n\n\n\n

Corresponding Author:<\/strong>
Lindsey Eberman, PhD, LAT, ATC
Department of Applied Medicine and Rehabilitation
Indiana State University
567 North 5th<\/sup> Street,
Terre Haute, IN 47809
E-mail: lindsey.eberman@indstate.edu
Phone: 812-237-3961<\/p>\n\n\n\n

The\nWorkplace Experiences of Athletic Trainers in the Professional Sports Setting
\n<\/strong><\/h3>\n\n\n\n

ABSTRACT:<\/strong><\/p>\n\n\n\n

Purpose:<\/strong> Previous literature has reported that athletic trainers in the professional sports setting (PSS) experience role strain from extreme organizational expectations and demands, resulting in perceived limitations in patient care and work-life balance.Therefore, the purpose of this study was to explore the experiences of athletic trainers working in the PSS. <\/p>\n\n\n\n

Methods:<\/strong> We recruited 18 participants from various professional sports who partook in a semi-structured, one-on-one phone interview. A 3-person data analysis team used a multi-phased process to identify emerging domains and core ideas, ultimately developing a consensus codebook. Trustworthiness was established with member checking, multiple researcher triangulation, and external auditing. <\/p>\n\n\n\n

Results:<\/strong> Three domains emerged: 1) job attractors, 2) feeling valued, and 3) characteristics of the workplace environment. Participants reported being attracted to athletic training in the PSS to work with elite athletes, because of supportive coworker relationships, having a network of athletic trainers, and increased access to resources and education. Athletic trainers reported feeling valued by employers through increasing professional responsibilities and increasing compensation or recognition.  They also reported having trusting relationships with their patients. Participants described mutual organizational and employee loyalty in their workplace environment. Participants detailed examples of inappropriate behaviors and a sub-culture of acceptance, whereby these workplace experiences were accepted as a byproduct of the PSS.  Participants discussed common coworker tensions related to miscommunication.  Although participants were overall positive about their workplace\u2019s experiences, they acknowledged sacrifices to acquire and retain their positions, including significant time commitments, regular travel expectations, family compromises, and fewer opportunities for promotion. <\/p>\n\n\n\n

Conclusion: <\/strong>Athletic trainers in the PSS feel valued for their work despite the long hours, family and promotional sacrifices. Positive coworker environments and access to resources continue to attract athletic trainers to the PSS. A sub-culture of accepting inappropriate workplace behavior within the PSS should be further explored.  <\/p>\n\n\n\n

Application in Sport: <\/strong>Athletic trainers in the professional sports setting feel that they have added job attractors that may include access to resources and education. The professional sports setting may include a sub-culture of acceptance, where inappropriate behavior is overlooked as a result of the setting.   <\/p>\n\n\n\n\n\n\n\n

Key Words:<\/strong> worth, harassment, payment, consensual qualitative research<\/p>\n\n\n\n

INTRODUCTION<\/strong><\/p>\n\n\n\n

Health care\nprofessionals in all settings are predisposed to work-life imbalances due to\nthe nature of healthcare, and athletic trainers are no exception. Athletic\ntrainers in various settings have reported working on average forty plus hours\na week that does not include traveling.(20)\nThese long hours are brought on by attending to patient needs, administrative\nduties, athlete supervision, and travel to contests.(26,27)\nDue to the long hours, athletic trainers in various settings are succumbing to\nburnout in the workplace. The burnout is often attributed to role overload,\nstress, and personal perception of being undervalued or underappreciated in the\nworkplace.(19)\n<\/p>\n\n\n\n

Previous research\nhas been completed exploring the secondary school and college\/university\nathletic trainers\u2019 work experiences; however no such investigation has occurred\nwithin professional sports setting (PSS). Although only 3% of the National\nAthletic Trainers\u2019 Association (NATA) membership database identifying as\nworking within the PSS, it is a setting that many athletic training students\nand young professionals\u2019 may be drawn into the profession, simply based on its\nmedia exposure.(28)\nSettings have such variability, it is important for future athletic trainers to\nhave a better understanding of each.  The\nathletic trainers that work in a rehabilitation or clinical setting seem to\nhave a more consistent schedule (about 40 hours per week); however those in the\nsecondary school, college\/university, and PSS are reporting working more than\n40 hours a week accompanied by frequent travel.(30)\nThe role of the athletic trainer in the collegiate setting can be very\ndemanding due to the travel requirements, obligations to multiple teams,\nteaching duties, supervision of students, and various other administrative\nduties.(4)\nLiterature has also revealed that finances at institutions play a role in the\naccess to, expectations of, and priorities for athletic training services.(29)  <\/p>\n\n\n\n

The culture of\ncollege\/university and PSS has typically focused on the athletic team\u2019s success\nrather than high-quality, independent health care to athletes. When patient\ncare and sport performance are misaligned, which is not always the case but\noften is in competitive athletics, athletic trainers face conflicting priorities.(36)\nPrevious literature stated that athletic trainers in the PSS indicate they\nexperience moderate to high levels of role strain and role overload, which\ncreate work-life imbalances.(40,41)\nAthletic trainers have also become accustomed to the time demands which have become\n\u201clong-standing\u201d within competitive athletics and seen as indistinguishable with\ncommitment and productivity.(3)\nA recent NATA Position Statement further elaborated on the work-life balance\nthat is associated with an increase in quality of life for athletic trainers\nand the various outcomes which include burnout, job satisfaction, professional\ncommitment, health and wellness, and career intention.(30) Therefore, we sought\nto evaluate the experiences of athletic trainers working in the PSS.<\/p>\n\n\n\n

METHODS<\/strong><\/p>\n\n\n\n

Design<\/strong><\/p>\n\n\n\n

We used a qualitative design with\none-on-one interviewing to describe the workplace experiences of athletic\ntrainers in the PSS.  The\nInstitutional Review Board approved this study. <\/p>\n\n\n\n

Recruitment and Participants<\/strong><\/p>\n\n\n\n

We used a criterion sample of athletic\ntrainers that were practicing in the PSS athletic trainers between August to\nOctober 2018.  We recruited the sample of\nPSS athletic trainers through word of mouth, social media, snowball sampling,\nand the NATA membership database. We posted 66 tweets on Twitter through\nthe XXX Twitter\u00ae<\/sup> page (@XXX). The tweets were addressed to 66\ndifferent professional sports associations, state athletic training\nassociations, as well as individuals. We selected these individuals based off\npresence in the PSS and activity on social media. Current literature supports\nutilizing social media as a feasible way to target specific populations for the\nrecruitment of studies.(8)<\/p>\n\n\n\n

A total of 18 participants (15 male, 3\nfemale; age = 38 \u00b1 8 years; credentialed experience = 14 \u00b1 7 years; experience\nin the PSS = 11 \u00b1 9 years) from various professional sports leagues [Major\nLeague Baseball (MLB; n = 8), National Football League (NFL; n = 1), National\nBasketball Association (NBA; n = 1), Major League Soccer (MLS; n = 2), National\nHockey League (NHL; n = 4), Major League Rugby (MLR; n = 1), Women\u2019s National\nBasketball Association (WNBA; n = 1)] volunteered for the study. Table 1\ndescribes the demographics of the participants.<\/p>\n\n\n\n

Table 1. <\/strong>Participant Demographics<\/p>\n\n\n\n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n
Pseudonym<\/strong><\/td>\n Age<\/strong><\/td>\n Sex<\/strong><\/td>\n Years BOC
Certified<\/strong><\/td>\n 		Years of
Experience in PSS<\/strong><\/td>\n 		Ethnicity<\/strong><\/td>\n Professional
Affiliation<\/strong><\/td>\n <\/tr>\n
Adam<\/td>\n 34<\/td>\n Male<\/td>\n 11<\/td>\n 1<\/td>\n East Asian<\/td>\n MLS<\/td>\n <\/tr>\n
Charlie<\/td>\n 30<\/td>\n Male<\/td>\n 8<\/td>\n 6<\/td>\n Caucasian<\/td>\n NFL<\/td>\n <\/tr>\n
Edward<\/td>\n 28<\/td>\n Male<\/td>\n 6<\/td>\n 5<\/td>\n Caucasian<\/td>\n MLB<\/td>\n <\/tr>\n
Everett<\/td>\n 29<\/td>\n Male<\/td>\n 5<\/td>\n 4<\/td>\n Caucasian<\/td>\n MLS<\/td>\n <\/tr>\n
Kane<\/td>\n 42<\/td>\n Male<\/td>\n 20<\/td>\n 20<\/td>\n Hispanic\/Latino<\/td>\n MLB<\/td>\n <\/tr>\n
Johnathan<\/td>\n 30<\/td>\n Male<\/td>\n 7<\/td>\n 3<\/td>\n Caucasian<\/td>\n MLB<\/td>\n <\/tr>\n
Iris<\/td>\n 29<\/td>\n Female<\/td>\n 2<\/td>\n 2<\/td>\n Caucasian<\/td>\n MLB<\/td>\n <\/tr>\n
Maverick<\/td>\n 33<\/td>\n Male<\/td>\n 11<\/td>\n 10<\/td>\n Caucasian<\/td>\n MLB<\/td>\n <\/tr>\n
Kayden<\/td>\n 41<\/td>\n Male<\/td>\n 19<\/td>\n 11<\/td>\n Caucasian<\/td>\n NHL<\/td>\n <\/tr>\n
Dylann<\/td>\n 49<\/td>\n Male<\/td>\n 22<\/td>\n 22<\/td>\n Caucasian<\/td>\n NHL<\/td>\n <\/tr>\n
Beverly<\/td>\n 38<\/td>\n Female<\/td>\n 12<\/td>\n 1<\/td>\n Caucasian<\/td>\n MLR<\/td>\n <\/tr>\n
Kyle<\/td>\n 47<\/td>\n Male<\/td>\n 24<\/td>\n 24<\/td>\n Caucasian<\/td>\n NHL<\/td>\n <\/tr>\n
Glenn<\/td>\n 44<\/td>\n Male<\/td>\n 21<\/td>\n 10<\/td>\n Caucasian<\/td>\n MLB<\/td>\n <\/tr>\n
Jean<\/td>\n 33<\/td>\n Female<\/td>\n 10<\/td>\n 4<\/td>\n Caucasian<\/td>\n WNBA<\/td>\n <\/tr>\n
Robert<\/td>\n 39<\/td>\n Male<\/td>\n 15<\/td>\n 15<\/td>\n Caucasian<\/td>\n MLB<\/td>\n <\/tr>\n
Christopher<\/td>\n 39<\/td>\n Male<\/td>\n 17<\/td>\n 5<\/td>\n African-American<\/td>\n NBA<\/td>\n <\/tr>\n
Corey<\/td>\n 44<\/td>\n Male<\/td>\n 21<\/td>\n 21<\/td>\n Caucasian<\/td>\n MLB<\/td>\n <\/tr>\n
Trent<\/td>\n 53<\/td>\n Male<\/td>\n 23<\/td>\n 29<\/td>\n Caucasian<\/td>\n NHL<\/td>\n <\/tr>\n<\/tbody>\n<\/table>\n\n\n\n

Abbreviations: BOC, Board of Certification; MLB, Major League Baseball; MLR, Major League Rugby, MLS, Major League Soccer; NBA, National Basketball Association; NFL, National Football League; NHL, National Hockey League; WNBA, Women\u2019s National Basketball Association<\/p>\n\n\n\n

Instrumentation <\/strong><\/p>\n\n\n\n

The primary\ninvestigator (AAA) developed the interview protocol (Table 2) based on existing\nliterature related to athletic training in the PSS. The interview protocol\nincluded 10 semi-structured questions. Following development, the interview\nprotocol was reviewed by the co-authors (BBB, DDD) and two content and methods\nexperts with minor edits to the final protocol. Next, the primary investigator\nconducted two pilot interviews with athletic trainers that had previous work\nexperience in the PSS. The research team met to discuss the pilot interviews\nwith final edits made to the interview protocol. <\/p>\n\n\n\n

Table 2.<\/strong> Interview Script.<\/p>\n\n\n\n\n\n \n \n \n \n \n \n \n \n \n \n
1. Describe you role as an athletic trainer in the professional setting.\n
    \n
  1. What was your career path to prepare you for this position?<\/li>\n
  2. Can you describe what a typical day looks like? Is that all the time or seasonal?<\/li>\n
  3. What do you do in the “off season”?<\/li>\n <\/ol>\n\t<\/td>\n <\/tr>\n
2. Do you enjoy working in your career setting? Why or why not?<\/td>\n <\/tr>\n
3. What is your relationship like with coworkers?\n\t\t
    \n\t\t\t
  1. Have you experienced any difficulties with coworkers? If so, please tell me about that.<\/li>\n\t\t<\/ol>\n\t<\/td>\n <\/tr>\n
4. Do you have mentorship in or outside the organization? How does that influence you as a professional?<\/td>\n <\/tr>\n
5. What are your prospects for job growth in this organization? Do you see yourself being able to get promoted? Why or why not?<\/td>\n <\/tr>\n
6. Can you describe the methods in which you see yourself earning raises, praises, or promotion? Why or why not?<\/td>\n <\/tr>\n
7. Describe your satisfaction with compensation.\n\t\t
    \n \t\t
  1. Is it equitable to your peers? Why or why not?<\/li>\n \t<\/ol>\n\t<\/td>\t\n <\/tr>\n
8. What is your ultimate career goals? Do you have the resources to achieve that goal working within this organization or setting? Why or why not? <\/td>\n <\/tr>\n
9. Describe your interactions with patients. For instance, how do you interact with patients? How frequently do you interact? What are the nature of those interactions?<\/p>\n \t
    \n\t\t
  1. What challenges, if any, have you experienced providing patient care in the professional setting?<\/li>\n\t\t<\/ol>\n\t<\/td>\n <\/tr>\n
10. How would you describe the term workplace harassment? Based upon your definition and understanding of harassment, have you ever experienced any workplace harassment? What about bullying? Or discrimination? Can you describe those experiences for me? <\/td>\n <\/tr>\n<\/tbody>\n<\/table>\n\n\n\n

Following\ninterview protocol development, a demographic survey using a web-based platform\nwas created including the electronic informed consent. Once participants\nclicked on the link, they were then transferred to the web-based, demographic\nsurvey (Qualtrics\u00ae<\/sup>, Provo, UT). As part of the demographic survey,\nthe participant provided their contact information to schedule the interview. <\/p>\n\n\n\n

Data Collection and Analysis<\/strong><\/p>\n\n\n\n

All interviews and\nverbal consent were audio recorded using a video conferencing platform (Zoom,\nSan Jose, CA). Each interview was performed by the primary investigator (AAA).\nThe interviews were audio recorded and field notes were taken. We used\nparticipant numbers to protect the identities of the contributors, and then\ncoordinated pseudonyms to represent each. The primary investigator then reviewed\nthe interview transcripts between 48 and 72 hours after conducting the\ninterview and then transcribed using a web-based transcription company (Temi,\nSan Francisco, CA). Once the interview was transcribed, it was then sent back\nto the participant to allow for \u201cmember checking\u201d where the participant was\nallowed to read the transcript and ensure that everything stated was correct.(15,16,17)<\/p>\n\n\n\n

 Interview data was analyzed using the\nconsensual qualitative research (CQR) approach.(15,16,17)\nThe CQR approach has 5 essential components: 1) open-ended questions in\nsemi-structured data collection that allows for a consistent collection of data\nacross all participants and a more in-depth investigation of individual\nexperiences; 2) a 3-member code team to analyze the data using individual\nperspectives; 3) the data analysis team meets to come to a consensus on the\nmeaning of the data; 4) the use of an auditor to check the work of the data\nanalysis team; and the 5) development of domains, categories, core ideas, and\ncross analyses.(15,16,17)<\/p>\n\n\n\n

To begin the data\nanalysis process, the transcriptions were deidentified before being sent to the\nother two members of the data analysis team. \nThe CQR approach specific to the code team included: 1) identifying\ninitial code domains; 2) extracting core ideas from each domain; 3)\ncross-analysis of multiple participant interviews to create a code book; and 4)\nestablishing the frequency of data presented in the determined categories.(15,16,17).\nThe three members (AAA, BBB, and DDD) of the data analysis team met to review\nfour participant interviews to discuss\nemerging concepts. Once the domains were agreed upon the initial codebook was\ncreated. Following that initial code book, the data analysis team coded the\nfirst four transcripts independently and assigned the data to the domain as\nthey saw fit. The data analysis team met again to discuss the four transcripts\nand edit the codebook based on findings to reach a consensus on the core ideas.\nWe used an external auditor (CCC) who is a qualitative researcher to verify the\ninterpretation made by the three researchers. The roles and experience of the\ndata analysis team are detailed in Table 3. <\/p>\n\n\n\n

Table 3.<\/strong> The Roles and Experience of the Research Team <\/p>\n\n\n\n\n\n \n \n \n
Researcher<\/strong><\/td>\n (AAA)<\/strong><\/td>\n (BBB)<\/strong><\/td>\n (CCC)<\/strong><\/td>\n (DDD)<\/strong><\/td>\n <\/tr>\n
Role<\/td>\n Principal investigator; Data analysis team member<\/td>\n Data analysis team member<\/td>\n External reviewer<\/td>\n Data analysis team member; Senior investigator<\/td>\n <\/tr>\n
Research Experience<\/td>\n Novice qualitative researcher<\/td>\n Experienced qualitative research<\/td>\n Expert qualitative researcher<\/td>\n Expert qualitative researcher<\/td>\n <\/tr>\n<\/tbody>\n<\/table>\n\n\n\n

The cross-analysis comprised of putting\nall the categories into separate documents. Which was then followed by\ndistinguishing those categories into a frequency count. The transcripts were\nindividually reviewed for each category and counted for frequency counts of\nappearance. Trustworthiness was established using a 3-person data analysis team\ncombined with a multi-phase process to identify emerging domains, categories,\nand core ideas. The domains and categories were then discussed collaboratively\nto minimize the potential of individual researcher bias with the use of an\nexternal audit. The data trustworthiness was also established using peer\nreview.<\/p>\n\n\n\n

RESULTS<\/strong><\/p>\n\n\n\n

Three primary\ndomains emerged from the interviews: (1): job attractors, (2) feeling valued,\nand (3) characteristics of the workplace environment (Figure 1). During the\ncoding process and external review, we determined the need to supplement the\nworkplace environment domain with sub-categories. Additionally, the CQR process places frequency labels on the domains and\ncategories that was established from the number of interviews (n=18) with general <\/em>labeled as a category that\nappeared in all (n=18) or but one (n=17), typical\n<\/em>labeled as a category that appeared in more than half (n=9) but less than\n17 transcripts, variant<\/em> labeled if\nthe category appeared between 2 to 9 of the transcripts, and rare <\/em>labeled if the category appeared 2\nor less times in the transcripts.(15,16,17) Table 4 provides a frequency count of\nthe coded data per interview transcript that allowed each participant to be\ncounted per domain and\/or category.  <\/p>\n\n\n\n

Figure 1. <\/strong>Domains and Themes<\/p>\n\n\n\n

\"Figure<\/figure>\n\n\n\n

Table 4<\/strong>. Participant Cases by Category (n=18)<\/p>\n\n\n\n\n\n \n \n \n \n \n \n \n \n \n
Domains, Categories, and Subcategories<\/strong><\/td>\n Frequency*<\/strong><\/td>\n No. of Participant Cases<\/strong><\/td>\n <\/tr>\n
Job Attractors<\/u><\/strong><\/td>\n <\/tr>\n
Elite Athlete
\n Coworker Relationship\/Support
\n Network
\n Access<\/td>\n 		Variant
\n Typical
\n Typical
\n Typical<\/td>\n 		7\/18
\n 17\/18
\n 15\/18
\n 9\/18<\/td>\n <\/tr>\n
Feeling Valued<\/u><\/strong><\/td>\n <\/tr>\n
Increased Responsibilities
\n Compensation and Recognition
\n Trusting Relationships with Patients
\n Loyalty<\/strong><\/td>\n 		Typical
\n Typical
\n Typical
\n Typical<\/td>\n 		11\/18
\n 18\/18
\n 15\/18
\n 12\/18<\/td>\n <\/tr>\n
Characteristic of The Workplace Environment<\/u><\/strong><\/td>\n <\/tr>\n
Sacrificing personally
\n Time<\/em>
\n Travel<\/em>
\n Family<\/strong><\/em><\/td>\n
\n General
\n Variant
\n Typical<\/td>\n
\n 18\/18
\n 8\/18
\n 11\/18<\/td>\n <\/tr>\n
Sacrificing Professionally
\n Promotion<\/em>
\n Progression<\/em><\/td>\n
\n\t\tTypical
\n\t\tTypical<\/td>\n\t
\n\t\t14\/18
\n\t\t14\/18<\/td>\n <\/tr>\n
Sacrificing Professionalism
\n Inappropriate Behavior<\/em>
\n Coworker Tension<\/em>
\n Sub-culture of Acceptance<\/em>
\n Cultural Differences<\/strong><\/em><\/td>\n
\n Variant
\n Typical
\n Typical
\n Variant<\/td>\n
\n 6\/18
\n 15\/18
\n 17\/18
\n 5\/18<\/td>\n <\/tr>\n<\/tbody>\n<\/table>\n\n\n\n

*General 18\/18; Typical 9\/18; Variant < 2 < 9; Rare \u00b3 2<\/p>\n\n\n\n

Job Attractors<\/strong><\/p>\n\n\n\n

We identified that\nparticipants were attracted to working with elite athletes, having supportive\ncoworker relationships, having a network of athletic trainers and mentors from\nthe PSS community, and having increased access to resources and education due\nto their position. The participants identified that it is important to foster\nstrong relationships so that everyone can achieve a common goal within the\norganization. Everyone under the medical team has a vision to provide the best\nquality health care for their athletes, being surrounded by forward thinkers,\nintelligent people, and clinicians of varying backgrounds and experiences, as\nwell as winning games. The participants in this study were just as inclined as\nthe athletes to pursue post-season play offs and hopefully a championship\ntitle. Furthermore, the participants were more willing to stay if the\norganization and the people who worked in it upheld a high quality of patient\ncare, coworker relationships, and professional development. Supporting quotes\nfrom each of the categories including elite\nathlete, coworker relationships, network, <\/em>and access<\/em> are available in Table 5. <\/p>\n\n\n\n

Table 5.<\/strong> Supporting Quotes for the Job Attractors Domain and Category<\/p>\n\n\n\n\n \n \n \n \n \n \n
DOMAIN<\/strong><\/td>\n CATEGORY<\/strong><\/td>\n SUPPORTING QUOTES<\/strong><\/td>\n <\/tr>\n
Job Attractors<\/td>\n Elite Athletes<\/td>\n
    \n
  • \u201cI love it because I get paid to watch NHL games, the players really. We have elite level athletes competing at the top of their game\u2026\u201d \u2013 Kayden <\/li>\n
  • \u201cThey’re motivated to stay healthy [and] get better. Basketball is their job and so if they are hurt, it is their job to come in and do rehab. Their livelihood depends on it. So they have an extra level of motivation.\u201d \u2013 Jean <\/li>\n <\/ul><\/td>\n <\/tr>\n
Coworker Relationships<\/td>\n
    \n
  • \u201c\u2026the relationships and the people that you work with\u2026 I think that’s what makes my job most enjoyable. It’s really working with good people that are go getters and forward thinkers like myself\u2026[we] found a way to collaborate with each other and work together. I think when someone has that forte that they’re very good at. We need to let them run with it. I think when someone has a weakness as well, we need to rely on our other colleagues that may have a strength in that and run with that as well.\u201d \u2013 Christopher<\/li>\n
  • \u201cYou know bouncing ideas off each other, someone [may do something] a little bit different than someone else [and you] learn from each other. I think all veteran staff in our organization, are very involved in the development of the younger staff. The medical coordinator puts on a professional development [in-service]; a hands-on type of environment.\u201d \u2013 Johnathan <\/li>\n <\/ul><\/td>\n <\/tr>\n
Network<\/td>\n
    \n
  • \u201c\u2026if we hear of a new product\u2026across the board in the NFL, we do a really good job of sharing information and having everyone at least be on the same playing field in terms of information\u2026\u201d \u2013 Charlie<\/li>\n
  • \u201cI think in order to be successful you have to rely on certain people in the profession or even outside of the profession. From a clinical standpoint or from a leadership standpoint or even from a support standpoint. My mentorships come in different directions. Those that have been in the profession of a major league baseball that I see as a mentor certainly early in my career\u2026I utilize him quite a bit from decision making, future plans from recommendation, from how he’s done things in the past. And then there is always the one that’s from a clinical standpoint to reach out to that you see as making you better as clinician so that individual, I know I can reach out to with case studies or difficult situations.\u201d \u2013 Kane <\/li>\n <\/ul><\/td>\n <\/tr>\n
Access<\/td>\n
    \n
  • \u201c\u2026forces us to continue to maintain a high level of education. I’m continuing every single day to try to find the newest thing that’s coming out\u2026as a department [we] pride ourselves in being aggressive and progressive and so anything and everything that comes out that’s new, we’ve tried it\u2026That’s my favorite part about this [setting] is having the access and ability to do just about anything.\u201d \u2013 Charlie <\/li>\n
  • \u201cA lot of our continuing education or in services during the off season\u2026 [as well as] receiv[ing] advance preparation, to use services and [conduct] in services. I do a lot of talks in the off season.\u201d \u2013 Kane <\/li>\n <\/ul><\/td>\n <\/tr>\n<\/tbody>\n<\/table>\n\n\n\n

    Feeling Valued<\/strong><\/p>\n\n\n\n

    Participants\nreported feeling valued by employers through increasing professional\nresponsibilities within their current position and increasing compensation or\nrecognition. They also discussed having trusting relationships with their\npatients that made them feel valued within their respective organizations. This\nstudies participants stated that the time spent to get into their roles takes\nnumerous years and personal dedication, almost guaranteeing a slow promotion,\nwhich results in the participants being satisfied with an increase in\nresponsibilities. The participants revealed they were being recognized with\nawards within their organization or league, both as a medical staff or an\nindividual. The PSS athletic trainers were largely satisfied with their\nsalaries and stated that shortly after annual performance evaluations, they\nexperienced an increase in salary or were awarded another contract. However,\nthe athletic trainers also stated that even though they are pleased with their\nsalaries they feel that they should earn a higher salary when compared to\ncoaches and athletes. Supporting quotes from each of the categories including increased responsibilities, compensation and\nrecognition, trusting relationships with patients, <\/em>and loyalty <\/em>are available in Table 6. <\/p>\n\n\n\n

    Table 6.<\/strong> Supporting Quotes for the Feeling Valued Domain and Category <\/p>\n\n\n\n\n\n \n \n \n \n \n
    DOMAIN<\/strong><\/td>\n CATEGORY<\/strong><\/td>\n SUPPORTING QUOTES<\/strong><\/td>\n <\/tr>\n
    Feeling Valued<\/td>\n Compensation and recognition<\/td>\n
      \n
    • \u201c\u2026[My organization] take[s] care of us they will fly our family out to visit you one time \u2026 ensure that you get a little break where you can see your family\u2026minimally they have at least throughout the seasons been able to give raises. These are based on monetary inflation or through improvement of promotions. Or even trying to even a level the playing field of trying to be more on the line of competitive [salaries] with other organizations and how they pay [their athletic] trainers, as well as,] pay player development staff. [My organization offers a] fairly decent benefits and retirement package. So that’s one way they really try and take care of us and they really try and put us first in that regard\u2026they’ve given bonuses for those who have worked extra camps here or there. They understand that beyond the standard contract job, even though this is part of the contract, if you’re asked upon the work this, they understand that it is another time [commitment] they take you away from your family. [So to respect the time the organization is] going to do monetary, compensate you a little bit. [Furthermore,] if the organization\u2026is successful [and] makes playoffs because that in essence is successful\u2026Oftentimes it will be a winter bonus depending on how the year goes\u2026but not always\u2026I know our directors have always tried to recognize those who have been doing a lot\u2026I’ve found my organization is competitive\u2026more money never hurts the situation all the time. And could often, depending on a certain amount, you know, lead to a possibly nicer family life in essence of allowing one spouse not to work if they wanted to.\u201d \u2013 Maverick<\/li>\n
    • \u201c\u2026Maybe instead of just having a one-year contract offer or a two year to your deal, maybe you start getting to that three or four year raised contract that provides a sense of financial security\u2026 [however,] even though you reach that spot where there’s maybe no more growth upwardly because you’ve already reached that top level [position]. There’s always room to go upwards financially\u2026\u201d \u2013 Corey <\/li>\n <\/ul><\/td>\n <\/tr>\n
    Trusting Relationships with Patients<\/td>\n
      \n
    • \u201cSome interactions with my players [pertain to my knowledge within the] athletic training profession [and we] discuss an injury that happens on the field. [However, if a] player has a question about nutrition. We have a nutritionist that they can contact and making sure that they have the advice that they need. There is also the social aspect like being in the dugout and just getting along with players, getting to know players, and getting a better understanding their mental status. Or just developing a great relationship with the player. At the rookie level, there’s a lot of different cultures, especially in a Latin American community. I interacted with a large amount of Dominican Republic players, Venezuela. So knowing the Spanish language as well as different cultural aspects of their background is always helpful. I think that players kind of respect that. Players can see and discuss certain things it creates more of a relationship with them.\u201d \u2013 Johnathan <\/li>\n
    • \u201cI interact at least daily with every patient a few times a day…I think it’s important for us to interact with our patients. Just as people. To see how they’re doing\u2026If we don’t have that relationship, then there is no trust, if there is no trust, then we are no good to them\u2026I believe no one cares of how much you know until they know how much you care. And because that is the case we need to understand who our athletes are as people first\u2026 When they know you have a vested interest in them and you treat them as if they were your family member.\u201d \u2013 Christopher<\/li>\n
    • \u201c\u2026we’re interacting on a daily basis in season. [Some] interactions are in person [during the] season [they are] face to face\u2026there’s also interactions\u2026 either by phone call or text message\u2026 the nature of those interactions I would say are\u202695 percent professional in respects to, related to injuries, their participation level or anything kind of on the medical side. The five percent is checking in on them or their families kind of in more of a personal manner.\u201d \u2013 Jean <\/li>\n <\/ul><\/td>\n <\/tr>\n
    Increased Responsibilities<\/td>\n
      \n
    • \u201cThere’s an opportunity to oversee both sports medicine and strength and conditioning\u2026 we could [look] more globally because we know what goes on between equipment managing and strength and conditioning, sports medicine and nutrition, support side, we have an opportunity to serve in the assistant general manager role where we would be in charge of player health or in charge of performance…\u201d \u2013 Christopher<\/li>\n <\/ul><\/td>\n <\/tr>\n
    Loyalty<\/td>\n
      \n
    • \u201cPeople want to work here. People want to stay within the organization because they know what we have here is a very, very good thing. There’s definitely the potential for promotion because a lot of our athletic trainers are qualified and could easily go to other organizations and work at higher levels and do so. I would say that the positives outweigh that. I mean, you wouldn’t want to work in a place where you’re constantly looking over your shoulder. Your job’s in jeopardy if you make a mistake or something like that, dealing with players that are worth millions and millions of dollars on your team. You want to know that you have supporters It’s good to work in a family-oriented organization [instead of a] nasty professional athletic business.\u201d \u2013 Edward <\/li>\n
    • \u201cI know that my organization would be happy to give [another organization] permission to speak with me. They know what my ultimate goal is\u2026\u201d \u2013 Kane <\/li>\n
    • \u201cI got a phone call from my boss, Orthopedic Group saying that they had found out that the team was going with another medical company and mentioned if I wanted to pursue staying with the team, they totally understand that even if it means me leaving the company\u2026\u201d \u2013 Everett <\/li>\n <\/ul><\/td>\n <\/tr>\n<\/tbody>\n<\/table>\n\n\n\n

      Characteristics of the Workplace\nEnvironment  <\/strong><\/p>\n\n\n\n

      Finally, the third\ndomain described by the participants was characteristics of the workplace\nenvironment. Overall, the participants were positive.  However, they also acknowledged that they\nmade sacrifices to acquire and retain their current positions, including a high\ntime commitment to the job and regular travel expectations, family compromises,\nfewer opportunities for promotion, and a long period to progress to their\ncurrent position. They also described situations where inappropriate behaviors\nhad been exhibited (e.g. patients in the athletic training facility in a towel\nor naked, offensive language) and a sub-culture of acceptance for behaviors\nthat would otherwise be unacceptable (e.g. job duties outside the realm of\nhealthcare, banter that would be otherwise unacceptable in a healthcare\nfacility).  Participants detailed common\ncoworker tensions related to miscommunication and coworker conflict, and\ndescribed challenges related to providing care to non-native language speakers.\nSupporting quotes from each of the categories including sacrificing personally, sacrificing professionally, <\/em>and sacrificing professionalism <\/em>are\navailable in Table 7.<\/p>\n\n\n\n

      Table 7.<\/strong> Supporting Quotes for the Characteristics of the Workplace Environment Domain and Category<\/p>\n\n\n\n\n\n \n \n \n \n
      DOMAIN<\/strong><\/td>\n CATEGORY<\/strong><\/td>\n SUPPORTING QUOTES<\/strong><\/td>\n <\/tr>\n
      Characteristic of The Workplace Environment<\/td>\n Sacrificing Personally\n  <\/td>\n
        \n
      • \u201cIt’s a grind\u2026Half of a season away from home or your home base if you don’t live in that town all year\u2026So my body finally breaks down because it’s a grind riding on buses all the time, sleeping in hotels, lugging hockey gear, all that kind of stuff.\u201d \u2013 Kyle<\/li>\n
      • \u201cBecause you have to have friends and family who understand that you’re going to miss things and\u2026don’t hold that against you and support you and give you those opportunities to succeed. Because if they’re draining on you and your personal life\u2026then that’s when the burnout occurs\u2026It occurs because there may not be a good support system personally.\u201d \u2013 Edward <\/li>\n
      • \u201cI got married and my wife was pregnant and I always thought that I could get back into baseball when my kids were a little bit older, but I could never see them grow up again\u2026I left affiliate [baseball] after seven years [and] I took a job at a high school to give myself a little bit more consistent hours and the availability to be home more often… baseball season\u2026 I’m rarely home for dinner, I travel often, basically two weeks out of every month for six months\u2026\u201d \u2013 Glenn<\/li>\n
      • \u201c\u2026 I’ve limited myself in [promotional sacrifices] capacity as well. Being that I’ve wanted to stay closer to my family. I have passed up, promotions that would have put me across country or made it more difficult for me to see my family at times.\u201d \u2013 Maverick <\/li>\n <\/ul><\/td>\n <\/tr>\n
      Sacrificing Professionally<\/td>\n
        \n
      • \u201cI\u2019m the head athletic trainer right now. In my field there’s really not going to be anything else available within our organization. I’m okay with that\u2026I’ve done this for 23 years with this team and things are going good so I think I’m just going to keep the run going and try to get maybe 10 more years out of it. Then that’ll be it.\u201d \u2013 Trent<\/li>\n
      • \u201cI did a five-month internship with the [said] organization and the rookie ball level\u2026from there I spent the next 13 years in professional baseball at the minor league level\u2026and then I just concluded my first year as the head athletic trainer.\u201d \u2013 Corey <\/li>\n <\/ul><\/td>\n <\/tr>\n
      Sacrificing Professionalism<\/td>\n
        \n
      • \u201cIt’s hard to say how much is genuine and how much is it actual truthful or how much of it [is] horseplay. When you work in an environment of men from the ages of 23 to 35 [with a lot of] strong Alpha male mentality [there is going to be] a lot of joking around\u2026[I do not think that I have] ever once felt that I was being strictly derogatory or offensive genuinely\u2026there’s [going to] be some type of hazing or some type of rule\u2026[however,] it’s definitely been decreased a lot lately since 2016 when Major League baseball implement[ed] that rule of no hazing or bullying policy.\u201d \u2013 Kane <\/li>\n
      • \u201cI have a feeling if you asked a female athletic trainer in my same position, they might have a different answer…I feel like for a female to be in a professional sport setting is a lot more difficult than it is for me and it’s been a barrier for female athletic trainers as far as getting into baseball, football, basketball, but you see that changing\u2026I think they’re asked to be a little bit more understanding [of the culture of the game and] that it’s different.\u201d \u2013 Glenn<\/li>\n
      • \u201c\u2026there’s always cultural difficulties\u2026people from different countries that are not used to [the Western Medicine] healthcare system, whether it be an insurance difficulty, they don’t understand that they’re going to have to pay for things or why they have to do all these things first rather than get an MRI just right away. Or it could be a communication issue\u2026there’s always things to navigate, language barrier, sometimes it’s a style of treatment\u2026a lot of athletes are more familiar with physiotherapists and they’re mostly manual therapy and rehab based and not so much preventative.\u201d \u2013 Beverly <\/li>\n
      • \u201cThe toughest part\u2026 you’re not only the athletic trainer, but you’re also kind of a road secretary and travel secretary. A lot of your responsibilities lie outside the realm of athletic training\u2026 you’re making hotel reservations, bus reservations, flight reservations. You’re handling baggage stuff for flights, you control player transfers. You’ll get calls from the operations director to have a player fly from one city to another or you’re getting another player and you need to work out picking them up.\u201d \u2013 Glenn<\/li>\n <\/ul><\/td>\n <\/tr>\n<\/tbody>\n<\/table>\n\n\n\n

        DISCUSSION<\/strong><\/p>\n\n\n\n

        Athletic trainers\nhave been known to take on many roles and responsibilities related to their\njobs as healthcare providers.(40,41)\nHowever, the additional roles and job requirements may contribute to the role\nstrain commonly cited in the PSS.(40,41)\nRole strain can cause a decrease in job satisfaction and performance which may\nlead to retention concerns, as well as burnout.(29,30)\nThe NATA has published a Position Statement on facilitating work-life balance\nin athletic training to provide guidance for athletic trainers to successfully\nmanage job stressors.(30)\nThe findings for the study confirmed the stressors, but also helped to\nappreciate why athletic trainers in the PSS are willing to continue working in\nthe setting regardless of the various strains. <\/p>\n\n\n\n

        Job Attractors <\/strong><\/p>\n\n\n\n

        The participants\nin this study noted numerous reasons for being attracted to working in the PSS\nincluding working with elite athletes, coworker relationships and support,\nnetwork, and access to professional development. Additionally, they stated\npersonal enjoyment while working with highly motivated individuals who were determined\nto return to sport. The participants stated that being able to partake in the\nculture and establish relationships with their patients is what made the work\nplace exciting and fun to come to everyday. The study findings are similar to\nprevious research that identified the creation of a supportive work environment\nhelps to foster work-life balance.(26,27,28,30,36,37)\nAs a result, there has been a decrease in athletic trainers that leave their\npositions who work within the collegiate setting(11)\nand we found this to be similar with the PSS.  <\/p>\n\n\n\n

        Previous research\nidentified that athletic trainers in the PSS stressed the importance of having\nmentors from within and outside the PSS to help decrease role strain and\nacclimate the athletic trainer to the profession by providing on the job\nlearning and guidance.(30)\nThis study revealed that participants stated that in PSS they value the family\nbond that is created over the duration of the season and years spent with these\nindividuals. Specifically, the role of the mentor provided them advice on\nhandling situations that may arise during the season or their career. Informal\nand formal workplace mentors should be considered during the onboarding process\nin the PSS. <\/p>\n\n\n\n

        The participants\nalso mentioned they obtained their positions within the PSS due to the\nconnections they had with those already working in the profession. Literature\nshows that networking behaviors lead to job satisfaction and commitment.  However, networking is different between male\nand females. When networking is explored between female and males; females\npositively relate job satisfaction to professional networking, males positively\nrelate job satisfaction to peer networking. \nFurthermore, based on these methods males are more inclined to encourage\nstrength, independence, competitiveness, task oriented, goal oriented and\nget-to-business; while females are more likely to along with a nurturing,\nrelational, sensitivity to others, and building a relationship.<\/p>\n\n\n\n

        Most athletic\ntrainers described that organizations throughout the PSS provided feedback\nthroughout the season or at least at the end of the season. Feedback has been\ndescribed as one of the most important characteristics to improving clinical\nperformance.(25)\nDuring the off season is when most athletic trainers were provided professional\ndevelopment opportunities through in service educational, national conferences,\nthe specific sport conference (PBATS, NBATA, PFATS, or PSATS), and attending\nany other interesting continuing educational opportunities. Most athletic\ntrainers in our study described having an unlimited or easy access to the newest\ncutting-edge modalities because their budgets afforded them. There is lack of\nresearch on the resourcing of organizations; a lack of healthcare resources can\nnegatively influence patient outcomes, but there lacks research on over\nresourcing to state it leads to the implementation of best practice standards\nand how it influences the clinical philosophy of the clinician.(22,44)\n<\/p>\n\n\n\n

        However,\nliterature otherwise states that there is often an inaccessibility to\ncontinuing education units (CEU) due to location, employers unaware of the CEU\nneeds, family commitment restricts flexibility and availability, staffing\nshortages, or even having to self-fund or partially pay for CEU.(9,18,34,35,43)\nThe MLR organization was the only PSS that had complained of access to\nmodalities due to not having the budget or lack of space.(32)\nHowever, this was one athletic trainer and may not be the same for all athletic\ntrainers within the league. However, with it being a new sport within the\nUnited States, the growth within the league is promising as stated from the\nathletic trainer and with that comes more money and more opportunities.<\/p>\n\n\n\n

        Feeling Valued<\/strong><\/p>\n\n\n\n

        In order for\ncompanies to have successful goals and interest that will drive employees, it\nis important to define and measure value. Value is essential to understanding\nthe performance of any organization and driving continuous quality improvement.(38)\nAn athletic trainer may assess his or her value through respect, importance,\nworth, and usefulness of the athletic trainer in a particular position,\norganization, or setting.(30,31)\nOur research aligns with previous literature which shows how work-family\nconflict can be additional stress which can reduce psychological and physical\nwellbeing.(5)\nThe athletic trainers described that organizations that had an invested\ninterest in them, as well as had a family-oriented atmosphere, made them more\ninclined to stay with the organization.(24)\nFurthermore, the job expectations of athletic trainers and other healthcare\nproviders with increased responsibilities and or demands of the job, emotional\ninvolvement with the workplace, as well as, inflexible requirements(30)\nare all responsible for retention rates within the athletic training\nprofession. <\/p>\n\n\n\n

        Athletic trainers\npreferred to have supervisors that would advocate for them, provide\nrecognition, allow for some degree of autonomy in the work place and not be\nmicromanaged.(10)\nLiterature supports that athletic trainers like to be respected and recognized\nfor their skills and contributions to their organization and patients.(30)\nParticipants in our research agreed that promotions or advancements had\nfavorable effects on job satisfaction, organizational commitment, and\nintentions for staying.(39)\nRetention rates have been researched and shows that keeping employees happy\nrequires the company to offer work-life balance, organizational commitment,\ndevelopmental programs, appropriate salaries, career advancement opportunities,\ntangible rewards and high-quality leadership.(6,21)\nThose who stay in the place of employment but are not satisfied with their\nposition explain the reasons why they stay are because they are too old to\nstart over, financially dependent on the companies benefit program, have family\nresponsibilities, working to make ends meet and cannot risk seeking a new job,\nand or the company has been good to them, and they do not believe in leaving\nthe organization. Our participants either had the right social support, respect\nand loyalty from their employer or they decided that it was too much on their\npersonal life and left the PSS.<\/p>\n\n\n\n

        Our research\nrevealed that our participants across all PSS agreed that having a personal and\nprofessional relationship with their patients was important in gaining their\ntrust.(13)\nIn healthcare, there are two components to patient-clinician relationships: 1)\nthe emotional care that can include mutual trust, empathy, respect,\ngenuineness, acceptance and warmth and 2) the cognitive care which includes\ninformation gathering, sharing medical information, patient education, and\nexpectation of the management of care.(23)\nFurthermore, honesty and genuineness to earn the athletes\u2019 trust was also\nimportant to building the clinicians reputation and relationship.(1,2)\nAthletic trainers are in a unique position that affords them the ability to\ncreate trusting relationships that other health care providers may not have\nbecause they do not have daily patient interactions. However, patients describe\nthat having a clinician that shows compassion, engagement, and a caring\nrelationship provide healing, hope, and strength during vulnerable situations.\nThe ability to be easily accessed by their athletes allowed for our\nparticipants to have check-ups with their patients in the comfort of their\nlocation. Having the capability to perform telemedicine efforts allows for\nefficient and quick access to healthcare for a flow of communication, however\nit will lack the hands on portion of the interaction as well as full\nobservational access.<\/p>\n\n\n\n

        Nonetheless in the\nPSS, athletic trainers and athletes have the ability to interact daily\nallotting a special relationship that exists where the athletic trainer is\nviewed as safe, approachable, care-taking individuals and feel comfortable\ndisclosing personal information.(33)\nFurthermore, the athletic trainer shows an invested genuine interest in the\nathlete. Some of the participants in our study discussed having both\nprofessional and personal relationships with their athletes which included\ngoing out to eat or going to the movies. While outside the scope of this study,\nwe recommend that that employees in the PCC review human resource policies\nrelated to workplace relationships to ensure they are protecting themselves\nlegally and ethically. <\/p>\n\n\n\n

        Characteristics of the Workplace Environment <\/strong><\/p>\n\n\n\n

        Americans are\nshowing an increased interest in obtaining work-life balance. The work place\nenvironment looks into the personal, professional and professionalism\nsacrifices that athletic trainers are making in the PSS. However, healthcare\nproviders have a natural tendency to work more than 40 hours a week, especially\nathletic trainers.(30)\nOur study is consistent with previous literature that athletic trainers are\nworking 80 hours or more,(30)\n10 to 14 hour days, during the season and more \u201cregular\u201d 40 to 50 hour days in\nthe offseason. Additionally, these subtleties with organizational\nfactors of long working hours, work schedules, and job dynamics such as travel\nand flexibility were commonly seen as added stressors with participants in our\nresearch as well as previous literature.(3,7)\n<\/p>\n\n\n\n

        Work-life balance\nis defined as the individual\u2019s ability to successfully balance work, personal,\nand family roles happily.(12)\nThe work-life balance can be seen as a benefit or a unfavorable consequence which\nis why it is separated into work-family balance; being positive outlooks, and\nwork-family conflicts; being negative outlooks. The underlying causes to\nwork-life conflicts include employee schedule, hours worked, and job demands.\nHowever, athletic trainers in each PSS, depending which level in the\norganization, should expect varying demands and roles expectations.\nParticipants identified that off-season duties consisted of checking in with\nathletes, working with long term rehabs, working camps, working winter ball\nleagues (MLB athletic trainers), and finally getting some down time to\nrecuperate and spend time with family and friends. Athletic trainers may\nperceive that because the profession has always been this way that they need to\nbe available and present 24 hours per day, 7 days a week.(30)\nDespite the long hours spent at work, the athletic trainers were happy working\nwithin the PSS. Recent literature on athletic trainers working in the PSS\nstated that regardless of the average in-season workweek of more than 70 hours,\nthey accepted the workload, associated stress that was placed on them due to\ncompeting demands of the job, and the added non-athletic training duties; they\nwere willing to stay working in the setting.(26)<\/p>\n\n\n\n

        Furthermore,athletic trainers described that\ntraveling was tedious and that it can cause them to become sluggish. The\nextreme time and travel loads that are expected of an athletic trainer pose\nchallenges to performing everyday job responsibilities while allocating time\nfor leisure and family.(30)\nHowever, athletic trainers showed gratitude for the excessive traveling as well\nstating that they would never otherwise visit a majority of destinations if it\nwere not for working in the PSS.The\ntime spent traveling conversely means theathletic trainers reported having a strong family support was really\nimportant to their success in working in the PSS and the fact their family\nunderstood the demands the job required of their time. However, the athletic\ntrainers are accept the mentality that missing family functions and holidays is\nan unwritten expectation in their respective setting. Those who respectively\nsaw family as more important than work or did not have the right family support\nleft the PSS. <\/p>\n\n\n\n

        Athletic trainers\nstated that when the organization shows loyalty to their employees the\npromotion process is even slower because people do not want to leave the\norganization. It was even stated that once an athletic trainer finally obtains\nthe top of the totem pole position that they stay as long as possible which makes\npromotion for those lower on the hierarchy chain harder to attain promotions.\nAthletic trainers in the PSS described promotion as a long process because they\neither wait for someone to get fired, quit, or retire. The same promotional\nadvancements up the hierarchy chain is also seen in NCAA Division 1 settings,\nwhich pose for athletic trainers seeking other job opportunities or retiring.(30)\nThe athletic trainers within the WNBA and MLR stated that with the growth of\ntheir settings they hope to have opportunity for promotions. A majority of our\nparticipants had a similar progression of undergraduate and then graduate\nathletic training programs before obtaining internships or positions within the\nPSS. The progression was cited to be slower for MLB athletic trainers as they\nhad to experience an internship first then affiliate ball within one of the six\naffiliate leagues prior to bring promoted to the MLB. MLS athletic trainers\nstated having somewhat of a similar progression with internships, academy\nteams, NASL, and MLS. Then the NFL athletic trainers stating having to complete\ninternships first. Regardless of the sport setting, the athletic trainers were\nslow to progress due to the lack of available positions within the PSS.<\/p>\n\n\n\n

        The participants\ncommented that verbal harassment was being witnessed within their settings. The\nfemale participants experienced comments that they could not do certain\nactivities or job duties because they were a female or not strong enough,\nhaving inappropriate comments said to them, or athletes and or coaches going to\nother staff members who were below them just because they were a female. These\nbarriers for female athletic trainers have been associated with gender equity\nand work-life balance challenges, particularly those in the Division 1 setting.(11)\nAthletic trainers in the PSS setting may be responsible for interrole conflict;\nwhich is defined as \u201ca situation in which a role occupant simultaneously has\nmore than one role and the demands of one role conflict with the demands of\nanother role;\u201d due to the health care provider roles and non-athletic training\nduties.(14,26)\nOur participants stated that having added responsibilities that are outside\ntheir role as an athletic trainer which included handling meal money, hotel rooming\nlists and arrangements, scheduling bus or plane times, transporting players,\ncoordinating player transfers, pre\/post-game meal(s), and even cleaning laundry\nor performing equipment duties. <\/p>\n\n\n\n

        The majority of the\nPSS have an intimate setting that is in close corridors. In some of the\nsettings, the locker room and athletic training facility are in the same room.\nThe players are often walking through shirtless, just in their underwear, or\nwalking in a towel and that is just normal of the setting. Most athletic\ntrainers stated that they have become numb to cursing and some forms of verbal\nharassment and state that it is due to the unique setting. However, some of\norganizations have a fining system in place if they fall out of line of the\norganizations standard. Bullying and \u201crookie\u201d hazing of both athletes and the\nmedical staff was often mistaken as friendly banter and taking things light\nhearted. However, in 2016 the MLB specifically cracked down and implemented and\nanti-hazing and anti-bullying policy. It is vital that all athletic trainers,\nbut those specifically in the PSS, have access to and have read their\norganizational policies related to anti-hazing and anti-bullying while also\nbeing mindful of hostile work environment labor laws in the United States that\nprotect all employees from discriminatory behaviors or comments that make it\ndifficult or unwelcoming to work. <\/p>\n\n\n\n

        In the PSS there\nare varying nationalities, ethnicities, and cultures that are all housed under\nthe same roof.  Athletic trainer\u2019s\ndiscussed having a challenging time communicating with their athletes if they\ndid not speak the same language. However, communication was more accessible\nwith an improved connection for those athletic trainers that were bilingual\nprimarily in speaking English and Spanish. The athletic trainers struggled to\nexplain medical care differences between western techniques and those of other\ncountries of their athletes. The athletes from other countries did not\nunderstand the process of the western medicine, insurance issues, or the steps\nneeded to receive diagnostic imaging. Overall, each sport setting saw the\nimportance of fostering an environment where everyone, regardless of cultural\ndifferences, could feel comfortable. <\/strong>Communication\namongst health care providers and patients that relate to culture-related\ncommunication issues involved similarities seen in our study; cultural\ndifferences in the treatments of health and illness, varying cultural values,\nand linguistic barriers.(42)<\/p>\n\n\n\n

        CONCLUSIONS<\/strong><\/p>\n\n\n\n

        Athletic trainers in the PSS feel valued\nfor their work despite the long hours, family and promotional sacrifices. The\nwork environment, as cited by our participants, created positive coworker interactions,\nmutual loyalty, and access to resources is what continues to attract them to\nthis setting. Positive coworker\nenvironments and access to resources continue to attract athletic trainers to the\nPSS. Despite feeling valued, some athletic trainers in PSS reported leaving the\nprofession altogether because they regarded family time more than the time\nspent at work. A sub-culture of accepting inappropriate workplace behavior\nwithin the PSS should be further explored.  \n<\/p>\n\n\n\n

        APPLICATION IN SPORT<\/strong><\/p>\n\n\n\n

        Our study had\nthree female participants, which is consistent with the representation of\nfemales employed in the setting itself. During the interviews, male\nparticipants expressed that their responses may have been different if they\nwere a female in the PSS or had female coworkers in the PSS. This finding was\nespecially evident during the workplace environment questions. The\nparticipants, of both genders, expressed numerous times that inappropriate\nbehavior was deemed acceptable in the PSS. As such, professional sports\nadministration including executive management and human resources should collaborate\nwith the medical staff, specifically the athletic trainers, to create inclusive\nworkplace environments, which will likely improve the talent acquisition and employee\nretention for those healthcare providers. Lastly, athletic trainers should be\nproactive in navigating the workplace to improve career longevity and work-life\nintegration within this job setting. Specifically, athletic trainer should gain\nconfidence in immediately addressing and reporting inappropriate behaviors in\nthe workplace, because of the potential impact it has on other patients, not\njust other healthcare providers. We suggest exploring mindfulness and self-help\napplications, connecting with human resource personnel before an incident occurs\nto establish workplace boundaries, and negotiating their roles and\nresponsibilities that afford career advancement and continued positive\ninteractions. <\/p>\n\n\n\n

        ACKNOWLEDGEMENTS<\/strong><\/p>\n\n\n\n

        None<\/p>\n\n\n\n

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          Authors: Katelyn A. 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Weidner. 1* Sport Studies, Department of Kinesiology and Nutrition,\u00a0University of Illinois at Chicago Abstract There has been considerable increase in the number of participants running marathons between 1990 and 2014 with the majority of runners between 23-54 years of age (Running USA, 2015).\u2026","rel":"","context":"In "Contemporary Sports Issues"","img":{"alt_text":"fig1","src":"https:\/\/i0.wp.com\/thesportjournal.org\/wp-content\/uploads\/2015\/06\/fig11.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":8414,"url":"https:\/\/thesportjournal.org\/article\/rowing-performance-following-a-single-teaching-session-in-school-children\/","url_meta":{"origin":6824,"position":2},"title":"Rowing Performance Following a Single Teaching Session in School Children","date":"November 25, 2022","format":false,"excerpt":"Authors: Giovanni Ficarra1, Fabio Trimarchi1, Alessandra Bitto2, Debora Di Mauro1 1Department of Biomedical and Dental Sciences and Morphological and Functional Sciences, 2Department of Clinical and Experimental Medicine, University of Messina, c\/o AOU Policlinico G. 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Nilsson, MD, MS St. Luke's Health System St. Luke\u2019s Concussion Clinic Hilary Flint, PhD, MPH St. Luke\u2019s Health System St. Luke\u2019s Research Janet Reis, PhD Boise State University College of Health Sciences Office of Research Krisi Pardue, CCC-SLP, CBIS St. Luke's Health System St. Luke\u2019s Concussion Clinic\u2026","rel":"","context":"In "Sports Medicine"","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":2866,"url":"https:\/\/thesportjournal.org\/article\/high-school-coaches-continuing-education-delivery-preferences\/","url_meta":{"origin":6824,"position":5},"title":"High School Coaches\u2019 Continuing Education Delivery Preferences","date":"July 15, 2015","format":false,"excerpt":"Submitted by\u00a0Brooke E. Forester, Ph.D.1*;\u00a0Shelley L. Holden, Ed.D.2*;\u00a0Christopher M. 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