Sports Medicine Research: In the Lab & In the Field: Athletic Directors’ Barriers to Hiring Athletic Trainers in High Schools (Sports Med Res)


Tuesday, November 24, 2015

Athletic Directors’ Barriers to Hiring Athletic Trainers in High Schools

Athletic Directors’ Barriers to Hiring Athletic Trainers in High Schools

Mazerolle SM, Raso SR, Pagnotta KD, Stearns RL, Casa DJ. J Athl Train. 2015; 50(10): 1059-1068. doi: 10.4085/1062-6050-50.10.01

Take Home Message: Lack of power, budget concerns, misconceptions about the role of an athletic trainer, and rural location emerged as primary barriers to hiring an athletic trainer by an Athletic Director in the public secondary school setting.

In 2012 the Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletics Programs published a consensus statement with the recommendation that an athletic trainer (AT) be available for practices and competitions. While the national average of schools employing ATs has increased in the last decade, only 42% of high schools reported employing an AT. In current organizational hierarchy, hiring and administration of secondary school ATs is typically the purview of the Athletic Director (AD). Despite a rise in the national trend for employment, barriers exist that prevent ADs from hiring an AT, even though they acknowledge their importance in athletic health care. The purpose of this qualitative study was to identify issues ADs face that prevent them from employing ATs in secondary schools. Using data from the Collaboration for Athletic Training Coverage in High Schools–An Ongoing National Study (CATCH-ON), the authors initially identified 1504 public schools that participated in the CATCH-ON and reported not employing an AT. From that pool, the authors randomly selected a subset of schools and categorized by geographic region (north, south, east, and west). The researchers initiated contact with the ADs and conducted semi-structured telephone interviews. Data saturation was reached at 20 participants. Questions for the interview focused on AD perception of ATs, medical care provided for student-athletes, and risk of catastrophic injury or death for student-athletes. Three major themes emerged from analysis: lack of power as well as budget and non-budget concerns. Lack of power was associated with ADs stating an inability to hire and allocate a portion of their budget to an AT salary. Budget concerns were centered on declining state and federal funding for public schools and school board priorities to maintain teacher over AT employment. Non-budget barriers included rural location of the school, misconceptions about the credentials and role of an AT, and community interference (volunteers from the community providing free emergency services).

Budget issues related to hiring an AT are likely not a surprise; lack of funds due to state and federal shortfalls have placed significant strain on school boards. ADs commented that justifying an AT salary is difficult as teachers face potential job cuts. While the concern is valid, it is also places student-athletes at risk. In a typical organizational structure at the secondary school level, the AT reports to the AD. The profession is just beginning to see a shift away from this model, with collegiate athletic medicine programs being realigned with student health services. One of the themes identified in this study was the misconception about the role of an AT, in that a coach who is certified in First Aid/CPR is equitable to a certified and licensed athletic trainer. If ATs were aligned with the school’s nursing staff, the perception may shift away from a line item in an athletic budget to ATs being viewed as a necessary part of the school’s health care team. This study also reminds us that the sports medicine community needs to target advocacy efforts not just at ADs but also at school boards. These efforts may include a continued effort to educate school administrators about ATs.

Questions for Discussion: How can ATs more effectively promote our qualifications to better serve secondary school athletes? Do you feel organizational alignment with a school’s nursing staff could shift the perception of ATs in secondary schools?

Written by:  Laura McDonald
Reviewed by: Jeffrey Driban

Related Posts:

Mazerolle SM, Raso SR, Pagnotta KD, Stearns RL, & Casa DJ (2015). Athletic Directors' Barriers to Hiring Athletic Trainers in High Schools. Journal of Athletic Training, 50 (10), 1059-68 PMID: 26509776


Chris Donner said...

I agree with what this article is saying. Many people have no idea what an athletic trainer is or what we do. I still have to explain to some people what I do for a living. I think that part of this has to do with the name of our profession. So many people call us "trainers" as opposed to "athletic trainers." This tells me that there is no awareness of what we do to the general public. Part of the fault could be on us. There are definitely times when I do not interact with parents like I should. If we all made a point to do this, then that would bring more awareness to the public about our profession.

Caroline L. said...

I believe organizational alignment with a school’s nursing staff could shift the perception of ATs in secondary schools and strengthen healthcare at the secondary schools as a whole.This shift would have the potential to change public perception of athletic trainers as healthcare providers by aligning them with other health care providers in the school. It could also increase communication between the nursing staff and athletic trainers. In my previous experience working as an athletic trainer at a high school, the county’s athletic trainers and nursing staff were working together to help establish protocols rooted in improving communication between the two entities when caring for an athlete who had sustained a concussion. Athletic trainers are responsible for the wellbeing of an athlete who is concussed, but many do not work at the school during the school day. Therefore, the nurse would be responsible for the care of this athlete. By placing these health care providers in the same organizational hierarchy it could help facilitate communication and potentially improve healthcare for students during school and during sports participation for all medical needs beyond concussions.

Candace Bernitt said...

Education for the public on what being an athletic trainer actually entails is needed. As a profession that is sometimes under-appreciated and misinterpreted within the community, it is our duty as athletic trainers and healthcare providers to educate others and advocate for what we do. If we aren't going to step up to the plate, then who is? If we sit back and complain about the lack of knowledge regarding our practice, and the disrespect we sometimes see from others, then no changes will be made and Athletic Director's will continue to struggle to come up with reasons why they should hire us. We need to get out in our communities and educate parents, coaches, teachers, and athletes about who we are, what we do, and why we are needed. It is essential to not just physically attend practices and competitions, but to make it known that you are there. In this way, members of administration and members of the community will be able to see the value in having an ATC, and that it goes beyond basic first aid skills.

Catherine Donahue said...

While this article is frustrating to read (for obvious reasons), having worked in the high school setting I can also sympathize to the AD. AD's in our district were teaches who took the additional role for the extra stipend it brought with it. Many had a good idea as to what I did but I can understand why an AD would not feel as though they could make any difference in getting a AT hired. They took the job as extra money, and therefor did not have the resources to or hierarchy to get someone hired. But I agree with previous comments that the heart of the problem is our lack of education to the community about our qualifications. I think education is something that starts out small to gradually build over time. For example, our high school had a sports medicine class taught by the school's former AT, and every year there was a waiting list for it. Having a class like this teaches kids what our profession is about, but also gives them an opportunity to spread the knowledge they have learned to other to let them know why athletic trainers are necessary.

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