Challenges for newly credentialed athletic trainers during their transition to practice.

Walker SE, Thrasher AB, Singe SM, Rager J. J Athl Train 2019;doi:10.4085/1062-6050-387-17. [Epub ahead of print]

Full Text Freely Available

Take-Home Message

Newly credentialed athletic trainers face challenges in making a decision, developing confidence, role ambiguity, communication, and lack of mentor accessibility.


The transition from student to credentialed health care provider can be a shocking and stressful process for an individual as they adjust into an unknown environment, develop their own identity in a new role, and face different workplace challenges. Investigators have studied the challenges faced by a newly credentialed athletic trainer (AT) in certain practice settings (i.e., collegiate or secondary school). However, it is unclear what challenges are faced among ATs in a broader group of practice settings. Hence, the authors examined the challenges faced by newly credentialed ATs across a diverse range of employment settings. They interviewed 34 ATs that were certified within the prior nine months and working as a part- or full-time AT. The ATs worked in a variety of settings including all levels of the NCAA, junior college, secondary school, health/fitness industry, and professional sports. The ATs discussed their transition to practice and the difficulties they encountered in their first year as a clinician. From the interviews, five common themes emerged: (1) difficulty making decisions, (2) developing confidence, (3) role ambiguity (uncertainty about basic organizational structures and expectations), (4) communication (e.g., with parents or coaches), and (5) lack of mentor accessibility.


The authors found that the challenges faced by newly credentialed athletic trainers are similar to those experienced by other healthcare providers (e.g., nurses or physicians). The authors suggested that new ATs should seek feedback early and often, while more senior ATs should freely provide feedback and mentor novice clinicians. Having clearly defined roles for new hires can help reduce role ambiguity. Furthermore, introducing policy and procedure manuals during orientation can ensure that ATs know the proper steps for common duties. Communication was defined as discussing patient care, practice scheduling, and conflict resolution when it came to coaches and discussing the condition itself with parents and patients. Identifying these situations and having the ability to experience and practice this skill prior to entering the field may be beneficial for new ATs. The authors also noted that professional programs need to educate students on these challenges to help them anticipate what might happen during the transition. New ATs should be aware of their limitations as a newly certified health care provider and expect a lack of confidence in their first year as a clinician. Understanding the struggles of newly credentialed ATs allows employers to prepare and support their new hires. Providing job descriptions, policies and procedures manuals, and continuing job training up to a year after hiring may produce better outcomes for both the employee and employer.

Question for Discussion

Did your employer utilize an onboarding/orientation process during the first few months to a year of your employment? If you are an employer, do you have a formal onboarding/orientation process for new hires, particularly newly credentialed ATs?

Written by: Karlee Burns
Reviewed by: Jeffrey Driban