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]
Take-Home Message
Newly credentialed athletic trainers face challenges in making a decision, developing confidence, role ambiguity, communication, and lack of mentor accessibility.
Summary
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.
Viewpoints
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
Hi Karlee,
I found this article very enlightening and heart-warming as I am about to make the transition into becoming a certified athletic trainer. This touches on a few things that I was already thinking about on my own. I have always questioned how is that first year going to be — Will I be ready and fully confident in what needs to be done? Will I know how to handle any situation that arises? Can I ask for help without feeling incompetent?
This study is very necessary to people who want to enter this field. The five common themes are all things that I can relate to however I think the main ones would be: Developing Confidence, Role Ambiguity, Mentor Accessibility. In my experience so far as an ATS I have struggled with confidence, in the sense of just feeling unsure and also in my role of what I can and can’t do in the clinical setting. The mentorship aspect of this study I found very shocking, because in my experience I have gotten to see a first-year ATC navigate and grow and she had a great team of co-workers that were willing to help if need be. The environment of that training room promoted group support and it took away that negative feeling of being afraid to ask for help or feeling like you don’t know what you’re doing. It was great thing to see and be a part of. I feel that confidence is something that will grow as time progresses, and I agree that clearly defined roles would be incredibly beneficial in the transition. As well as having constructive feedback from the more experienced ATs would be such an awesome thing. I believe that if some of these potential methods would be used in my upcoming transition, I would definitely have a smoother ride in that first year. I also believe they would be a helpful development tool as I prepare for a career with many years to come.
Overall I found this article comforting to know that I am not the only one that feels this way, and its also reassuring to know that someone cares and wants to help. Thank you!
Hi Braylon,
Good luck in your transition to a certified AT! I agree that this article is a good resource for new ATs and I’m glad that you related to it. Hopefully you can utilize some of the tips from it and have a smoother transition to practice. Thanks for your comment!
Best,
Karlee
Karlee,
I completely agree with Brandon! I am also getting ready to make the transition this May and it is very comforting knowing that these are issues a lot of athletic trainers run into in their first year. It is also a little alarming and I wish, as with any profession, that programs did a better job with “exit training” not only with the profession itself, but with life after college. Confidence and decision making is especially difficult since we are set up as students to frequently double check everything we do with our preceptors, so when it comes to decision making on my own I worry how that will translate.
One great thing that our program does is require EMT certification. These environments force us to continually make critical decisions without the comfort of the training room or having a preceptor watching our every move. As we continue to see various types of populations and work with different people we are forced to find our rhythm and get into our routine. I think another step would be incorporating more conversations about the types of jobs available and different expectations before we begin interviewing. I think giving the students the knowledge of what’s out there and what to expect can prevent these feelings and also eventually burnout.
I loved this article and will defiantly share this information with my classmates that are feeling the same way!
Karlee,
As a student I am not yet sure about the on boarding/orientation process yet. However I do know that I am already experiencing some of the fears that first year ATCs are having. As Jolene mentioned above I think the lack of confidence and trouble decision-making is developed during our schooling. Depending on the program, students may have varying levels of autonomy in their clinical rotations which will obviously greatly effect ones ability to operate on their own. I know in our program as we advance in our training we gain more independence at our clinical sites and are able to perform more skills. However in our last year of school, we take our first semester off from AT clinical practice to train as emergency medical technicians. While this certification is a great asset to have, for me it has also created a fear that I will have forgotten skills as I enter back into traditional AT practice come January.
I found it interesting that other first year healthcare professionals are also experiencing similar feelings. Further, you mentioned at the end of the article that job training for a year after hire may result in better outcomes for both the employee and the employer. This reminded me of how we are seeing rise in residency programs for Athletic Trainers as we work to be better identified and recognized as healthcare entities. Though this makes our curriculum and training similar to that of nurses and physicians we already have a significant starting pay gap compared to these other fields. I wonder how residency programs or encouraging such a lengthy on the job training could effect starting salaries of athletic trainers.
I am currently on my second to last clinical rotation as a graduate Athletic Training Student. I certainly have experienced some of the challenges discussed in the article and have some of my own. Communication is certainly one of the biggest challenges. In the secondary, and collegiate school settings, ATC’s are required to meet with team coaches to discuss injuries and limitations of certain players when returning to play. I feel that this will be a challenge, forming a professional relationship with the coaches. In my clinical rotations, I have not been part of a staff meeting or even allowed to sit in one. I have not been formally introduced to other staff members or students in other departments. Often I have been instructed to speak to when spoken to. I feel like an “onboarding” for students will prepare graduating seniors with the familiarity to communicate with the sports medicine and athletics staff of whatever setting they choose to work in. However, with articles like this, in hindsight, I will be able to prepare for these situations by making the personal effort to communicate with coaches and other staff.
Another challenge I agree with and have experienced myself is with the number of exposures and clinical decision making on the spot. This is a numbers game and even though we are in a limited role as students, it would directly affect our first year as clinicians.
I thought that this was a very helpful article. I am a student looking to make that transition in May however I have developed some of the same fears that this article mentions. Although I feel as if confidence will grow with time, that has been one of my biggest struggles while doing clinical rotations at different sites. Like this article mentions it think that it is important for new athletic trainers to have clearly defined roles for new which can help reduce role ambiguity. Also in one of my classes we had to develop our own policy and procedures handbook which allowed me to make note of all the important goals that need to be established and discuss before accepting a new role. It also helped me to realize the importance of having one and if one is not in place at a site then one needs to be established. I found that this article was a very good source as I am heading in the transition phase. I also think another good step would continuing job training at a the specific site would be beneficial like this article mentioned. This would allow the new athletic trainer to understand things that have worked well in the past and give them the confidence they need and allow them to continue to develop their skills.
I think this article is interesting yet comforting. As a second year AT student I am experiencing some of these difficulties myself. I have always wondered if other ATs are having the same or similar difficulties and after reading this, knowing that I am not alone genuinely made me feel better.
I think it is okay and normal for one to feel this way. Confidence, communication, and kills are a working progress and grows overtime. Those are things take time to master and an individual will always have to work on them in their lifespan. One thing that was alarming to me was that the article discussed professional programs need to educate students on these challenges to better prepare them during the transition. I have to agree with this statement and with Jolene. This speaks volume. It has crossed my mind many times before and professional programs need to do a better job at preparing us for life after graduating and transitioning as first-year health professionals. I can personally say I do not get that type of feedback in my professional program and I feel as though it would be beneficial for me and my classmates as well. I do not think I am prepared and confident enough to step into that world.
I hope to utilizer these tips to help me with an easy transition into my professional career.
This article was very informing, and I think more students should push for help within their programs. More programs should take this into consideration and implement some of these strategies that were mentioned.
Hi Karlee,
This article represents my exact perspective of what it is like to be a new Athletic Trainer. Even though I have one more year left of school, I feel a lot of pressure about when I graduate and get my first job as an ATC. I feel like I have learn a lot in school as well as clinical, but it is intimidating to see how efficient my preceptors were at my clinical rotation. It’s not that I don’t believe in my abilities as an ATC, I am fearful that it is not enough to be like my former preceptors. You said a lot of how I feel in this article and it really gives me comfort knowing that I am not the only one feeling this nervousness. All I can do for now is try my best and continue to learn as much as I can. I hope that if I continue with a humble but eager mindset, I can be the best ATC possible.
Thank you for the relief in your message!
Hello,
Great article and I can truly relate about the feelings each newly athletic trainers have. I am getting ready to make my transition in May and I am honestly nervous. This could be due to what was pointed out in this article, the lack of confidence and decision-making. I agree with having that “person” there to get feedback when you are wrong as a student, but now I am nervous about making the wrong decision when I become certified.
Secondly, I love the recommendation of having a mentor. Over the years, I have gain some mentors that have helped me along my journey through college and I feel keeping in touch throughout my professional career is a must! They have once been in our shoes before and can only try to help in the best possible.
Overall, I found this article to be very enlightening to know I am not the only one feeling this way! Although I am nervous about my future of being a newly ATC, I am happy to almost be done with school and be on my own in this profession!