Legislators’ perception and knowledge of the athletic training profession: Specific considerations for secondary schools
Pike AM, Eason CM, Sterns RL, Tosakoon S, and Casa DJ. J Athl Train. 2019. 54(11).
Take-Home Message
Many state legislators lack knowledge about an athletic trainer’s educational requirements, qualifications, and responsibilities, which may negatively impact their view of the value of athletic trainers.
Summary
Legislation regarding athletic training practice is critical to promote the profession of athletic training and set a standard of care for athletes. However, many state practice acts fall short of outlining best-practice standards. It is important to understand how state legislators view and understand athletic trainers to improve the perception of athletic trainers (ATs) and the standard of care in state practice acts. Therefore, Pike and colleagues sought to explore the view and knowledge of the athletic training profession among state legislators through a mixed-methods cross-sectional study. The research questions which the researchers attempted to answer were, (1) “What were legislators’ perceptions of the value and influence of an AT on physical activity and sports safety?” and (2) “What did legislators perceive to be the qualifications and responsibility of the AT?” The authors emailed a validated online survey to all state legislators in May of 2017. The survey assessed 3 areas of interest: (1) demographics of the state legislators, (2) quantitative measurement of legislators’ knowledge of ATs qualifications and responsibilities, and (3) open-ended questions for respondents to expand on their previous thoughts.
Of the 6841 legislators identified, 143 legislators (2%) from 34 states responded. About 69% of legislators considered an AT to be a trusted source of medical information. However, only 16% considered an AT as the best person to provide daily medical care to an injured athlete. Furthermore, only 30% indicated “AT employed at the school” as a top sports safety measure. The authors also found that a state legislator’s knowledge of the qualifications and responsibilities of an AT related to the value the legislator placed on the role of the AT. Qualitatively, the 3 major themes which emerged were the recognition of the prevention domain, misconceptions about the difference between ATs and personal trainers, and lack of knowledge regarding educational requirements for athletic training.
Viewpoints
Overall, the gaps in legislators’ understanding of athletic training are concerning because legislators are responsible for introducing and changing legislation to set standards of practice. If these individuals lack adequate knowledge of athletic training, their ability to draft and amend legislation would be impaired. While athletic training advocates have made significant strides in promoting the profession, this advocacy has not yet impacted the people who can significantly change these laws. The conclusions of this study demonstrate a need for more advocacy of athletic training, especially with a focus on improving our state legislators’ knowledge about the qualifications and responsibilities of ATs. These efforts could also be supported by further research regarding the most effective tools for communication and advocacy. In the meantime, sport medicine clinicians should reach out to their local state legislator to help educate them on athletic training and invite them to athletic training facilities to see firsthand the role of athletic training in sport safety.
Questions for Discussion
What experiences do you have with advocating for the athletic training profession with those who are not familiar with ATs? Do you feel like those efforts have been successful or unsuccessful, and how could they be improved?
Written by: Kyle Harris
Reviewed by: Jeffrey Driban
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As a student I haven’t had much firsthand experience advocating for my profession to state legislators however through researching state definitions and scope of practices for ATs I’ve noticed that some are very “uninformed” on what exactly we do as athletic trainers and how we can help the institutions that hire us. I don’t know if inviting more legislators to conventions where they can hear and see up-to-date information and steps we are taking to improve our patient outcomes would but think it would be a step in the right direction. Interested to hear more personal stories of advocacy, so please share.
Thanks for you comment Michael. I agree that really a sticking point here is not THAT legislators are uninformed but how can we better inform them. I have limited experiences at the state level but have seen legislators invited or involved in different ways to help them experience more about ATs. Another way although more expensive, is for state and regional organizations to become involved with lobby efforts and lobbyists. This could open doors that ATs themselves might have trouble accessing on their own.
As an athletic trainer I have been on the receiving end of the comment, “oh you’re and athletic trainer? So, you help people work out, right?” many times. It is sad and unfortunate to see how our profession has gone almost unnoticed by the public and many state legislators. The fact that most of the legislators, who responded to the survey, did not even know the difference between athletic training and personal training is almost laughable. Also, the statistic showing that only 30% of those who responded consider having an athletic trainer employed at a school to be a top safety measure offends me to my core.
Overall, this journal has opened my eyes to the lack of knowledge of athletic trainers to the public and state legislators. Hopefully we can do a better job in the future of making it known how much of a necessity we are.
Gavin,
I agree that this is hard to read at times. I would imagine though that these results would be more encouraging if we could compare them to a similar study done 10-15 year ago. In the meantime, mentorship and refining our educational standards to better help athletic trainers know how to demonstrate “returns on investments” is important.
As an athletic training students I have not had much contact or first hand experience with state legislators. But agreeing with Gavin, comments such as “what is an athletic trainer or you just help get athletes in shape”, has showed me our profession is unnoticed by our peers and state legislators.
Knowing that our profession is newer than most health professions, I still feel it is important that people know what we do and why we are important. I feel our first step is to get more individuals educated with what we do is our first step. We have to figure out how we can rely our importance to our peers and espically the state legislators.
Hopefully reading this article will open our eyes in the AT profession and make a difference!
Thank you for the great article!
Courtney,
Thanks for a great comment. I agree with your comment that the ground up approach can be very powerful. Having parents of our athletes advocate for us in different avenues could be extremely helpful. I do think though, that when we interact with parents we need to let them know that this is an area where they can help us. This grassroots type of advocacy coupled with more top down approach is such as AT organizations being involved with lobbyist could yield a great result.
As an athletic training student I also, have not had hands-on experience advocating the profession with state legislators. However, from my limited experience the question, “what is an athletic trainer?”, is one most of the general population does not know. For example, I have some friends in medical school and ended up going out with a group of about 8 of them and one PT student the PT student and maybe 4/8 of the med students had a general understanding of what an Athletic Trainer really is. This experience was really eye-opening to me because those are the potential future physicians that an athletic trainer may work with and they do not even know the scope of practice of an athletic trainer. So my question is, should we go right to the legislators and educate them first or should the focus be on the education of the general public and other health care professionals then working our way up to legislators?
Kyle,
Thanks for a great comment. I don’t think the ultimate answer would be one or another but a combination approach. I think a total grassroots campaign would not propel athletic training forward at the pace we would be happy with. It could also be open to misinformation which would distract from the overall goal. Focusing on legislation efforts may yield some progress, but as this study identified, legislators are a difficult audience to contact. I think the best option for influencing legislation is through lobbying efforts and large groups such as NATA district meetings. I don’t think there is a silver bullet here. In your interaction you mentioned, did you feel that the other individuals in the group were receptive to knowing more about athletic training?
Athletic Trainers need a new title. It is more often than not that I have to explain what an athletic trainer is to the general population. I have been misconceived as a massage therapist, a physical therapist, ems, and a personal trainer more often than someone has identified me as an athletic training student. I have often identified myself as “a member of the sports medicine team” and an “emergency care provider that specializes with athletes”. I use these titles for respect, and a basic introductory for my job. It obviously does not tell the whole story about what we do, but it is also not selling ourselves short the way many do when they call us “trainers”.
I think as with many other fields, with more awareness, we will have more respect and clarity among the general population. When some of those legislators have athletes of their own that requires help from a phenomenal ATC one day, there will certainly be a clearer depiction of athletic trainers.
Dan,
Thanks for a great comment. I was curious if someone would advocate for some change in nomenclature. I could see how this could benefit public knowledge and engagement. What are some words or potential titles which may more accurately reflect what athletic trainers are and what they do? I appreciate any feedback you would have!
I am currently an athletic training student with my clinical site at a high school. In the high school setting, most students do not even know who we are or what we are there for unless they are involved with one of the sports teams at the school. My preceptor and I work under the supervision of a physical therapist and have specific standing orders from a physician. We cover all the on-field injuries and the doctor/physical therapist is the afterthought. Both the physical therapist and doctor are comfortable with the knowledge and skill set of my preceptor. On the other hand, when I am asked by my current co-workers what I am going to school for, they all associate the words athletic trainer with the literal breakdown of the words. In addition, they ask, “So you’ll be training athletes?” I typically change the words athletic trainer with sports medicine and then I get a nod of approval. I don’t think that we as athletic trainers have the proper lobbyist fighting for the field in comparison to physical therapists and other parts of the sports medicine realm. I have not had any personal experience advocating for the field outside of my family and friends. I feel like NATA should do more informative sessions on the field of athletic training as a whole and open it up to more professions to increase awareness to those in charge of writing the laws we abide by.
Olivia,
Thank you for your comment. I think more targeted education could be quite beneficial. I think most athletic trainers have experiences that would mirror the challenging interactions you have had. As much as these interactions are opportunities for education, I have heard from many athletic trainers that are frustrated with the lack of progress they see overall despite number conversations. I think a more focused and goal-oriented approach from our governing organizations may not only be widely accepted by its members but could be more effective than relying on person by person education.
Thanks again for your comment!