William A. Pitney

A Qualitative Examination of Professional Role Commitment Among Athletic Trainers Working in the Secondary School Setting

CONTEXT Work-related demands can challenge an athletic trainers professional role commitment for an extended period throughout ones career. OBJECTIVE To explore how athletic trainers perceive the phenomenon of professional commitment and maintain this commitment while working in a professionally challenging environment. DESIGN Basic, interpretive qualitative study. SETTING Secondary school. PATIENTS OR OTHER PARTICIPANTS A criterion sample was used. Each participant had a minimum of 10 years of experience as an athletic trainer and self-identified as having maintained his or her professional commitment. Seventeen individuals (14 men, 3 women) with a mean age of 44.3 +/- 6.8 years and 19.0 +/- 6.7 years of experience in the secondary school setting participated in the study. DATA COLLECTION AND ANALYSIS Seventeen total interviews were conducted. Interviews were transcribed and an inductive analysis was performed. A peer debriefing and member checks with 7 participants were completed to enhance the trustworthiness of the findings. RESULTS Four themes emerged from the findings: 1) professional responsibility, 2) rewards, 3) respect, and 4) rejuvenation. Participants explained that a strong sense of responsibility to their patients was a prominent feature of maintaining their commitment. Their professional commitment was influenced by both intrinsic and extrinsic rewards and respect from others. The last emergent theme, rejuvenation, explained the necessity of having appropriate time away from the athletic training role to interact with peers and address personal needs. CONCLUSIONS A strong sense of professional responsibility to both patients and the athletic training discipline is a central feature of professional commitment. Organizations, such as high school athletic programs, can play an influential role in helping an athletic trainer to maintain professional commitment by examining the intrinsic and extrinsic reward systems, assessing the work structure to ensure time to address personal needs, fostering effective communication, and addressing continuing education needs to maintain competence.

Undergraduate athletic training students' influences on career decisions after graduation.

CONTEXT Career opportunities for athletic training students (ATSs) have increased substantially over the past few years. However, ATSs commonly appear to be opting for a more diversified professional experience after graduation. With the diversity in available options, an understanding of career decision is imperative. OBJECTIVE To use the theoretical framework of socialization to investigate the influential factors behind the postgraduation decisions of senior ATSs. DESIGN Qualitative study. SETTING Web-based management system and telephone interviews. PATIENTS OR OTHER PARTICIPANTS Twenty-two ATSs (16 females, 6 males; age = 22 ± 2 years) who graduated in May 2010 from 13 different programs accredited by the Commission on Accreditation of Athletic Training Education. DATA COLLECTION AND ANALYSIS All interviews were transcribed verbatim, and the data were analyzed inductively. Data analysis required independent coding by 2 athletic trainers for specific themes. Credibility of the results was confirmed via peer review, methodologic triangulation, and multiple analyst triangulation. RESULTS Two higher-order themes emerged from the data analysis: persistence in athletic training (AT) and decision to leave AT. Faculty and clinical instructor support, marketability, and professional growth were supporting themes describing persistence in AT. Shift of interest away from AT, lack of respect for the AT profession, compensation, time commitment, and AT as a stepping stone were themes sustaining the reasons that ATSs leave AT. The aforementioned reasons to leave often were discussed collectively, generating a collective undesirable outlook on the AT profession. CONCLUSIONS Our results highlight the importance of faculty support, professional growth, and early socialization into AT. Socialization of pre-AT students could alter retention rates by providing in-depth information about the profession before students commit in their undergraduate education and by helping reduce attrition before entrance into the workforce.

Supervising Athletic Trainers' Perceptions of Professional Socialization of Graduate Assistant Athletic Trainers in the Collegiate Setting

CONTEXT Many newly credentialed athletic trainers gain initial employment as graduate assistants (GAs) in the collegiate setting, yet their socialization into their role is unknown. Exploring the socialization process of GAs in the collegiate setting could provide insight into how that process occurs. OBJECTIVE To explore the professional socialization of GAs in the collegiate setting to determine how GAs are socialized and developed as athletic trainers. DESIGN Qualitative study. SETTING Individual phone interviews. PATIENTS OR OTHER PARTICIPANTS Athletic trainers (N = 21) who had supervised GAs in the collegiate setting for a minimum of 8 years (16 men [76%], 5 women [24%]; years of supervision experience = 14.6 ± 6.6). DATA COLLECTION AND ANALYSIS Data were collected via phone interviews, which were recorded and transcribed verbatim. Data were analyzed by a 4-person consensus team with a consensual qualitative-research design. The team independently coded the data and compared ideas until a consensus was reached, and a codebook was created. Trustworthiness was established through member checks and multianalyst triangulation. RESULTS Four themes emerged: (1) role orientation, (2) professional development and support, (3) role expectations, and (4) success. Role orientation occurred both formally (eg, review of policies and procedures) and informally (eg, immediate role immersion). Professional development and support consisted of the supervisor mentoring and intervening when appropriate. Role expectations included decision-making ability, independent practice, and professionalism; however, supervisors often expected GAs to function as experienced, full-time staff. Success of the GAs depended on their adaptability and on the proper selection of GAs by supervisors. CONCLUSIONS Supervisors socialize GAs into the collegiate setting by providing orientation, professional development, mentoring, and intervention when necessary. Supervisors are encouraged to use these socialization tactics to enhance the professional development of GAs in the collegiate setting.

An Electromyography Analysis of 3 Muscles Surrounding the Shoulder Joint During the Performance of a Chest Press Exercise at Several Angles

Trebs, AA, Brandenburg, JP, and Pitney, WA. An electromyography analysis of 3 muscles surrounding the shoulder joint during the performance of a chest press exercise at several angles. J Strength Cond Res 24(7): 1925-1930, 2010-This study compared the activation of the clavicular head and the sternocostal head of the pectoralis major and the anterior deltoid when performing the bench press at several different angles. Fifteen healthy male subjects participated in this study. Subjects performed the chest press exercise at 0 (flat bench), 28, 44, and 56° above horizontal using 70% of their respective 1 repetition maximum for each angle. Electromyographic activity was recorded during each repetition. Activation of the clavicular head of the pectoralis major was significantly greater at 44° compared to 0° (p = 0.010), at 56° compared to 0° (p = 0.013), and at 44° compared to 28° (p = 0.003). Activation of the sternocostal head of the pectoralis major was significantly greater at 0° compared to 28° (p = 0.013), at 0° compared to 44° (p = 0.018), at 0° compared to 56° (p = 0.001), at 28° compared to 56° (p = 0.003), and at 44° compared to 56° (p = 0.001). Activation of the anterior deltoid was significantly greater at 28° compared to 0° (p = 0.002), at 44° compared to 0° (p = 0.012), and at 56° compared to 0° (p = 0.014). To optimize recruiting the involved musculature, it would seem that performing both the flat and incline chest press exercises is necessary.

The Professional Socialization of the Graduate Assistant Athletic Trainer

CONTEXT The graduate assistant athletic trainer (AT) position often serves as ones first experience working independently as an AT and is also an important aspect of the professional socialization process. The socialization experiences of graduate assistant ATs have yet to be fully explored. OBJECTIVE To understand the socialization process for graduate assistant ATs during their graduate experience. DESIGN Qualitative study. SETTING We conducted phone interviews with all participants. PATIENTS OR OTHER PARTICIPANTS A total of 25 graduate assistant ATs (20 women, 5 men) studying in 1 of 3 academic tracks: (1) accredited postprofessional athletic training program (n = 8), (2) postprofessional athletic training program (n = 11), or (3) a nonathletic training degree program (n = 6). The average age was 25 ± 5 years, and the median age was 24 years. Participants were certified by the Board of Certification for an average of 2 ± 0.4 years. DATA COLLECTION AND ANALYSIS We analyzed the data using a general inductive approach. Peer review, field notes, and intercoder reliability established trustworthiness. Data saturation guided participant recruitment. RESULTS The ability to gain clinical independence as a practitioner was an important socialization process. Having the chance to develop a relationship with a mentor, who provided support, guidance, and more of a hierarchical relationship, was an important socializing agent for the graduate assistant AT. Participants used the orientation session as a means to understand the expectations and role of the graduate-assistant position. Academic coursework was a way to achieve better inductance into the role via the opportunity to apply classroom skills during their clinical practice. CONCLUSIONS Socializing the graduate assistant blends formal and informal processes. Transition to practice is a critical aspect of the profession; thus, supporting autonomous practice with directed mentoring can promote professional maturity.

Future Directions of Evidence-Based Practice in Athletic Training: Perceived Strategies to Enhance the Use of Evidence-Based Practice

CONTEXT The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care. OBJECTIVE To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training education and clinical practice. DESIGN Qualitative study. SETTING Individual telephone interviews. PATIENTS OR OTHER PARTICIPANTS Twenty-five ATs (12 educators, 13 clinicians; athletic training experience = 16.00 ± 9.41 years) were interviewed. DATA COLLECTION AND ANALYSIS One phone interview was conducted with each participant. After the interview was transcribed, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. RESULTS Participants identified several components they perceived as essential for enhancing the use of EBP within the athletic training profession. These components included the need for more EBP resources, more processed information, focused workshops, peer discussion and mentorship, and continual repetition and exposure. Participants also indicated that ATs need to accept their professional responsibilities to foster EBP in their daily practices. CONCLUSIONS The proper shift to a culture of EBP in athletic training will take both time and a persistent commitment by ATs to create strategies that will enhance the implementation of EBP across the profession. Researchers should focus on continuing to identify effective educational interventions for ATs and to determine successful strategies to implement EBP into didactic curricula and clinical practice. Additional focus should be given to which strategies most effectively produce changes in clinical practice.

Achieving Work-Life Balance in the National Collegiate Athletic Association Division I Setting, Part I: The Role of the Head Athletic Trainer

CONTEXT Supervisor support has been identified as key to the fulfillment of work-life balance for the athletic trainer (AT), yet limited literature exists on the perspectives of supervisors. OBJECTIVE To investigate how the head AT facilitates work-life balance among staff members within the National Collegiate Athletic Association Division I setting. DESIGN Qualitative study. SETTING Web-based management system. PATIENTS OR OTHER PARTICIPANTS A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered for an asynchronous, Web-based interview. DATA COLLECTION AND ANALYSIS Participants responded to a series of questions by journaling their thoughts and experiences. We included multiple-analyst triangulation, stakeholder checks, and peer review to establish data credibility. We analyzed the data via a general inductive approach. RESULTS Four prevailing themes emerged from the data: modeling work-life balance, encouraging disengagement from the AT role, cooperation and community workplace, and administrative support and understanding. CONCLUSIONS Head ATs at the Division I level recognized the need to promote work-life balance among their staffs. They not only were supportive of policies that promote work-life balance, including spending time away from the role of the AT and teamwork among staff members, but also modeled and practiced the strategies that they promoted.

Athletic Trainers' Facilitators of Professional Commitment in the Collegiate Setting

CONTEXT Professional responsibility, rewards and respect, and time for rejuvenation are factors supporting professional commitment for athletic trainers (ATs) in the high school setting. The inherent complexities of an occupational setting can mitigate perceptions of professional commitment. Thus far, evidence is lacking regarding professional commitment for ATs in other occupational settings. OBJECTIVE To extend the literature on professional commitment of the AT to the collegiate setting. DESIGN Qualitative study. SETTING Collegiate. PATIENTS OR OTHER PARTICIPANTS Thirty-three Board of Certification-certified ATs employed in the collegiate setting (National Collegiate Athletic Association Division I = 11, Division II = 9, Division III = 13) with an average of 10 ± 8 years of clinical experience volunteered. Data saturation guided the total number of participants. DATA COLLECTION AND ANALYSIS Online journaling via QuestionPro was used to collect data from all participants. Two strategies, multiple-analyst triangulation and peer review, were completed to satisfy data credibility. Data were evaluated using a general inductive approach. RESULTS Likert-scale data revealed no differences regarding levels of professional commitment across divisions. Two themes emerged from the inductive-content analysis: (1) professional responsibility and (2) coworker support. The emergent theme of professional responsibility contained 4 subthemes: (1) dedication to advancing the athletic training profession, (2) ardor for job responsibilities, (3) dedication to the student-athlete, and (4) commitment to education. Our participants were able to better maintain their own professional commitment when they felt their coworkers were also committed to the profession. CONCLUSIONS The collegiate ATs investigated in this study, regardless of division, demonstrated professional commitment propelled by their aspiration to advance the profession, as well as their dedication to student-athletes and athletic training students. Maintaining commitment was influenced by a strong sense of coworker support.

Achieving Work-Life Balance in the National Collegiate Athletic Association Division I Setting, Part II: Perspectives From Head Athletic Trainers

CONTEXT Work-life balance has been examined at the collegiate level from multiple perspectives except for the athletic trainer (AT) serving in a managerial or leadership role. OBJECTIVE To investigate challenges and strategies used in achieving work-life balance from the perspective of the head AT at a National Collegiate Athletic Association Division I university. DESIGN Qualitative study. SETTING Web-based management system. PATIENTS OR OTHER PARTICIPANTS A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered. DATA COLLECTION AND ANALYSIS Participants journaled their thoughts and experiences in response to a series of questions. To establish data credibility, we included multiple-analyst triangulation, stakeholder checks, and peer review. We used a general inductive approach to analyze the data. RESULTS Two higher-order themes emerged from our analysis of the data: organizational challenges and work-life balance strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The work-life balance strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration. CONCLUSIONS Head ATs are susceptible to experiencing work-life imbalance just as ATs in nonsupervisory roles are. Although not avoidable, the causes are manageable. Head ATs are encouraged to prioritize their personal time, make efforts to spend time away from their demanding positions, and reduce the number of additional responsibilities that can impede time available to spend away from work.

Experiences of Work-Life Conflict for the Athletic Trainer Employed Outside the National Collegiate Athletic Association Division I Clinical Setting.

CONTEXT The intercollegiate setting receives much of the scholarly attention related to work-life conflict (WLC). However research has been focused on the National Collegiate Athletic Association Division I setting. Multiple factors can lead to WLC for the athletic trainer (AT), including hours, travel, and lack of flexibility in work schedules. OBJECTIVE To investigate the experiences of WLC among ATs working in the non-Division I collegiate setting and to identify factors that contribute to fulfillment of work-life balance in this setting. DESIGN Qualitative study. SETTING Institutions in the National Collegiate Athletic Association Divisions II and III, the National Association of Intercollegiate Athletics, and the National Junior College Athletic Association. PATIENTS OR OTHER PARTICIPANTS A total of 244 ATs (128 women, 114 men; age = 37.5 ± 13.3 years, experience = 14 ± 12 years) completed phase I. Thirteen participants (8 women, 5 men; age = 38 ± 13 years, experience = 13.1 ± 11.4 years) completed phase II. DATA COLLECTION AND ANALYSIS For phase I, participants completed a previously validated and reliable (Cronbach α > .90) Web-based survey measuring their levels of WLC and work-family conflict (WFC). This phase included 2 WFC scales defining family; scale 1 defined family as having a partner or spouse with or without children, and scale 2 defined family as those individuals, including parents, siblings, grandparents, and any other close relatives, involved in ones life. Phase II consisted of an interview. Qualitative data were evaluated using content analysis. Data source and multiple-analyst triangulation secured credibility. RESULTS The WFC scores were 26.33 ± 7.37 for scale 1 and 20.46 ± 10.14 for scale 2, indicating a moderate level of WFC for scale 1 and a low level of WFC for scale 2. Qualitative analyses revealed that organizational dimensions, such as job demands and staffing issues, can negatively affect WLC, whereas a combination of organizational and personal dimensions can positively affect WLC. CONCLUSIONS Overload continues to be a prevalent factor in negatively influencing WLC and WFC. Supervisor and peer support, personal networks, and time away from the role positively influenced work-life balance and WFC. Athletic trainers are encouraged to support one another in the workplace, especially when providing flexibility in scheduling.