Work-family conflict, part I: Antecedents of work-family conflict in national collegiate athletic association division I-A certified athletic trainers

CONTEXT: Work-family conflict (WFC) involves discord that arises when the demands of work interfere with the demands of family or home life. Long work hours, minimal control over work schedules, and time spent away from home are antecedents to WFC. To date, few authors have examined work-family conflict within the athletic training profession. OBJECTIVE: To investigate the occurrence of WFC in certified athletic trainers (ATs) and to identify roots and factors leading to quality-of-life issues for ATs working in the National Collegiate Athletic Association Division I-A setting. DESIGN: Survey questionnaire and follow-up, in-depth, in-person interviews. SETTING: Division I-A universities sponsoring football. PATIENTS OR OTHER PARTICIPANTS: A total of 587 ATs (324 men, 263 women) responded to the questionnaire. Twelve ATs (6 men, 6 women) participated in the qualitative portion: 2 head ATs, 4 assistant ATs, 4 graduate assistant ATs, and 2 AT program directors. DATA COLLECTION AND ANALYSIS: Multiple regression analysis was performed to determine whether workload and travel predicted levels of WFC. Analyses of variance were calculated to investigate differences among the factors of sex, marital status, and family status. Interviews were transcribed verbatim and then analyzed using computer software as well as member checks and peer debriefing. The triangulation of the data collection and multiple sources of qualitative analysis were utilized to limit potential researcher prejudices. RESULTS: Regression analyses revealed that long work hours and travel directly contributed to WFC. In addition to long hours and travel, inflexible work schedules and staffing patterns were discussed by the interview participants as antecedents to WFC. Regardless of sex (P = .142), marital status (P = .687), family status (P = .055), or age of children (P = .633), WFC affected Division I-A ATs. CONCLUSIONS: No matter their marital or family status, ATs employed at the Division I-A level experienced difficulties balancing their work and home lives. Sources of conflict primarily stemmed from the consuming nature of the profession, travel, inflexible work schedules, and lack of full-time staff members.     

National collegiate athletic association division and primary job title of athletic trainers and their job satisfaction or intention to leave athletic training

Context:

Membership in the National Athletic Trainers'' Association (NATA) has declined in recent years, generating much debate about professional commitment.

Objective:

To compare the contributing factors of job satisfaction and intention to leave athletic training of certified athletic trainers (ATs) employed in National Collegiate Athletic Association (NCAA) institutions.

Design:

Cross-sectional study.

Setting:

A link to a Web-based questionnaire containing the Spector Job Satisfaction Survey (JSS) and an original Intention to Leave Survey (ITLS) was distributed by e-mail to 1003 certified members of the National Athletic Trainers'' Association.

Patients or Other Participants:

A total of 191 certified members of the NATA employed in a college or university setting in a primarily clinical capacity; representing all NCAA divisions; and having the job title of head athletic trainer, associate/assistant athletic trainer, or graduate assistant/intern athletic trainer.

Main Outcome Measure(s):

We used separate 3 × 3 factorial analyses of variance to compare the mean scores of each JSS subscale and of the ITLS with NCAA division and job title. A stepwise multiple regression was used to determine the strength of the relationships between the JSS subscales and the ITLS.

Results:

We found differences for job title in the subscales of Fringe Benefits (F_2,182 = 7.82, P = .001) and Operating Conditions (F_2,182 = 12.01, P < .001). The JSS subscale Nature of Work was the greatest indicator of intention to leave (β = −0.45).

Conclusions:

We found a strong negative correlation between various facets of job satisfaction and intention to leave athletic training. The NCAA division seemed to have no effect on an individual''s job satisfaction or intention to leave the profession. In addition, only Fringe Benefits and Operating Conditions seemed to be affected by job title. The ATs had similar levels of job satisfaction regardless of NCAA division, and their job titles were not a major factor in job satisfaction.     

Role strain in collegiate athletic training approved clinical instructors

CONTEXT: Certified athletic trainers who serve as Approved Clinical Instructors (ACIs) in the collegiate setting are balancing various roles (eg, patient care and related administrative tasks, clinical education). Whether this balancing act is associated with role strain in athletic trainers has not been examined. OBJECTIVE: To examine the degree of, and contributing factors (eg, socialization experiences, professional and employment demographics, job congruency) to, role strain in collegiate ACIs. DESIGN: Cross-sectional survey design. SETTING: Geographically stratified random sample of ACIs affiliated with accredited athletic training education programs at National Collegiate Athletic Association (NCAA) Division I, II, and III institutions. PATIENTS OR OTHER PARTICIPANTS: 118 collegiate ACIs (47 head athletic trainers, 45 assistant athletic trainers, 26 graduate assistant athletic trainers). MAIN OUTCOME MEASURE(S): The Athletic Training ACI Role Strain Inventory, which measures total degree of role strain, 7 subscales of role strain, socialization experiences, professional and employment characteristics, and congruency in job responsibilities. RESULTS: A total of 49% (n = 58) of the participants experienced a moderate to high degree of role strain. Role Overload was the highest contributing subscale to total role strain. No differences were noted between total role strain and role occupant groups, NCAA division, or sex. Graduate assistant athletic trainers experienced a greater degree of role incompetence than head athletic trainers did (P = .001). Division II ACIs reported a greater degree of inter-role conflict than those in Division I (P = .02). Female ACIs reported a greater degree of role incompetence than male ACIs (P = .01). Those ACIs who stated that the ACI training provided by their institution did not adequately prepare them for the role as an ACI experienced greater role strain (P < .001). CONCLUSIONS: The ACIs in the collegiate setting are experiencing role strain in balancing their roles as health care providers, clinical educators, and administrators. Methods to reduce role strain need to be considered.     

The Development of Expert Male National Collegiate Athletic Association Division I Certified Athletic Trainers

OBJECTIVE: To identify the major influences in the development of expert male National Collegiate Athletic Association (NCAA) Division I certified athletic trainers. DESIGN AND SETTING: The participants were individually interviewed, and the data were transcribed and coded. SUBJECTS: Seven male NCAA Division I certified athletic trainers, who averaged 29 years of experience in the profession and 20 years at the Division I level. RESULTS: We found 3 higher-order categories that explained the development of the certified athletic trainers and labeled these meaningful experiences, personal attributes, and mentoring. The growth and development of the athletic trainers were influenced by a variety of meaningful experiences that began during their time as students and continued throughout their careers. These experiences involved dealing with challenging job conditions, educational conditions, and attempts to promote and improve the profession. The personal attributes category encompassed the importance of a caring and service-oriented attitude, building relationships with athletes, and maintaining strong bonds within their own families. Mentoring of these individuals occurred both inside and outside the athletic training profession. CONCLUSION: We provide a unique view of the development of athletic trainers that should be of interest to those in the field, regardless of years of experience.     

Motivational congruency and discrepancy between certified athletic trainers and noncertified student athletic trainers in the state of hawaii

In March 1992, a survey to assess motivational preference was sent to all certified athletic trainers who were practicing in the State of Hawaii and all noncertified student athletic trainers who were enrolled in the athletic training curriculum at the University of Hawaii. The return rate was 80% for certified athletic trainers and 100% for student athletic trainers. The findings of the study indicated that a motivational discrepancy exists for the following motivational stems: freedom on the job, job growth, benefits and wages, being appreciated, helping the organization obtain goals, receiving raises, being an integral part of the work team, job security, and feedback on job performance (p <.05). Further, the study indicated differences in rating the importance of motivators between the certified and the student athletic trainers concerning freedom on the job, opportunity for advancement, benefits and wages, and job security (p <.05). The differences in motivational factors between the two groups indicated that the students are more concerned with intrinsic types of motivators and less concerned with extrinsic rewards. Further investigation needs to include mainland populations and students in approved/accredited curriculums.     

Professional role complexity and job satisfaction of collegiate certified athletic trainers

CONTEXT: Whenever professionals have multiple role obligations in the workplace, they face potential professional role complexities. OBJECTIVE: To examine whether certified athletic trainers (ATs) employed at the collegiate level experienced professional role complexities, and if so, what effect those complexities had upon their job satisfaction and intent to leave a current position or the profession. DESIGN: Survey. SETTING: We used Internet survey methods to gather information from 1000 randomly selected collegiate ATs regarding the amount of stress they felt due to role complexities. PATIENTS OR OTHER PARTICIPANTS: We obtained a random sample of e-mail addresses for 1000 collegiate ATs in the United States and contacted these individuals with an invitation to participate. A total of 348 usable responses were received, for a 36% response rate. MAIN OUTCOME MEASURE(S): The role complexity aspect of the survey consisted of 45 questions addressing role ambiguity, role overload, role incongruity, role incompetence, and role conflict. The job satisfaction portion consisted of global questions regarding overall job satisfaction and intent to leave the job or profession. RESULTS: A total of 38% of respondents experienced moderate to high stress levels from role overload, whereas 23% and 22% had moderate to high levels of stress from role ambiguity and role conflict, respectively. Clinicians and joint appointees who reported moderate to high levels of stress from role complexity issues had lower job satisfaction and more frequent thoughts of leaving than did their faculty counterparts. CONCLUSIONS: The majority of collegiate ATs experienced low levels of professional role complexities and were relatively satisfied with their jobs. However, collegiate ATs began to experience less job satisfaction and more thoughts of leaving when moderate to high stress levels occurred due to role ambiguity, overload, incongruity, incompetence, and conflict. Lessening the stress due to role complexities is critical to positive employment experiences for ATs employed in higher education.     

The Relationship Between Spiritual Well-Being and Burnout in Collegiate Athletic Trainers

ContextSpiritual well-being is the expression of one''s spirituality as measured in the dimensions of existential and religious well-being. The Smith Cognitive Affective Model of Athletic Burnout suggests that personality factors such as spiritual well-being and the use of religious coping methods may affect burnout as well as its causes and outcomes. This has not been examined in collegiate athletic trainers (ATs).ObjectiveTo investigate the relationship between spiritual well-being and burnout in collegiate ATs.DesignCross-sectional study.SettingWeb-based survey.Patients or Other ParticipantsA total of 783 certified ATs employed full time in the collegiate setting participated. Part-time employees (eg, graduate assistants, interns) were excluded.Main Outcome Measure(s)A 100-item online questionnaire was created for this study. It used items from previously developed scales, including the Spiritual Well-Being Scale, the Brief RCOPE, the Maslach Burnout Inventory, and substance-use questions from the Monitoring the Future study. Participants were able to complete the survey in approximately 10–15 minutes. Multiple regression analyses were used to analyze survey data. We mapped all independent (existential well-being, religious well-being, positive and negative religious coping) and dependent variables (situational variables, Maslach Burnout Inventory burnout subscales, substance use, and intention to leave) onto the Smith Cognitive-Affective Model of Athletic Burnout to determine which variables altered burnout levels, substance use, and intention to leave. Tests of mediation or moderation were conducted when appropriate.ResultsExistential well-being was a significant positive predictor of social support and a significant negative predictor of work-family conflict, decreased sense of personal accomplishment, emotional exhaustion, depersonalization, intention to leave the profession, and binge drinking. Existential well-being also served as a mediator or moderator in several components of the model.ConclusionsExistential well-being was a protective factor against burnout as well as some of the causes and effects of burnout in collegiate ATs.     

Evaluation of professional preparation in athletic training by employed, entry-level athletic trainers

The purpose of this study was to determine the perceived adequacy of professional preparation in athletic training among employed, entry-level certified athletic trainers. Data were gathered by means of a self-reporting questionnaire designed specifically for the study. There were 277 questionnaires mailed, and 183 entry-level certified athletic trainers (66%) responded to the survey. Demographic and employment characteristics of the respondents were examined. Respondents rated their perceptions of adequacy of professional preparation and growth in several academic and clinical task areas. Entry-level athletic trainers felt more prepared in the areas of prevention of athletic injuries/illnesses, evaluation and recognition of athletic injuries/illnesses, and first aid/emergency care. They felt less prepared in the areas of rehabilitation and reconditioning, organization and administration of athletic training programs, counseling and guidance of athletes, and education of athletes. Many entry-level certified athletic trainers were not strongly impressed with the adequacy of the number of clinical hours required or the areas of clinical experiences encountered during their professional preparation programs. Respondents felt that their mentors/certified athletic trainers could have provided more leadership, guidance, and evaluation. According to this study, professional preparation programs in athletic training are adequately preparing entry-level professionals, but certain task areas need increased emphasis.     

Motivational congruency and discrepancy of hawaiian athletic trainers

Motivation is an integral part of an effective organizational management scheme. In March 1992, we sent a survey designed to assess motivational preference to all certified athletic trainers in the State of Hawaii. The population included: 6 high school athletic trainers, 10 university athletic trainers, and 9 clinic athletic trainers. The surveys were completed and returned by 80% of the population. With the exception of being an integral part of a work team (p<.05), athletic trainers in the State of Hawaii showed little discrepancy in terms of motivation. Further, there are differences among the three groups of athletic trainers in rating the importance of motivators concerning being appreciated, receiving raises, and being an integral part of a team (p< .05) Differences in motivational factors among these three groups could be influenced by the organizational structure in which the athletic trainers operate. Further investigation should include a mainland population that includes athletic trainers in professional sports and the industrial setting.     

A national survey of athletic trainer roles and responsibilities in the allied clinical setting

Data collected from a survey instrument mailed to all 188 NATA-approved allied clinical setting directors were analyzed to assess the current levels of professional preparation as related to the NATA competencies, job roles, and responsibilities of certified athletic trainers in the allied clinical setting. The topics examined included specific roles and responsibilities of certified athletic trainers currently employed in an allied clinical setting. A response rate of 70.5% was obtained. Skills and services provided by the clinical ATC rated as very important were: evaluation, prevention, and rehabilitation/reconditioning of athletic injuries. Competency regarding recognition and evaluation received the highest relative importance score, which is consistent with the findings of the 1982 NATA Role Delineation Study and the 1991 NATA Validation Study. Educational preparation through NATA-approved curriculums had the highest importance in professional preparation for a career in athletic training. The data indicated that educational emphasis for athletic training students interested in employment in the nontraditional setting has diverged from the guidelines established in the 1982 Role Delineation Study. The results of this study suggest that students preparing for a career in a nontraditional (clinical) setting should focus on developing skills in athletic injury evaluation, rehabilitation and reconditioning, and prevention. While these results support findings of the 1982 Role Delineation Study, additional research is needed to address the levels of professional preparation as related to the NATA competencies, job roles, and responsibilities of the clinical athletic trainer.     

An assessment of burnout in graduate assistant certified athletic trainers

Context:

Graduate assistant athletic trainers (GAATs) must balance the demands of clinical care and the academic load of graduate-level students.

Objective:

To examine burnout among GAATs with clinical assistantships at National Collegiate Athletic Association (NCAA) Division I institutions and to identify the personal and situational variables that are related to burnout.

Design:

Cross-sectional study.

Setting:

Division I universities offering graduate assistantship programs.

Patients or Other Participants:

Two hundred one GAATs enrolled at NCAA Division I universities with graduate assistantship positions.

Main Outcome Measures(s):

The Athletic Training Burnout Inventory, which assesses stress and burnout among ATs through 4 constructs: emotional exhaustion and depersonalization, administrative responsibility, time commitment, and organizational support. The 6-point Likert scale is anchored by 1 (never true) and 6 (always true).

Results:

The GAATs who traveled with athletic teams (4.051 ± 0.895) and those who provided classroom instruction (4.333 ± 1.16) reported higher levels of stress due to time commitment than those who did not travel (3.713 ± 1.22) or teach (3.923 ± 0.929). We also found a difference in administrative responsibility across clinical settings (F_6,194  =  3.507, P  =  .003). The results showed that GAATs in NCAA Division I clinical settings (44.55 ± 13.17 hours) worked more hours than those in NCAA Division III clinical settings (33.69 ± 12.07 hours) and those in high school settings (30.51 ± 9.934 hours).

Conclusions:

Graduate assistant ATs are at risk for burnout because of the time necessary to complete their clinical and academic responsibilities and their additional administrative responsibilities. Graduate assistants who work in the Division I clinical setting are at greater risk for burnout than those in the secondary school setting because of the large number of hours required.     

Sex and Employment-Setting Differences in Work-Family Conflict in Athletic Training

Context

 Work-family conflict (WFC) has received much attention in athletic training, yet several factors related to this phenomenon have not been examined, specifically a practitioner''s sex, occupational setting, willingness to leave the profession, and willingness to use work-leave benefits.

Objective

 To examine how sex and occupational differences in athletic training affect WFC and to examine willingness to leave the profession and use work-leave benefits.

Design

 Cross-sectional study.

Setting

 Multiple occupational settings, including clinic/outreach, education, collegiate, industrial, professional sports, secondary school, and sales.

Patients or Other Participants

 A total of 246 athletic trainers (ATs) (men = 110, women = 136) participated. Of these, 61.4% (n = 151) were between 20 and 39 years old.

Main Outcome Measures(s)

 Participants responded to a previously validated and reliable WFC instrument. We created and validated a 3-item instrument that assessed willingness to use work-leave benefits, which demonstrated good internal consistency (Cronbach α = 0.88), as well as a single question about willingness to leave the profession.

Results

 The mean (± SD) WFC score was 16.88 ± 4.4 (range = 5 [least amount of conflict] to 25 [highest amount of conflict]). Men scored 17.01 ± 4.5, and women scored 16.76 ± 4.36, indicating above-average WFC. We observed no difference between men and women based on conflict scores (t₂₄₄ = 0.492, P = .95) or their willingness to leave the profession (t₂₄₄ = −1.27, P = .21). We noted differences among ATs in different practice settings (F_8,245 = 5.015, P <.001); those in collegiate and secondary school settings had higher reported WFC scores. A negative relationship existed between WFC score and comfort using work-leave benefits (2-tailed r = −0.533, P < .001). Comfort with using work-leave benefits was different among practice settings (F_8,245 = 3.01, P = .003).

Conclusions

 The ATs employed in traditional practice settings reported higher levels of WFC. Male and female ATs had comparable experiences of WFC and willingness to leave the profession.Key Words: work-life balance, work-leave benefits, retention, attrition

Key Points

• Work-family conflict (WFC) continues to be an important employment concern in athletic training.
• The level of perceived WFC did not differ between men and women but did differ among practice settings.
• Comfort using work-leave benefits to address family challenges was negatively correlated with WFC.
• Researchers need to examine the role of workplace policies in mitigating WFC.

The ever-changing demographic makeup of the workforce appears to drive scholarly attention toward work and family challenges. Work-family and work-life balance have become predominant concerns for working Americans. Americans work more hours than people in other industrialized countries,¹ which affects the time available to address nonwork responsibilities and personal hobbies and interests. Whereas these factors have been cited among all occupations, health care professionals, such as physicians² and athletic trainers (ATs),³ are susceptible to challenges with work-family balance because of the long work hours, inflexible work schedules, and demands associated with patient care.^2,3Work-family conflict (WFC) appears to be emerging as a greater concern in athletic training because of its association with retention,^3,4 particularly of female ATs.^4–6 In a recent report, Kahanov and Eberman⁷ noted that many female ATs leave the profession before they are 30 years old, indicating a relationship between starting a family and incompatibility with a career in athletic training. Hours worked are linked repeatedly to this dichotomy between a lifelong career in athletic training and the demands of parenthood.^6,8,9 Dodge et al¹⁰ were among the first to report concerns about the time-intensive nature of the profession and longevity, noting that some athletic training students changed majors to more family-friendly career paths. This observation directly links the importance of early socialization and mentoring of students because their results implied that some students decide to leave the profession before serving as ATs. Whereas female ATs appear to make career-setting or occupational-setting changes due to motherhood, limited data exist to support sex differences in the profession. Researchers^5,7,9 have postulated that male ATs shift occupational settings to accommodate the need to provide for the family financially, both in the traditional sense and with job security, whereas female ATs make career changes to fulfill their parenting roles. Despite the strong speculation that sex mitigates experiences of WFC mostly because of the traditional ideology that exists about parenting roles and needs, no such differences have been found in athletic training.⁸ The lack of a sex difference is potentially misleading because the data were based only on a large group of ATs working in the collegiate setting, which provides rationalization for future research.In addition, a facet of WFC that has not been explored is the use of work-related benefits, including personal time, sick days, and appropriate family-medical leave, that allow a person to attend to necessary family and personal obligations. Many organizations have family-friendly workplace policies to help employees more easily balance and manage their family and work obligations. A variety of policies are commonly offered, including flex time, job sharing, telecommuting, maternity/paternity leave, and child care options.^3,9 Researchers^3,9 have suggested that these policies are more readily accessible to and are used more often by women because of the gendered nature of the policies. The advantages of workplace benefits that allow for fulfillment of work-family balance include job and life satisfaction, improved workplace productivity, and retention of quality employees.¹¹ Despite these universal workplace benefits, little is known about ATs'' comfort levels in using them to address personal and family needs and, thus, to potentially mitigate WFC.The collegiate setting appears to be an occupational setting that precipitates departure because of the hours worked, along with other demands placed on the ATs employed in that setting.⁴ Whereas information on WFC in the collegiate and secondary school settings is available, it is limited within emerging practice settings, such as military and industrial. The experiences of ATs working in the National Collegiate Athletic Association Division I-A and secondary school settings cannot be generalized among all athletic training populations, as job demands and responsibilities may differ and affect experiences of WFC. Researchers^5–8 have reported that WFC in athletic training is facilitated by many organizational factors; thus, we need to understand occupational-setting differences. Most data that exist on occupational settings and experiences of WFC are qualitative, and although these data are valuable and insightful, transferability is limited. In most cases, the sample sizes are small, and the intended purpose is to gain exploratory knowledge on a particular topic for a holistic understanding. Therefore, the purpose of our study was multifaceted: (1) to investigate if a difference exists in perception of WFC between sexes in athletic training, (2) to determine whether sex differences exist in how WFC affects willingness to leave the profession, (3) to access how occupational settings affect WFC, (4) to examine the comfort level in using work-leave benefits, and (5) to evaluate whether this comfort level differs by practice setting. We hypothesized that female ATs would perceive more WFC than male ATs and that female ATs would be willing to leave athletic training based on WFC. We also hypothesized that a difference would exist among settings for WFC and willingness to leave the profession.     

Self-reported comfort in athletic training of gender-specific and non-gender-specific injuries and issues

Context: To assist athletes in maintaining optimal health, athletic trainers must work with athletes of both sexes.Objective: To examine athletic trainers'' comfort levels in providing care for gender-specific and non-gender-specific injuries and issues.Design: We mailed 235 Gender Comfort in Athletic Training Questionnaires to program directors, who were asked to distribute and collect them.Setting: We randomly selected 21 athletic training education program directors and invited them by e-mail to participate in the study. Fourteen program directors representing the 10 National Athletic Trainers'' Association districts agreed to participate.Patients or Other Participants: A total of 192 participants returned completed questionnaires, for a response rate of 82% (103 women, 89 men; 101 senior athletic training students, 91 certified athletic trainers).Main Outcome Measure(s): The questionnaire consisted of 17 injuries and issues common to both female and male athlete scenarios. Three gender-specific items were added to each scenario. Responses were scored on a 5-point scale anchored by 1 (very uncomfortable) and 5 (very comfortable). Participants were asked to indicate the reason for any degree of discomfort. Internal consistency, determined by the Cronbach alpha, was .92 for the female athlete scenario and .93 for the male athlete scenario.Results: We found significant differences between women and men certified athletic trainers for the female and male athlete scenarios. Overall, women were more comfortable caring for female injuries and issues, whereas men were more comfortable caring for male injuries and issues. Certified athletic trainers reported more comfort overall than athletic training students. The most common underlying reason reported for discomfort in caring for female and male injuries and issues was experience level.Conclusions: Athletic training education programs should provide early and more deliberate experiences with injuries and issues of a more intimate nature, including those that are gender specific and non-gender specific. These experiences may increase athletic trainers'' level of comfort in providing care to athletes of the opposite sex.     

中小学教师的工作家庭冲突对工作态度的影响

目的:探讨中小学教师的工作家庭冲突对工作态度的影响。方法:采用工作家庭冲突、工作满意、组织承诺、离职意向问卷对浙江省270名中小学教师进行调查。结果:工作对家庭的冲突与工作满意存在显著负相关,与离职倾向存在显著正相关;家庭对工作的冲突与组织承诺之间存在显著负相关,与离职倾向有显著正相关。结论:工作对家庭的冲突比家庭对工作的冲突对工作满意具有更高的预测作用;而家庭对工作的冲突比工作对家庭的冲突对组织承诺具有更高的预测效果。工作对家庭的冲突和家庭对工作的冲突对于离职意向均具有显著预测作用。     

The importance of state regulation to the promulgation of the athletic training profession

States regulate professions to protect the public from harm by unqualified practitioners. Without regulation of athletic trainers (ATs), there is no legal way to assure quality health care to athletes because there is no legal definition as to what an AT can and cannot do. Problems exist, however; 1) ATs nationwide may not be adequately familiar with state regulations; 2) without regulation, legal support is given to high schools to use less qualified persons to care for student-athletes; 3) more education is needed to familiarize the public and the health care industry with the functions and qualifications of a certified AT; and 4) without uniformity of regulation, athletes may continue to suffer as untrained and/or unqualified persons continue to be perceived as members of the profession and as certified and noncertified ATs continue to practice without legal sanction, perhaps beyond their area of expertise. This article encompasses both a literature review and an opinion survey (of ATs) with regard to state regulation of the athletic training profession. The intent of this article is to help ATs understand the implications of state regulation on our profession. A survey was mailed to 500 ATs across the country soliciting opinions on state regulation and its implication of the profession of athletic training. The intent of the survey results are not to verify the literature review nor to infer information regarding other ATs, but merely to be a gathering tool to solicit information from fellow ATs.     

The Stress and Coping Responses of Certified Graduate Athletic Training Students

OBJECTIVE: To assess the sources of stress and coping responses of certified graduate athletic training students. DESIGN AND SETTING: We interviewed certified graduate athletic training students 3 times over a 9-month period. We transcribed the interviews verbatim and used grounded theory analytic procedures to inductively analyze the participants' sources of stress and coping responses. SUBJECTS: Three male and 3 female certified graduate athletic training students from a postcertification graduate athletic training program volunteered to participate in this investigation. The participants were full-time graduate students, with a mean age of 23 years, who had worked an average of 1.5 years as certified athletic trainers at the time of the first interview. MEASUREMENTS: We used grounded theory analytic procedures to inductively analyze the participants' sources of stress and coping responses. RESULTS: A total of 6 general sources of stress and 11 coping dimensions were revealed. The stress dimensions were labeled athletic training duties, comparing job duties, responsibilities as student, time management, social evaluation, and future concerns. The coping responses were planning, instrumental social support, adjusting to job responsibilities, positive evaluations, emotional social support, humor, wishful thinking, religion, mental or behavioral disengagement, activities outside the profession, and other outcomes. CONCLUSIONS: Certified graduate athletic training students should be encouraged to use problem-focused (eg, seeking advice, planning) and emotion-focused (eg, positive evaluations, humor) forms of coping with stress.