Submitted by: Timothy J. Henry, Robert C. Schneider, and William F. Stier Jr. - The State University of New York at Brockport
In an effort to determine the importance of desirable qualities, attributes and characteristics necessary for the success of interscholastic athletic trainers a Likert-type scale survey was mailed to all head athletic trainers of NCAA Division III institutions in the United States. The survey consisted of 24 statements allowing for the following responses: essential, very important, important, not very important, and irrelevant. The qualities that were deemed the most desirable by head athletic trainers were trustworthiness (76.2%), honesty (73.5%), dependability (66.4%), and possessing high ethical standards (66.4%). The two characteristics that were found to be the least essential were being a risk-taker (2.1%) and being a visionary (6.4%).
Certified athletic trainers (ATCs) are allied health care professionals who specialize in preventing, recognizing, managing, and rehabilitating injuries that result from physical activity. The ATC works as part of a complete health care team and functions under the direction of a licensed physician and in cooperation with other health care professionals, athletics administrators, coaches, and parents (NATA, 2006c). In order to become a certified athletic trainer, an individual must graduate from a Commission on Accreditation of Athletic Training Education (CAATE) approved Athletic Training program and successfully pass the Board of Certification Examination (NATA, 2006b).
The Board of Certification, Inc. (BOC) regularly conducts a role delineation study among a sample of certified athletic trainers. This study determines the current role, or standards, of the profession. This role delineation study may also be considered a job analysis and determines the minimal competencies to practice as an athletic trainer. It also serves to define the contemporary standards of practice for the athletic training profession (NATA, 2006a). The information gathered by this job analysis is used as a template for the NATA Educational Council to develop the Educational Competencies for Athletic Training. These competencies define the minimum skills and characteristics that entry-level athletic trainers should possess and define the educational content that students enrolled in an accredited athletic training program must master. The competencies are broken down into 12 content areas (Table 1) (NATA, 2006a).
“Athletic trainers are the critical link between the sport program and medical community” (Anderson and Hall, 2000, p. 6) and fulfilling this job requires the athletic trainer to fill many roles. In addition to the educational knowledge outlined by the educational competencies, ATCs must possess other qualities and attributes in order to succeed in the all-encompassing role of athletic trainer. Arnheim and Prentice (2000) describe some of these qualities as stamina and ability to adapt, empathy, sense of humor, communication, intellectual curiosity, ethical standards, and being active in professional organizations. Gaedek, Toolelian & Schaffer (1983) describe communication with other athletic trainers, physicians, physical therapists, and so forth as one of the primary attributes an ATC must possess.
Attaining a position in athletic training and, ultimately, success as an athletic trainer can be dependent upon several factors. Employers look for candidates who have both a formal and informal educational background (including certification from the BOC) as well as a demonstration of other skills and attributes that might have been obtained through experience as well as through formal educational courses (Gaedeke, Toolelian & Schaffer, 1983). When looking at employers’ hiring criteria for athletic trainers, the prevailing criterion predicting employment and salary is the educational status of the applicant (Kahanov and Andrews, 2001). This study by Kahanov and Andrews (2001) found that the four most important criteria for hiring were personal characteristics, educational experience, professional experience, and work-related attributes. Educational experience included a college minor, grade point average, membership in a fraternity, and college reputation. The personal characteristics included self-confidence, maturity, interpersonal skills, assertiveness, enthusiasm, technical skills, ability to articulate goals, oral communication skills, leadership skills, initiative, ambition, problem-solving skills, writing skills and personal appearance. Smith (2006, p.47) states that “certification and experience are important, but possibly even more critical are personality, character, and people skills”. Certified athletic trainers hold the key to a successful program, whether it is a professional team, a school, a physician’s office, a hospital, or a clinic. Thus, it is imperative to hire the right person for the job (Smith, 2006).
Although the literature contains many studies highlighting hiring criteria and desirable knowledge areas for ATCs, very few studies have investigated the personal characteristics and qualities of certified athletic trainers as viewed by employers in specific employment settings. The purpose of this study was to investigate the desired personal qualities, attributes, and characteristics of certified athletic trainers in the division III setting as viewed by head athletic trainers in these settings. To date, this is the only national study that surveyed all of the division III head ATCs asking them what personal qualities, attributes, and characteristics they believed to be important for the success of ATCs.
The population surveyed included head athletic trainers of all NCAA division III colleges and universities. The mailing addresses of the colleges and universities were obtained from the NCAA headquarters located in Indianapolis, Indiana. Of the 410 surveys mailed out, 185 were returned for a return rate of 45.1%.
The survey instrument utilized in the study was approved by the Institutional Review Board at the surveying institution. The instrument was developed based upon the professional literature and as well as communication with experts in the area of athletic training. Twenty-four specific skills and competencies were identified and included in the survey.
After approval of the survey instrument, all surveys were mailed to the NCAA division III head athletic trainers. A return envelope that was pre-stamped, and addressed to the principal investigator, was included in the mailings. Anonymity of the head athletic trainer, as well as the college and university surveyed, was ensured.
The head athletic trainers were asked to provide their opinions as to the level of importance of the personal qualities, attributes, and characteristics included on the survey that were related to the success of the athletic trainers in providing health care to student athletes. By responding to a 5-point Likert scale, essential, very important, important, not very important, irrelevant, the head athletic trainers provided their opinions as to the level of importance of specific skills and competencies found in successful athletic trainers.
The findings are displayed in Table 2 and revealed varied opinions regarding the importance of personal qualities, attributes, and characteristics that Division III head athletic trainers believed to be essential, very important, important, not very important, and irrelevant in order to be successful as an athletic trainer at the Division III level. Most of the items were identified as either essential or very important; however, some were not viewed as highly.
Six items were reported as the most important personal attributes for successful ATCs. These items had the highest percentage of responses as essential to the success of athletic trainers at the Division III level:
In addition to the attributes reported as essential, three items were reported as being highly desirable (either essential or very important) by 90% of the respondents:
Head athletic trainers viewed the following as having the least impact (essential or very important) among all of the selected skills and competencies on success of the Division III ATCs:
This study examined the desirable personal qualities and attributes necessary to be a successful athletic trainer at the Division III level. The most desirable characteristics reported by head athletic trainers in this study, honesty, trustworthiness, and high ethical standards, can be grouped together as ethical qualities. Each of these attributes is important to the ability of the ATC to provide high quality health care to the physically active. All members of the NATA are required to observe the NATA Code of Ethics, which provides an outline of ethical behavior that should be followed in the practice of athletic training. The Code is comprised of 5 principals and presents aspirational standards of behavior that all members should strive to achieve (NATA, 2006c). ATCs typically deal with many controversial and sensitive issues in which honesty, trustworthiness, and high ethical standards are of the utmost importance. Some of these sensitive situations may include athletes with diseases or conditions, such as HIV or hepatitis, athletes with sexually transmitted diseases, athletes with season-ending or career-ending injuries, and athletes that may be using, or are suspected of using, performance enhancing substances. In each of these scenarios, the ATC may find themselves exposed to extremely sensitive and confidential information. Confidential information that is obtained as part of the professional relationship that an ATC has with an athlete might be personal, private, and sensitive. The ATC should handle this sensitive information carefully to avoid ethical, as well as legal, breaches of confidentiality. Another issue related to the ethical standards of athletic trainers is the high profile of athletes and of the athletic industry in our society. The accessibility of the media and the public’s desire to know everything possible about their teams and athletes can be a significant threat to an athlete’s privacy and to the confidentiality of information to which the ATC is privy (Ray, 2005). The fact that the respondents in this study valued the ethical attributes establishes the importance of the Code of Ethics in the daily practice of the ATC.
Trustworthiness is not only important when dealing with the confidentiality issues, but it is extremely important in establishing a good rapport between the athlete and the athletic trainer. The athlete needs to respect the athletic trainer as a person before they can trust the athletic trainer in the rehabilitative setting. The ATC must gain the trust of the athlete before the athlete will follow the protocols and programs designed for them by their athletic trainer (Arnheim and Prentice, 2000).
Other attributes that were deemed highly desirable were adaptability and dependability. Arnheim and Prentice (2000, p. 16) report, “The athletic trainer must be able to adapt to new situations with ease.” This is due to the large number of athletes and teams that they are typically responsible for covering. Practice and game schedules are frequently canceled or modified, depending on factors such as weather, facility availability, team condition, travel schedules, and so forth. In many cases, ATCs are at the mercy of the coaches and administrators in determining these schedules and may not be consulted as to their opinions in those matters. Due to the unique skills which the ATC provides, they are difficult to replace and they must be present at all practices and contests in order to provide the high quality health care that the athletes deserve.
The ability to communicate is an attribute that was deemed essential by 61.6% of the respondents; however, we expected a higher percentage of the head athletic trainers to list this as essential. Athletic trainers are often described as a liaison between athletes, coaches, team physicians, and other allied health care professionals. This role requires the ATC to serve as an educator, psychologist, counselor, therapist, and/or administrator and is dependent upon a constant flow of oral and written communication (Arnheim and Prentice, 2000). Lockard (2005) stressed the importance of having positive relationships by stating that because athletic trainers deal with a variety of people, they need good social and communication skills.
Personal attributes that were deemed desirable by the respondents were decisiveness and leadership. Decisiveness is a characteristic that does not appear in any of the previous literature relating to desirable personal attributes or hiring characteristics for an ATC. During the course of any typical day for an ATC, many situations arise in which the athletic trainer must make important decisions. Referral decisions are an inherent part of the injury management domain of athletic training, especially those dealing with potentially catastrophic injuries. These decisions must be made spontaneously in many cases with the well-being of the athlete at stake.
The importance of leadership in our study is similar to the findings of Kahanov and Andrews (2001). They listed leadership as one of 16 characteristics that were viewed as important by employers when hiring ATCs across different job settings, although leadership was not rated as highly as other characteristics in their study. As mentioned previously, the ATC is typically the leader or coordinator of the sports medicine team (NATA, 2006e). Smith (2006) stated that certified athletic trainers hold the key to a successful program, whether it is a professional team, a school, a physician’s office, a hospital, or at a clinic.
The personal attribute that was reported to be the least important in the Division III setting was being a risk-taker. This finding is not surprising when considering the myriad of legal and ethical issues confronting ATCs today. Risk management is an important term to all ATCs today, and the athletic trainer is intimately involved in developing safe athletic programs in all types of settings. Lyznicki et al. (1999) found the implementation of risk management programs by athletic trainers to be important in that it minimized liability in secondary schools. Chen and Esposito (2004) recognized the importance of risk management and acknowledged the need for athletic trainers to formulate a risk management plan.
Another personal attribute that was not deemed essential to the success of athletic trainers at the division III level was high energy level. Only 16.2% of the respondents reported this to be essential, while 39.4 % rated this as very important. This finding is extremely surprising and is contrary to many commonly described views of the ATC. ATCs typically work extremely long hours and are asked to cover numerous sporting events every day. Arnheim and Prentice (2000, p. 16) state, “Athletic training is not the field for a person who likes an 8-to-5 job. Long, arduous hours of often strenuous work will sap the reserve strength of anyone not in the best of physical and emotional health. Athletic training requires abundant energy, vitality, and physical and emotional stability.” In recent years, the NCAA and other administrators have begun to recognize the long hours and busy days of ATCs and have implemented changes in the sports medicine coverage provided by ATCs. The NCAA recently implemented the guidelines for appropriate medical coverage for intercollegiate athletics (NATA, 2003), which generally increases the number of ATCs required to meet the health care needs of student athletes on NCAA college campuses. This document suggested to collegiate administrators that they need to hire more certified athletic trainers to cover the ever-increasing health care needs of their student athletes. This recently implemented guideline may have in fact alleviated some of the long hours and strenuous days that had become commonplace for the ATC. With the addition of more staff, head ATCs may now feel that having a high energy level is not as important as it was traditionally viewed.
Being a visionary is another characteristic that was not reported as desirable as some of the others. Athletic training is a relatively young profession and the physically active community is just beginning to recognize the role and importance of ATCs in providing health care to the physically active. The recent evolution of athletic training is due to the long-term vision of many early athletic trainers; however there are still many hurdles for ATCs to clear in order for athletic training to become fully integrated into the larger sports medicine field. Some of the important issues currently confronting NATA members are third party reimbursement, expanding employment settings, and refining the educational process. These are issues that many ATCs are concerned with and are highly intertwined with the long-term vision and strategic plan of the NATA. (NATA, 2006d). It is somewhat surprising to the authors that being a visionary is not deemed more desirable by head athletic trainers at the division III level.
The most important personal characteristics and attributes for ATCs at the division III level were related to ethical issues and included honesty, trustworthiness, and possessing high ethical standards. Other highly desirable characteristics were being adaptable, dependable, and a good communicator.
The least important personal attribute was being a risk-taker. Other attributes that, surprisingly, were not deemed as highly desirable were having a high energy level and being a visionary.
|Risk Management and Injury Prevention|
|Pathology of Injuries and Illnesses|
|Orthopedic Clinical Examination and Diagnosis|
|Medical Conditions and Disabilities|
|Acute Care of Injuries and Illnesses|
|Conditioning and Rehabilitative Exercise|
|Psychosocial Intervention and Referral|
|Nutritional Aspects of Injuries and Illnesses|
|Health Care Administration|
|Professional Development and Responsibility|
|Qualities, Attributes, and Characteristics||Essential (%)||Very Important (%)||Important (%)||Not Very Important (%)||Irrelevant (%)|
|High energy level||16.2||39.4||40.2||3.7||.5|
|High ethical standards||66.4||28.9||1||.5||3.2|
|Professional visual image||30.8||43.7||19.1||3.2||3.2|
Note: The values represent mean percentages of the Likert-type-scale responses.
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Arnheim, D. D, & Prentice, W. E. (2000). The athletic trainer and the sports medicine team. In Principle of athletic training. (10th ed.) New York, NY: McGraw-Hill.
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National Athletic Trainers’ Association. (2006a) Athletic training educational competencies. (4th ed.). Dallas, TX: NATA.
National Athletic Trainers’ Association. (2006b). Athletic training education overview. Retrieved on November 20, 2006 from www.nata.org/consumer/docs/educationfactsheet05.pdf
National Athletic Trainers’ Association. (2006c). NATA Code of Ethics. Retrieved on January 30, 2007 from http://www.nata.org/codeofethics/code_of_ethics.pdf
National Athletic Trainers’ Association (2006d). Strategic Plan. Retrieved on January 27, 2006 from www.nata.org
National Athletic Trainers’ Association. (2006e). What is a certified athletic trainer?. Retrieved on November 20, 2006 from www.nata.org
National Athletic Trainers’ Association. (2003). Recommendations and guidelines for appropriate medical coverage of intercollegiate athletics. Retrieved on November 1, 2006 from www.nata.org/statements/support/amciarecsandguides.pdf
Ray, R. (2005). Ethics in sports medicine. In management strategies in athletic training. (3rd ed.) Champaign, IL: Human Kinetics.
Smith, L. (2006, November). Big job small staff. Training and Conditioning, pp. 47-51.
Timothy J. Henry, Associate Professor and Athletic Training Program Coordinator, The State University of New York at Brockport; Robert C. Schneider, Associate Professor, Department of Physical Education and Sport, The State University of New York at Brockport; William F. Stier, Jr., Distinguished Service Professor and Graduate Director, Department of Physical Education and Sport, The State University of New York at Brockport.
Correspondence concerning this article should be addressed to Timothy J. Henry, Department of Physical Education and Sport, The State University of New York at Brockport, 350 New Campus Drive, Brockport, NY 14420. E-mail: email@example.com; Fax: 585-395-2771; Work Phone: 585-395-5357.