Athletic Training and Sports Health Care

Original Research Supplemental Data

An Individual and Organizational Level Examination of Male and Female Collegiate Athletic Trainers' Work–Life Interface Outcomes: Job Satisfaction and Career Intentions

Christianne M. Eason, PhD, ATC; Stephanie Mazerolle Singe, PhD, ATC, FNATA; William A. Pitney, EdD, ATC, FNATA; Craig Denegar, PhD, PT, ATC; Jennifer McGarry, PhD

Abstract

Purpose:

To examine individual and organizational level factors that may affect the job satisfaction and career intentions of athletic trainers employed in the collegiate setting.

Methods:

Volunteers for this qualitative study included 30 athletic trainers aged 33 ± 8 years with 10 ± 8 years of experience who were employed in the National Collegiate Athletic Association (NCAA) Division I, II, or III or National Association of Intercollegiate Athletics (NAIA) setting. Semi-structured phone interviews were digitally recorded and transcribed verbatim. Data were analyzed using a general inductive approach. The credibility of the study was maintained using peer review and multiple analyst triangulation.

Results:

Organizational level factors appeared to influence the participants' job satisfaction and career intentions. Although there were similarities between individual level factors among collegiate athletic trainers, these factors alone did not account for job satisfaction or career intentions.

Conclusions:

Continued multilevel examinations of the work–life interface are warranted to better understand issues related to retention and attrition within the athletic training profession.

[Athletic Training & Sports Health Care. 2020;12(1):21–30.]

Abstract

Purpose:

To examine individual and organizational level factors that may affect the job satisfaction and career intentions of athletic trainers employed in the collegiate setting.

Methods:

Volunteers for this qualitative study included 30 athletic trainers aged 33 ± 8 years with 10 ± 8 years of experience who were employed in the National Collegiate Athletic Association (NCAA) Division I, II, or III or National Association of Intercollegiate Athletics (NAIA) setting. Semi-structured phone interviews were digitally recorded and transcribed verbatim. Data were analyzed using a general inductive approach. The credibility of the study was maintained using peer review and multiple analyst triangulation.

Results:

Organizational level factors appeared to influence the participants' job satisfaction and career intentions. Although there were similarities between individual level factors among collegiate athletic trainers, these factors alone did not account for job satisfaction or career intentions.

Conclusions:

Continued multilevel examinations of the work–life interface are warranted to better understand issues related to retention and attrition within the athletic training profession.

[Athletic Training & Sports Health Care. 2020;12(1):21–30.]

Work–life interface is the overlap, or intersection, of work and private life. There are numerous aspects of an individual's life that may overlap with work, including family, recreation, and health. The work–life interface is bidirectional, meaning that work can interfere with private life and private life can interfere with work. This interface can be adverse in nature (work–life conflict1) or it can be advantageous (work–life enrichment2). The balance that individuals need between the time allocated for work and other aspects of their lives is known as work–life balance, and this balance is different for everyone. Research2,3 has shown that there are numerous outcomes associated with the work–life interface, including job satisfaction and career intentions.

Job satisfaction has been defined as the degree to which individuals like their job,4 and it may be affected positively or negatively by numerous factors. For example, work–life conflict tends to decrease job satisfaction,5 whereas salary has been shown to have either a negative6 or positive7 influence on job satisfaction. An individual with high job satisfaction is less likely to leave a profession than an individual with low job satisfaction.8 Career intentions data provide an indication of whether employees will remain in their current position, look for another position within the same profession, or depart the profession entirely.

Current athletic training research demonstrates that travel demands, irregular and long hours, perceived inadequate compensation, stresses imposed by supervisors, and schedule changes are challenging aspects that may negatively affect the work–life interface.9,10 The aspects that influence the work–life interface unfavorably also serve as catalysts for job dissatisfaction and attrition. Although athletic trainers, coaches, and sports information individuals have similar adverse experiences, athletic trainers are unique because they are also health care providers, which brings the stresses and responsibilities associated with patient care and the possibility of role incongruity.11,12

The majority of athletic training research examining the work–life interface outcomes has focused on the female perspective,13 due to hypothesized gender norms that may impede career trajectories or impact career intentions. Despite a strong focus on female athletic trainers, research has not identified sex-related differences in experiences of work–life conflict. Mazerolle et al.14 found that work–life conflict was a causative factor for male athletic trainers to leave the Division I collegiate clinical setting. Because negative outcomes of the work–life interface have traditionally been viewed as a woman's issue, a man's perspective on work and family responsibilities is less understood in athletic training.

The need to approach work–life interface research within athletic training on multiple levels is essential, and its complexity within sport has been acknowledged.9 In their examination of the work–life interface, Dixon and Bruening9 identified individual and organizational factors and outcomes, including the outcomes of job satisfaction and career intentions. Individual level factors include characteristics such as personality, age, sexual identity, coping mechanisms, race, and gender. Research has consistently demonstrated that individuals differ in their experiences regarding work, personal domains, and the intersection between those roles.15,16 Organizational level factors relate to how workplace structures, such as policies and practices, interact with employee behavior to promote enrichment or create conflict.15 Although preference or choice at the individual level may appear to trigger an individual's departure from the profession, the attrition may be prompted by the organizational context in which the individual is embedded, or a combination of these factors.

Based on the importance of examining the work–life interface outcomes of job satisfaction and career intentions on multiple levels and between both sexes in athletic training, the purpose of our study was to examine and develop a better understanding of the factors that may influence collegiate athletic trainers' job satisfaction and career intentions, because the two outcomes are directly linked to the work–life interface. Our study was guided by the following research questions: (1) “What individual factors influence the job satisfaction or career intentions of collegiate athletic trainers?” and (2) “What organizational factors influence the job satisfaction or career intentions of collegiate athletic trainers?”

Methods

This study was part of a larger investigation that examined the career intentions of collegiate athletic trainers from a multilevel perspective.17 The current study is distinct because it offers the participants' perspectives via a qualitative analysis of data and focuses on their perceptions and experiences of career intentions and job satisfaction while working in the college setting. A qualitative lens was used to address the exploratory purpose and research questions because it provided the most flexibility and the chance to explore the experiences of collegiate athletic trainers.18 This study was approved by the institutional review board of the University of Connecticut before data collection was initiated.

Participants

As part of a larger project,17 this phenomenological study required all participants to complete an online survey. A secondary link asked the participants to provide their contact information if they were interested in participating in phone interviews (survey responses could not be linked to personal information). Inclusion criteria were athletic trainers who were employed in the college or university setting. Data saturation guided the recruitment of participants.19 Participants were excluded from the study if they were graduate assistants or athletic training interns. The participants (n = 30) in this study identified as athletic trainers and were employed in National Collegiate Athletic Association (NCAA) Division I, II, or III or National Association of Intercollegiate Athletics (NAIA) colleges or universities. Athletic trainers employed in the college or university setting were purposefully chosen due to the demanding nature of the setting and because they represent the largest population of certified members of the NATA.20

All participants were current NATA members. Our participants were aged 33 ± 8 years (range: 23 to 59 years) and had been certified for 10 ± 8 years (range: 2 to 33 years), with 6 ± 4 years (range: 1 to 15 years) at their current position. They worked an average of 54 ± 9 hours (range: 20 to 70 hours) per week and were contracted for 11 ± 1 months (range: 9 to 12 months) of the year. The average number of full-time athletic trainers on our participants' staff was 6 ± 4 (2 to 18). Participants identified as male (n = 14, 47%) and female (n = 16, 53%). The majority of our participants were married (n = 17, 57%) and did not have children (n = 19, 63%). All participants who reported having children also self-reported being married. Demographic information in addition to participant pseudonyms is presented in Table 1.

Participant Demographics

Table 1:

Participant Demographics

Procedures and Data Collection

We contacted the NATA to provide a list of athletic trainers currently employed in the college or university setting. E-mails were sent to 2,000 certified members of the NATA who were identified as working in the collegiate clinical setting. Potential participants were asked to complete an online survey housed on Qualtrics ( https://www.qualtrics.com/) and to click on a link that would allow them to provide contact information if they were interested in participating in a phone interview. It was not possible to match survey responses with personal contact information because participants were automatically linked to a separate survey to enter their contact information. All phone interviews were completed by the lead author (CME) and were scheduled at the convenience of the participant. Data saturation guided participant recruitment. The interview guide (Table A, available in the online version of this article) was developed to reflect the research agenda and incorporated questions derived from theories and concepts from the literature related to personality,21,22 job satisfaction,23,24 intrinsic motivation,25 coping,26 gender perceptions and ideology,27 work hours and scheduling,28 scarcity theory,29,30 and career intentions.31 An athletic training scholar (SMS) with expertise in the content area of work–life balance and organizational structure established content validity by reviewing the interview guide. The feedback obtained during the peer review process was used to make small adjustments to the instrument, including wording and order of the questions.

Semi-structured Interview Guide

Table A:

Semi-structured Interview Guide

Data Analysis and Credibility Procedures

Data analysis was guided by the following steps as explained by Thomas32: (1) preparation of the raw data and data cleaning consisting of printing each individual raw data file (each interview); (2) multiple read-throughs of the raw text until researchers were familiar with its content; (3) creation of categories from actual phrases or meanings within text segments; (4) category reduction by decreasing overlap and redundancy among categories; and (5) continuing revision and refinement of the category system. The purpose of this process was to create a small number of categories considered to be the most important themes based on the research questions and evaluation objectives.32 Multiple analyst triangulation and peer review were incorporated as steps to establish trustworthiness and intercoder reliability.

Two researchers with experience in the field of athletic training and personal perspectives on work–life balance in the workplace independently developed coding schemes. They created their codebooks independently and reviewed their codes. After two rounds of discussion, an agreement was reached and the peer reviewer confirmed the themes. When the themes were established, the researchers discussed the categorization of each theme within the framework of individual and organizational level factors. Each emergent theme was identified as either an individual or organizational level factor and confirmed by the peer reviewer. The peer reviewer was the same individual who established content validity of the interview guide and provided two separate peer reviews. Bracketing was used, consistent with the phenomenological method.33 Researchers identified their own personal beliefs and experiences regarding job satisfaction and career intentions and articulated them in writing to identify whether biases entered into data analysis. It was important for researchers to identify their own beliefs to ensure data were not analyzed in a prejudiced manner. Bracketing was helpful with establishing credible results, and the authors are confident no biases were presented in the final analysis.

Results

Predictors of job satisfaction and career intentions were organized as individual and organizational level factors after the themes were established (Figure 1). We will present the emerging themes for each factor level separately below with supporting quotes. Additional supporting quotations are presented in Table B (available in the online version of this article).

Individual and organizational level factor themes.

Figure 1.

Individual and organizational level factor themes.

Supporting Quotations

Table B:

Supporting Quotations

Individual Level Factors

We were able to identify three themes related specifically to the individual level factors: athletic identity, intrinsic motivation, and conscientiousness and extraversion. Although our participants had many individual level factors in common, these factors did not appear to play a decisive role in job satisfaction or career intentions.

Athletic Identity. Athletic identity is a concept in which individuals identify with the role of athlete, and this self-identification affects how they view themselves and the importance of athletics in an individual's life.34 The majority of our participants talked about how prior involvement in sport led them to a career in athletic training. Brady said:

When I went to college, I played baseball and also decided that I wanted to try to do athletic training. Fortunately, at the level I was, I could play baseball and do athletic training. . . . I feel like I got to experience both sides, and after doing that realized that, I wanted to stay within the sports realm and be able to help people.

Mia similarly noted: “to be honest, the interest in athletic training is very similar to what most athletic trainers will tell you. I was an athlete growing up.” Jamie pointed out that athletic training provides “opportunities to be on the sidelines, or involved with the athletics side of it.” Eugenia acknowledged: “I've been an athlete my whole life. Even when I was in grade school, I was always playing sports.” Jackson stated: “I've just always been active in sports.” For many of our participants, their involvement in athletics introduced them to the athletic profession. Yuri said: “I was very interested in athletic training after I injured myself, and I used to play tennis.”

Although no participants were currently competitive athletes, many discussed the importance that athletics and physical activity continue to play in their lives. John said: “when I get free time, we have a full gym in our athletics facility, so I use that.” Hayley described herself as “a pretty active person. I like to run a lot, I like to play sports.” Elizabeth stated: “I really enjoy athletics. . .I'm an active person. I'm in the gym or doing something active probably 6 or 7 days a week.” Aaron shared: “. . .I love being active. I love playing sports, working out, running, what have you, I'm willing to try different sports.”

Intrinsic Motivation. Intrinsic motivation refers to behaviors that are guided by internal rewards, meaning that the motivation to take part in a behavior develops from within the individual because it is intrinsically and innately rewarding.35 For the participants in this study, intrinsic motivation came from the reward of knowing they were key to others' success, and they were driven to do something for the fun of it or because they believe it is the right thing to do. Richard explained that the everyday challenge motivated him: “I think to me it's yeah, that's kind of the ultimate key, the challenge. And it makes the challenge of what can I do to get this athlete the best they can possible the quickest.” Will described himself as someone who “genuinely enjoys caring for others and who likes this feeling of. . .having a part of other people's success.”

Most of our participants were intrinsically motivated by the athletes they worked with. Khloe stated: “when athletes are injured, then the primary motivation is to get them back on the field because that's what they love to do.” When asked what motivates him in his career, Jaden said: “see[ing the athletes] succeed on the field, see[ing] them succeed in life, and you know, I hope that if they do have to come see me that what I teach them isn't just about their body it's about succeeding in life.” Elizabeth responded: “I like the success when the athletes do well, and I feel for them when they get defeated or when they don't do well.” Other participants echoed these sentiments. Matt said: “trying to help [the athletes] to better themselves and be a better athlete and better students and a better person definitely motivates me.” Individuals driven by intrinsic motivation do not seek external praise and rewards. Elizabeth explained this perfectly when she said:

Sometimes. . .when I look at someone and how they overcame an injury and they played really well in one game, I look at it and say, ‘I kind of had a hand in that success of that happening.’ So that makes me feel good. And even if I don't always get all the praise or the credit for it, or even some of it, I feel good anyway that that was partly me. . .that's what my job is all about I would say.

Conscientiousness and Extraversion. We asked participants to describe themselves and, overwhelmingly, their answers represented conscientiousness and/or extraverted personalities. These characteristics are two of the five personalities described in the Big 5 personality inventory.36 Individuals who demonstrate high levels of conscientiousness are efficient time managers, well-organized, and careful planners. They typically demonstrate lower levels of conflict because they are effective with time management.37 Elizabeth told us that she tried to manage stress by “planning ahead,” demonstrating her organizational and time management skills. Dexter explained how he “sets goals” for himself to stay motivated. Jamie described herself as “organized, attention to detail, [and] very conscientious.”

Extraverted individuals are outgoing, energetic, positive, and seek the company of others. Extraverts typically experience less fatigue and have more energy for multiple roles.37 Exhibiting these qualities, Aaron described himself as “out-going” and “a team player in everything that I do.” Amy, who described herself as someone who is “happy to be surrounded by other people,” “energetic,” and likely to “get along with most people,” would also be considered extraverted. Ginger displayed classic extra-vert characteristics and described herself as “an extremely outgoing individual” who “really enjoy[s] connecting with [the] athletes” through using “a lot of humor.”

Many of our participants displayed both of these personalities in combination. Brady said he was “kind of self-motivated. . . . I tend to put my nose down and do things regardless of what is going on around me,” and also told us how his “social life is very big.” Additionally, he said: “I'm very friendly, easy going. Sometimes I can be fairly anal and obsessive compulsive, so organized, but sometimes a little overkill.” In these descriptions of himself, Brady displayed both conscientious and extraverted personalities. Eugenia stated that she was “pretty energetic and goal oriented . . . certainly nurturing,” which would also classify her as a conscientious extraverted person.

Organizational Level Factors

Organizational level factors appeared to affect our participants' perceptions of job satisfaction most notably. We were able to identify three emergent themes from our participants' responses: inadequate staff size, inequity between hours and salary, and perceived work schedule autonomy.

Inadequate Staff Size. The athletic training staff size was a factor that was brought up consistently by our participants and appeared to play a substantial role in their job satisfaction. When asked if there was anything he would change about his current job, Jaden responded: “I would definitely add more staff members to our staff. I would say we are stretched way too thin, you know, with athletes we have.” Jeff noted: “with six athletic trainers, you know, we're still understaffed.” Similarly, Howard said: “ideally. . .I would like to see, maybe one or two more staff members hired just to kind of alleviate some of the pressure in the hours that we worked.” Kristen simply stated: “we probably need a fourth athletic trainer.”

Our participants believed that the inadequate staffing affected their ability to succeed in their positions. In describing his current position at an NAIA school Rob told us: “we're probably close to negligently understaffed, I mean it's pretty crazy. Being in the fall time, I mean I know it's hard to even remember an athlete's name let alone what they came to see me for a couple days prior.”

Inequity Between Hours and Salary. Participants told us that they did not feel they were receiving adequate financial compensation for the hours they were working or the responsibilities they had. This perception of inadequate pay appeared to affect both their job satisfaction and career intentions. Yuri, a Division I athletic trainer who told us she did not see herself remaining in athletic training, said: “I just wish that. . .[we] get paid a little more because we do carry liabilities by treating other athletes or clients.” She also said: “I work quite a bit without really any off season. So, I'm pretty much on the road 10 months of a year and I also work 60 to 80 hours a week.” “A better salary, a better lifestyle” is what Yuri said she would change about her current position. Amy, who was also employed in the Division I collegiate setting, replied: “the only thing. . .would be the intense amount of work versus the pay.” Hayley echoed this: “We don't get paid for working on the weekend, so we just get basically paid for forty hours a week, and it's a flat salary.”

Perceptions of inadequate salary were not isolated to the Division I setting or gender. Dexter, a Division III athletic trainer, considered leaving the collegiate setting to work as a physician's extender because “the hours are a little more stable” and “the salary might be a little bit better too.” Kristen, who was employed at a Division III university, said: “I wish I got paid a little bit more for what I do.”

Rob explained how his salary was not reflective of the effort that he puts into his work:

[In] my current job, whether I'm just doing amazing with athletes, or you know, the extra stuff in regards to administrative things, you know, working on rehab plans, there really is not, no matter what I do at least in my institution, it's not going to affect my pay, my compensation. Whether I'm just doing awesome or just sitting in my office ignoring athletes, it's not going to affect my compensation. So, I think having more control over that would be a good feeling as well.

Perceived Work Schedule Autonomy. Many participants told us that they had a semblance of control over their own work schedules but, when pressed, their schedules revolved around athletics and the teams they provided medical care for. Amy stated: “I have some autonomy over my work schedule. The director of athletic training doesn't really. . . micromanage me by any means. . . . So, the only thing that I don't really have control over is like when the coaches do schedule practices. So, that's pretty much how I base my work.” Aaron voiced his opinion over his work schedule control: “I do have some control. But I do try to communicate in advance with coaches and other athletic trainers I work with. . . . So, yes I do have control, but at the same token it's kind of controlled by too many.” Mia said: “I can pretty much to a certain extent structure my work day however I see fit. . . . [My] ability to leave whenever I want is obviously not something I have any control over because at the end of the day, you know you have to stay until practice is over.” Elizabeth said: “I think I have a lot of influence over my work schedule. . . . I've been here 3 years, so I kind of know how the system works.” The last-minute schedule changes or lack of schedules all together appeared to create some job dissatisfaction for our participants. Laura noted that one thing she would change about her job was “just getting schedules on time. I have practice tomorrow but I don't know what time.”

Additionally, the majority of the athletic trainers had vacation time built into their contracts. However, they expressed the limited flexibility in which they felt comfortable using that time. As Amy stated: “I'll take [vacation] when it doesn't conflict with the sports schedule.” Elizabeth said, “regarding vacations. . .I think that the summers are obviously when we are encouraged to take vacations because those are the easiest times.” Brady said: “I can take vacation essentially whenever I want to. Obviously within reason, not when my sports are traveling.” Regarding her vacation time Jamie reported:

[W]e accrue [vacation time]. I couldn't tell you how much every month and then typically our vacations are happening, for me, kind of May through July. That's when my sports are kind of at their lowest amount of time involvement.”

Discussion

The purpose of this study was to examine the impact individual and organizational level factors have on the work–life interface outcomes of job satisfaction and career intentions of collegiate athletic trainers. Although individual level factors have been examined among Division I female athletes13 and organizational factors have been studied extensively,38,39 to our knowledge, our study is the first to study individual and organizational factors concurrently between men and women employed at the collegiate level. Our findings reveal that, despite many similarities among our participants, individual level factors alone did not seem to influence participants' perceptions of either job satisfaction or career intentions. Organizational level factors including salary, staffing, and work scheduling appeared to influence the job satisfaction of our participants. Our findings help expand our understanding of these work–life interface outcomes and illustrate the importance of examining various factors from a multilevel perspective.

Individual Level Factors

Our participants described the importance of athletics in their lives, both currently and prior to entering the athletic training profession. Brewer et al.34 explained that individuals who value the athletic piece of their self-concept are more likely to be involved in physical activity than those who do not. It is possible that athletic trainers specifically chose a career path that enables them to remain in athletics due to their own athletic identities, as opposed to choosing a different health care profession. Athletic identity in isolation did not appear to have a relationship to the work–life interface outcomes of job satisfaction or career identity of our participants.

Intrinsic motivation has been reported previously in the athletic training literature and has been shown to relate to professional commitment.25,40 The intrinsic reward of interacting with student-athletes and seeing them progress through injuries is corroborated in previous research.40 The idea of intrinsic reward has been linked to affective professional commitment, which refers to identifying with a profession and being loyal and psychologically attached.41 Individuals with a strong, affective professional commitment remain in the profession because they want to and it is associated with employee satisfaction, retention, and motivation to contribute to the welfare of the organization.42 Despite the confirmation of intrinsic motivations present among male and female athletic trainers employed in the collegiate setting, this individual level factor alone did not seem to directly affect the job satisfaction or career intentions of our participants.

The participants identified as conscientious and extraverted. Conscientiousness encompasses the predisposition to demonstrate self-discipline, aim for achievement, manage time well, and carefully plan. Conscientious individuals often demonstrate lower levels of conflict because they can manage their time.37 Conscientiousness has been connected to job satisfaction because it denotes a general work penchant leading to a greater probability of obtaining both formal and informal satisfying work rewards.43 A recent study examining collegiate athletic trainers found a weak positive relationship between conscientiousness and job satisfaction.44 Extraversion is a personality trait that is often distinguished by positive emotions and the tendency to seek stimulation and the company of others.22 Extroverts enjoy being surrounded by people and the trait is marked by involvement with the external world. An individual who scores high in extraversion enjoys interactions with others, likes to talk, and is able to see the positive side of things.37 An extravert is inclined to experience positive life emotions and positive emotionality likely generalizes to job satisfaction.45 In athletic training, extraversion has been shown to have a weak positive relationship with job satisfaction.44

Organizational Level Factors

The organizational level factors described by our participants that emerged and affected their perceptions of job satisfaction were displeasure with salary, long work hours, and inadequate staff created dissatisfaction. The idea of inadequate financial compensation and excessive hours is not unique. Mazerolle et al.46 found that a work overload caused by the large number of hours athletic trainers were required to work and a lack of enough athletic trainers to adequately fulfill work responsibilities led to a decreased professional commitment among collegiate athletic trainers. Unfortunately in college athletics, the nature of the work is often entrenched as working excessive hours, with little flexibility or autonomy over work scheduling.10,47 Inadequate staffing has been addressed as problematic in the intercollegiate setting because many sports medicine departments often fail to meet the appropriate medical coverage guidelines established by the NATA.48 These inadequate staffing issues are problematic and can lead to reports of high student athlete to athletic trainer ratios, which often factors into the decision to depart the profession.49 These issues of staffing patterns will likely mean a higher volume of work for the current staff and lead to an overload, which is directly related to an individual's intent to leave. There is evidence that work–time control may alleviate the negative effect of work–time demands on health and work–life balance.28,49,50 Work–time control is an individual's autonomy related to starting and finishing times of work, breaks, days off, total number of work hours, and vacations. Geurts et al.50 found that work–time control may be an important tool to help individuals maintain work–life balance and they cautioned against working very long days. The organizational level factors that emerged from our results highlight the influence of top-down impact on the work–life interface, specifically the outcomes of job satisfaction and career intentions.

Limitations and Future Directions for Research

The results of this study may not be generalizable to all athletic training professionals because we only investigated the perceptions of collegiate athletic trainers. The job demands and patient populations of other athletic training clinical settings may affect organizational level factors and therefore need to be investigated. A quantitative analysis should be conducted to investigate the relationship between the varying levels of factors to definitively determine interactions between the levels.

Implications for Clinical Practice

The college setting in athletic training continues to be a central focus for research, because it is one of the largest and is commonly associated with the athletic training profession. Despite attractors to the setting, we know that athletic trainers frequently depart due to myriad complex reasons. Our findings continue to support that career intentions must be viewed with a multifactorial lens. Our participants shared many common individual characteristics, yet also had some variability. This finding highlights that individual level factors alone are not propelling attrition within athletic training. With respect to the role the organization can play on career intentions, our results continue to showcase its influence: demands and expectations of the work setting can be challenging. This also suggests the need for adequate professional and organizational training for athletic trainers because awareness of role expectations can allow for appropriate decision-making when selecting employment.

Conclusions

Our findings highlight that issues with retention and attrition among collegiate athletic trainers are multifactorial, not solely based on an individual's own preferences, and there is a top-down and bottom-up implication. Policy and procedural changes cannot be suggested or implemented until there is an understanding of the multifactorial needs of the athletic trainers employed in the organization. Recognizing the multifaceted nature of the work–life interface and its outcomes may stimulate organizational policy change to help retain quality athletic training professionals in collegiate athletics.

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Participant Demographics

PseudonymSexAge (y)Years CertifiedNCAA DivisionNATA DistrictYears in Current PositionHrs/WkLength of Contract (mo)No. of FT ATsMarriedChildren
AaronM232II4155124NN
AmyF275I9160126NN
BradyM274I10155123NN
CeceliaF3311I18501110YY
DexterM296III1445104YY
ElizabethF308II1348124NN
EugeniaF386Ia712092NN
EvaF4219II41460123YY
GingerF243II7160102NN
GrantM318I1350127YN
HayleyF276I9460124NN
HowardM295NAIA5445123NN
JacksonM349I3155127NN
JadenM296II5460104YY
JamieF308I9850124NN
JeffM3815NAIA9440126YY
JohnM327III2360103YN
KhloeF3310I65551216NN
KristenF287III1555123NN
LauraF3511I31.560119YY
MackenzieF3616II91065128YN
MattM5632III6650106YY
MiaF286III346010.53YN
NickM326III10650102YY
RichardM4725I715551212YY
RobM286NAIA10345113YN
ShirleyF4016I41350126YY
TrishaF287III456010.53YN
WillM5933I31060125YY
YuriF296I44701218NN

Semi-structured Interview Guide

1.Tell me about your career path and how you originally became interested in athletic training?
2.How would you describe yourself?
2a.Probe: Personality, values, etc.
3.What are the things that you value in your life?
4.What do you like most about your current job?
5.Is there anything that you would change about your current job?
6.What motivates you in your job? What motivates you in your personal life?
7.How do you manage stress? What do you do for fun?
8.Please tell me how much you agree or disagree with the following statement: Women are typically the caregivers and men are the breadwinners.
9.Should a male athletic trainer work with a female team and vice versa?
10.What are your biggest stressors at work? What are your biggest stressors at home?
11.How do you influence your work day and work schedule?
11a.Probe: Length of day, taking vacation, and when the day starts and ends.
12.How would you describe your department and organization in regard to its “family friendliness?”
13.Does your department or organization offer any formal “family friendly policies?”
14.If a conflict came up between a work and personal commitment, how would you decide which takes priority?
14a.Probe: Do you ever miss personal or family commitments because of work?
15.Tell me about your communication style. How does that compare to the communication style of your coworkers and your supervisors?
15a.Probe: How would you describe your supervisor?
16.Where do you see yourself in 5 to 10 years?
16a.Probe: If leaving athletic training, what other professions are you looking into?

Supporting Quotations

Factor LevelThemeQuotationPseudonym
IndividualAthletic identityBack in the day, kind of like the typical story that happened, I played athletics in high school. I was a three-star athlete. My family was all very athletic. I thought about going into medicine. I knew I wanted to do something around athletics. . . . I was kind of drawn to the athletics side of things and the medicine side and so that's how I got into athletic training. It was a way to marry those two, those two things together.Shirley
I went to college in southern [state name] to play hockey actually at a Division 3 school that also had a really good athletic training program. . . . But from there I got really interested in athletic training because I think like most athletic trainers [there was] a lot of times [where it was] the athletic trainer and myself [because I had] a number of surgeries. I didn't quite know what they were before. Where I came from in [state name], I mean there's athletic training but it's not really a well-supported profession. . . and it wasn't until I got to [play] prep hockey up in [state name] that I had. . .that's the first time I actually had a full time athletic trainer.Grant
IndividualIntrinsic motivationI think for me the motivating factor is the idea or the reality that as an athletic trainer someone is coming to you when they are injured, when they are ill, and you have an opportunity to provide healthcare to that individual. You have the opportunity to help that problem, whether it's a musculoskeletal injury or they're asking you about headaches that they've been having, or some fungus that's growing on their toe. They're coming to you looking for an answer and I think that's a pretty powerful responsibility that has to be respected and dealt with appropriately. But I think that's something that's really awesome about being an athletic trainer.Trisha
Being an athletic trainer now for a couple years I think what's important is, or what motivates me is getting to work with the athletes. They don't really know much about, sometimes it's their first injury they don't know much about [the] injury process. I think it's really rewarding. It motivates me to really help them through that process. It's rewarding to see athletes when they get hurt and they climb over all those hurdles or maybe their setbacks and return to play and succeed well, or to their standards in whatever sport that they play.Kristen
OrganizationalInadequate staff sizeHaving less staff, having five staff members in 17 sports. There are times where I feel that some of our student athletes are underserved athletic training need wise because I'm on the road today with the men's basketball team, so the men's soccer team [who I also provide care for], I'm not there to meet their needs. I have other staff members that will pick up the overload as I do when they travel. But, still the rapport that you try and we work hard to create with our groups is getting, it gets broken somewhat in these types of things. So, that's hard.Will
We probably need two more athletic trainers. So, quick math and it gets kind of, it gets pretty scary. I know personally I have not been able to perform at a standard that I would like, because it's just not possible. . . . There's just a lot of things professionally that just seem to fall to the wayside because there just doesn't seem to be enough time.Rob
OrganizationalInequity between hours and salaryYou know instead of paying us on a salary, you know [pay] us hourly. I think that's why people don't realize how much we actually do. It's because we are on the salary, so you know, you put us hourly for a year and I think a lot of people will change their tune toward the athletic trainer population.Jeff
[In] my current job whether I'm just doing amazing with athletes, or you know, the extra stuff in regards to administrative things, you know, working on rehab plans, there really is not, no matter what I do at least in my institution, it's not going to affect my pay, my compensation. Whether I'm just doing awesome or just sitting in my office ignoring athletes, it's not going to affect my compensation. So, I think having more control over that would be a good feeling as well.Rob
OrganizationalPreceived work schedule autonomyThat's another frustrating part I think about being an athletic trainer and thinking ‘wow I thought I had Sunday off’ but now I find out I have practice from 1:00 PM to 3:00 PM. . .so that kind of ruins my whole day where I had. . .I was planning on doing this or driving here or going to meet this person.Elizabeth
Authors

From the School of Health Sciences, Lasell College, Newton, Massachusetts (CME); the College of Agriculture, Health, and Natural Resources (SMS, CD), and the NEAG School of Education (JM), University of Connecticut, Storrs, Connecticut; and the Department of Kinesiology and Physical Education, North Illinois University, Dekalb, Illinois (WAP).

Supported in part by the New Investigator Award through the NATA Research and Education Foundation.

The authors have no financial or proprietary interest in the materials presented herein.

Correspondence: Christianne M. Eason, PhD, ATC, School of Health Sciences, Lassell College, 1844 Commonwealth Avenue, Newton, MA 02466. E-mail: ceason@lasell.edu

Received: November 29, 2017
Accepted: September 17, 2018
Posted Online: May 08, 2019

10.3928/19425864-20190207-01

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