Regular
readers of this blog and the Advocates for Injured Athletes Facebook
page
know that A4IA is a big advocate for athletic trainers, especially in high
schools. I’ve spent a lot of time
talking about various topics in an effort to help people become aware of the
information and skills that can make sports safer for them and their
children. I’ve also had the opportunity
to present local stories about the work others are doing to keep kids
safe. Today I wanted to bring to your
attention a recent article published in the Journal
of Athletic Training that defines the practice characteristics of those
athletic trainers working in the secondary school setting. We've already established that approximately
40% of high schools in the United States have ATs, with the highest rates being
in Florida (79%) and Wisconsin (86%).
Now we have information on what their work setting is like and the
services they’re able to provide.
This
particular study is important because it helps us understand the current
working conditions for secondary school athletic trainers and the athletes who utilize AT services. It also
provides the opportunity to direct future research for a deeper understanding
of the setting, to improve the care provided to the young athletes and improve the working conditions for ATs. According to current statistics almost 55% of
secondary school athletes participate in interscholastic athletics, resulting
in about 2 million injuries annually.
Athletic trainers have already been shown to reduce injuries, so
understanding their high school work settings can help get ATs in more schools
and provide improved medical care.
Article
citation:
McLeod,
TC, Bliven, KC, Lam, KC, Bay RC, Valier, AR, & Parsons, JT (2013). The National
Additional
Reference:
The
study, using data collected as part of the National Sport Safety in Secondary
Schools study, solicited participation in the descriptive study using NATA
members as potential participants.
Over 4054 secondary high school athletic trainers completed some portion
of the study. The authors did
acknowledge that there may be potential participants that were missed because
they are not members of NATA. The
results of the study provided descriptive data regarding three primary areas:
- AT demographics
- Secondary school demographics
- AT practice characteristics
AT
DEMOGRAPHICS
Based
on the data collected the typical high school athletic trainer has the
following characteristics:
- Only slightly more likely to be
male (51%) than female
- Average age is 35.7 +/- 9.9
years
- 55.4% have master’s degrees
- 69.6% hold title of Head AT
(most often as a the only AT in the school)
- 91% are licensed/regulated by
state credential
- 48%
hold ATC© as their only credential, additional credentials include teaching
certificate, CSCS, EMT
Reflecting
on these characteristics, most ATs who work at the high school level are
relatively young professionals, many with 10 years or less of experience in the
profession and tend to work alone as the school’s Head AT. A slight majority have a master’s degree and
likely hold additional certifications. This
is great news, as young ATs with master’s degrees they are likely to be
familiar with some of the most recent information published on the care of
young athletic patients and additional certifications also mean additional
skills, making them more prepared to care for your child. Working alone may present challenges for a
young AT in executing their responsibilities and their overall professional development
(particularly in very young professionals (less than 2 years)).
One of the things I like most
about working in the college setting with a staff of ATs was that there were
always other professionals to ask questions and seek advice from. Also, there was always easy access to library
resources and current sports medicine information. This is not to say that an athletic trainer
cannot be successful on his/her own as a clinician and take significant steps to continue growing professionally at the secondary school level (ATs are a very committed group when it comes to professional development), but school
administrators, team physicians and others need to make sure the resources are
available so this development happens. Everyone wants their athletic trainer to apply the most current
information and techniques with their athletes, we all can help with this.
SECONDARY
SCHOOL DEMOGRAPHICS
Based
on the data collected the typical high school with an athletic trainer has the
following characteristics:
- 77.2% of high schools are grades
9 – 12, with 73.5% being defined as public
- 80% of schools have football
- 35% have 200 – 399 male athletes
- 34.3% have 200 – 399 female
athletes
- 33% have a total enrollment of
1000 – 1999
These
are very basic descriptive statistics, but at least they give an idea of the
types of schools who are hiring athletic trainers. Based on this data public schools have done
well to get ATs into the schools, it’s not just private and charter schools
employing ATs. Based on the data it
appears that one of the factors in having an AT is having the sport of
football. Also, you cannot use school
size to predict who may have an AT, as ATs work at schools of all sizes with the largest percentage working in medium-sized schools. While this data may be useful, there is also
additional information that could be helpful in understanding the types of
schools and students who have access to an athletic trainer, including other
socioeconomic and geographical data.
Data could include looking family income, school location (rural,
suburban, urban), etc. This information
could help us better understand the distribution of available AT care among
various types of students/families.
ATHLETIC
TRAINING PRACTICE CHARACTERISTICS:
Based
on the data collected the typical job characteristics for an athletic trainer in
the secondary school setting are:
- 57% of ATs use a budget or bidding
mechanism to get supplies; typical budgets are around
$2000
- 47.1%
of ATs hold full-time positions that are paid by the high school
- 65.1%
of ATs are supervised by the Athletic Director (non-medical personnel)
- 22.8%
of ATs hold a teaching credential, 62.7% of these are paid a teaching salary
and a stipend for AT duties with about 56% working between 20 – 40 hours per
week as an AT (on top of teaching)
- 72%
of ATs travel to away FB games, 45% travel to non-FB playoff events, 15.6%
travel during regular season and playoffs for non-FB events
- 72%
perform on site evaluations regularly, with a lesser percentage performing
treatment (60.3%) and rehabilitation (39%)
- 46.9%
of ATs work under the direction of an orthopedist, while 19.1% work under the
direction of a primary care physician
Looking
at this information almost half of all ATs are in full-time positions in the
high school setting with a particular focus of covering football games and
practices (especially travel). ATs, considered
medical professionals, are often supervised on a day-to-day basis by the
athletic director, but also function under the school’s physician. Their primary job function is injury
evaluation, but where appropriate many also provide regular treatment and in some
cases rehabilitation services.
I
am glad to see that almost half of the ATs are in full-time positions that are
financially funded by the high school I believe this provides consistency of
care for all athletes involved in the athletic program and students know there
will always be someone available. I know
in the case of clinic-outreach positions limits (if in place) on hours allowed
in the high school can sometimes be a challenge to negotiate because of clinic commitments. While it is better to have an AT than, not I
would hope that someday all ATs would be full-time and funded by the
school. Additionally, for those that are
teacher-athletic trainers I would hope that there would be additional resources
for them to avoid burnout since they are working two very challenging jobs
within the school. I have had the
pleasure to know many teacher-athletic trainers and I know their primary challenge was
always balancing both responsibilities since teaching and being an AT are
easily full-time jobs on their own.
I
am also glad to see that many ATs have an orthopedist who is responsible for
overseeing the healthcare of the athletes, along with primary care sports
medicine physicians they are most familiar with the injuries the AT will be
addressing. It can be challenging to
work with a physician who is not familiar with the challenges specific to
sports medicine.
Finally,
I would invite all schools to look that money budgeted for AT supplies and be
sure it is enough to appropriately meet the medical needs of the
student-athletes (the authors of the article discuss this briefly). ATs are very good at
doing more with less, but that can only go so far. Let’s make sure we’re offering the best care
possible. You've taken the first step by
hiring an AT, now let’s make sure they have the resources they need.
Reflecting
on the study in its entirety I think it paints a generally positive picture of
the work setting for high school ATs and the athletes to whom they are
providing care, but that is not to say there isn’t room for improvement. While we have a long way to go before all
high schools have an AT, perhaps understanding this information can help get us
there faster. I hope it opens up the dialogue
between ATs, school administrators, sports medicine physicians, and parents about who is providing care for their athletes/children. I hope it will also cause people to reflect on whether the AT has the necessary professional and financial resources to
provide the appropriate standard of care for all athletes. Given that ADs are most often the direct
supervisors of the AT I encourage them to do the necessary work to learn what
it takes to operate a safe and high-quality athletic program that includes
appropriate sports medicine services. There
is much work to be done, but in order for us to move forward we must first
understand where we are, our strengths, our weaknesses and our
opportunities. I think this study is a
first step in the right direction.
Submitted by Heather L.
Clemons. MS, MBA, ATC
