Post-Pandemic Changes to Employment and Employment Satisfaction in Early Career and Career Advancing Athletic Trainers.

CONTEXT: The labor market suffered a mass exodus of employees, including healthcare workers, due to the COVID-19 pandemic. Previous research highlights the vulnerability of young professional athletic trainers (YPATs) to attrition. Investigating pandemic-related employment changes and their impact is essential for developing strategies to improve the retention of YPATs. OBJECTIVE: to determine impact of COVID-19 on YPATs' employment and effect of COVID-19 and employment setting migration on outcome measures of personal and financial well-being, job and career satisfaction, and optimism about staying in the profession. DESIGN: Cross-sectional, descriptive study. SETTING: Web-based survey. PARTICIPANTS: 1,111 participants responded to survey for an 11.5% response rate (n=1,111/12,810). Partial responses were included; thus, number of respondents varied by question. DATA COLLECTION AND ANALYSIS: A web-based survey comprised of 34 closed-ended questions was disseminated to NATA members in November 2022. Descriptive statistics including counts and frequencies for each surveyed item in addition to chi-square tests were used to analyze responses. RESULTS: 30.2% (n=335/1,111) of YPATs changed employers and 25.7% (n=286/1,111) reported a change in employment setting. Notably, YPATs migrated from high school, collegiate, and professional athletics to clinic, industrial, or sales settings. Overall, the pandemic decreased job satisfaction, career satisfaction, and optimism about professional longevity. Changes in employment had a positive impact on personal well-being in addition to job and career satisfaction, but not optimism regarding staying in profession. Salary and work-life balance were reported as important predictors of short and long-term retention for YPATs. CONCLUSIONS: The pandemic brought changes to employers and employment settings for many YPATs. To reduce turnover and attrition, administrators must begin to prioritize employee well-being and satisfaction. In addition to increasing salary and reducing workload, employers should recognize the importance of administrative support in promoting well-being together with satisfaction and professional optimism in early professional and career-advancing athletic trainers.

Muslim Collegiate Student-Athletes' Experience with Fasting During Ramadan While Participating in Sport.

CONTEXT: As colleges and universities continue to focus on creating diverse, equitable, and inclusive environments, it is important to gain more knowledge on the experiences that Muslim student-athletes have while fasting during the month of Ramadan. While previous researchers have investigated the physical effects of fasting on the body, little is known about the challenges or support Muslim student athletes experience while fasting and participating in sport during Ramadan. OBJECTIVE: To explore the experiences of Muslim collegiate student-athletes regarding fasting during Ramadan while participating in sports. DESIGN: Consensual qualitative research. SETTING: Individual video interviews. PARTICIPANTS: 12 Muslim collegiate student-athletes (4 women, 8 men; age = 19.9±1.4 years) from 7 universities across 7 states were interview. DATA COLLECTION AND ANALYSIS: semi-structured interview guide consisting of questions pertaining to the Muslim student-athletes' beliefs, challenges, experiences, and feelings were used to gather perceptions of fasting during Ramadan while participating in sport. Data were analyzed by a multi-analyst research team and coded into common themes and categories via a multi-phase consensus process. RESULTS: Four major themes emerged from the interview process, including the significance of fasting and Ramadan (familial influence, religious belief, introspection and spiritual growth), intrinsic challenges (physical mental and emotional, time constraints), extrinsic challenges (lack of available resources, knowledge and curiosity of others, lack of understanding by others) and various support (sport-specific support, community support, desired support) that impacted participants' experiences with fasting during Ramadan while participating in sport. CONCLUSIONS: The athletic community should seek to better support Muslim student-athletes and respect the importance of fasting during Ramadan. Parties interested in the success of these athletes in sport should improve their understanding regarding Ramadan and the desired support of Muslim student-athletes during fasting.

The Role of Title 1 Secondary School Athletic Trainers in the Primary and Patient-Centered Care of Low Socioeconomic Adolescents.

Athletic trainers (ATs) provide regular encounters with a healthcare provider for many Title 1 student-athletes with healthcare access and quality barriers. Thus, they are uniquely positioned to serve as a student-athletes' first point of contact for general medical concerns. This study aimed to describe ATs' experiences providing primary care for Title 1 student-athletes. This qualitative design employing an interpretative phenomenological analysis (IPA) approach used in-depth, virtual focus groups to examine the experiences of ATs practicing at Title 1 secondary schools. The findings reveal that ATs were called upon to evaluate, treat, and, when necessary, refer student-athletes with general medical conditions. However, Title 1 ATs encountered numerous complex social determinants of health (SDoH) preventing efficient and effective referral to specialty healthcare providers. Thus, ATs ultimately felt their most important roles in the primary care of low socioeconomic adolescents were as caregivers who mitigated avoidable healthcare barriers in addition to coordinators of integrated care that assisted student-athletes and their families with navigating the healthcare system. Title I ATs need to be aware of the SDoH affecting their student-athletes and the ability of those SDoH to affect health outcomes as well as overall student-athlete health and well-being.

Board of Certification Examination Achievement Gaps as a Barrier to Diversifying the Athletic Training Profession.

CONTEXT: Achievement gaps have been well documented in the medical and health professions. Previous researchers have indicated that individuals from underrepresented minority groups consistently fall short of White candidates in performance on standardized credentialing examinations. OBJECTIVE: To determine the relative risk of failure by ethnicity and first-time and retake pass rates on the Board of Certification (BOC) examination. DESIGN: Descriptive study. SETTING: Professional master's degree athletic training programs. PATIENTS OR OTHER PARTICIPANTS: A total of 3742 unique candidates with 4425 attempts between examination windows 1 of 2011-2012 (April) and 5 of the 2019-2020 (February) cycle of the BOC examination. MAIN OUTCOME MEASURE(S): Ethnicity as self-selected by the candidates, attempt number, result of each attempt, year, and testing window. RESULTS: Examination candidates self-identified as White (60.4%, n = 2261/3742), unknown (ie, withheld an ethnicity selection; 10.6%, n = 395/3742), Hispanic (8.6%, n = 320/3742), or African American (8.4%, n = 313/3742). On the first attempt, White candidates passed at a rate of 93.2% (2107/2261), African American candidates at 74.8% (234/313), and Hispanic candidates at 86.9% (278/320; overall first-time pass rate for this subsample = 90.5%, 2619/2894). The relative risk of first-attempt failure was higher for African Americans than for both White (relative risk = 3.706, 95% CI = 2.903, 4.730; P < .001) and Hispanic (relative risk = 1.923, 95% CI = 1.368, 2.703; P > .001) candidates. For Hispanic candidates, the relative risk of first-attempt failure was about 50% lower than for White candidates (relative risk = 0.519, 95% CI = 0.377, 0.715; P < .001). CONCLUSIONS: Achievement gaps existed between White candidates and those from ethnic minority groups in athletic training. Diversification of the athletic training workforce will require ensuring equity in preparation for and success on the BOC examination.

An Integrative Review of Interprofessional Collaboration in Health Care: Building the Case for University Support and Resources and Faculty Engagement.

BACKGROUND: In 2010, the World Health Organization issued a clarion call for action on interprofessional education and collaboration. This call came forty years after the concept of interprofessional collaboration (IPC) was introduced. AIM: To conduct an integrative review of interprofessional collaboration in health care education in order to evaluate evidence and build the case for university support and resources and faculty engagement, and propose evidence-based implications and recommendations. SEARCH STRATEGY: A literature search was conducted by an interprofessional faculty from a college of nursing and health sciences. Databases searched included CINAHL, Medline, Eric, Pubmed, Psych Info Lit., and Google Scholar. Keywords were interdisciplinary, interprofessional, multidisciplinary, transdisciplinary, health care team, teamwork, and collaboration. Inclusion criteria were articles that were in the English language, and published between 1995 and 2019. REVIEW METHODS: Thirteen interprofessional team members searched assigned databases. Based on key words and inclusion criteria, over 216,885 articles were identified. After removing duplicates, educational studies, available as full text were reviewed based on titles, and abstracts. Thirty-two articles were further evaluated utilizing the Sirriyeh, Lawton, Gardner, and Armitage (2012) review system. Faculty agreed that an inclusion score of 20 or more would determine an article's inclusion for the final review. Eighteen articles met the inclusion score and the data was reduced and analyzed using the Donabedian Model to determine the structure, processes, and outcomes of IPC in health care education. RESULTS: Structure included national and international institutions of higher education and focused primarily on undergraduate and graduate health care students' experiences. The IPC processes included curricular, course, and clinical initiatives, and transactional and interpersonal processes. Outcomes were positive changes in faculty and health care students' knowledge, attitudes, and skills regarding IPC, as well as challenges related to structure, processes, and outcomes which need to be addressed. Implications/Recommendations/Conclusions: The creation of a culture of interprofessional collaboration requires a simultaneous "top-down" and "bottom-up" approach with commitment by the university administration and faculty. A university Interprofessional Strategic Plan is important to guide the vision, mission, goals, and strategies to promote and reward IPC and encourage faculty champions. University support and resources are critical to advance curricular, course, and clinical initiatives. Grassroots efforts of faculty to collaborate with colleagues outside of their own disciplines are acknowledged, encouraged, and established as a normative expectation. Challenges to interprofessional collaboration are openly addressed and solutions proposed through the best thinking of the university administration and faculty. IPC in health care education is the clarion call globally to improve health care.