Perceptions of the Benefits to Using a Secondary Admissions Process in Professional Bachelor's Athletic Training Programs
Context: Some athletic training program (ATP) directors use direct admit, where students are admitted into the ATP directly out of high school. Other ATP directors admit students into the program after a set time period on campus through a secondary admissions process. It remains unknown why ATP directors use various admissions practices.
Objective: To determine why ATP directors use a secondary admissions process.
Design: Qualitative study.
Setting: Professional bachelor's ATPs.
Patients or Other Participants: We asked ATP directors from all 343 professional bachelor's ATPs to participate in an online survey. We received responses from 177 (51.6%).
Main Outcome Measure(s): The survey asked participants both when students are first eligible for admission into their ATP and to explain the rationale behind their specific admissions process. We used grounded theory to analyze the data and maintained the trustworthiness of the analysis via multiple-analyst triangulation, member checks, and a peer review.
Results: The majority (92.1%) of respondents used a secondary admissions process to formally select students into their ATP. The ATP directors stated that opportunities for socialization, the ability to maintain quality control, and the chance to complete general education requirements were important reasons to admit students into the ATP after they have been on campus for at least 1 semester.
Conclusions: The use of a secondary admissions process appears to help ATPs provide a glimpse of the profession through observation and introductory coursework. The secondary admissions process also allows faculty and staff to evaluate student potential, while students are given time to focus on their transition to college life. We believe the timing of formal admittance to the ATP is an important decision that warrants thought and discussion between the program faculty and staff to provide curricular sequencing that works for both prospective students and the ATP faculty and staff.
INTRODUCTION
Athletic training programs (ATPs) have the autonomy to structure their educational experiences to fit their program's needs, mission, and vision, as long as they adhere to the guidelines established by the Commission on Accreditation of Athletic Training Education.1 One aspect of ATP autonomy includes the admissions process, by which directors can use either a direct admit or a secondary admissions process. Direct admission involves an athletic training recruit being admitted directly into the ATP from high school, whereas the secondary admissions process occurs after a time period on campus, mostly likely after being introduced into campus and college life.
Previous research has suggested that athletic training recruits often lack a full appreciation for the complexity of the athletic trainer role prior to entering an educational program.2 Their lack of understanding is often due to limited exposure to the profession itself, which may negatively impact their commitment to their professional development. Mazerolle and Dodge3 suggest that athletic training recruits should gain a holistic impression of the profession through a diversified observation period, which comes prior to admission into an ATP. The diversified experience may stimulate a deeper understanding of the professional roles, complexities, and expectations of athletic trainers, thereby possibly improving retention. If an ATP uses a direct admit procedure, it is likely the recruits' exposure is limited to the high school setting, which can give an incomplete understanding of the athletic training profession and negatively impact retention. Athletic training students report valuing diversity in clinical education experiences, as it allows them to make better informed decisions regarding future employment settings.4 In fact, diversity of clinical education provides the chance for the athletic training students to visualize their future role and allows them to develop an increased level of professional commitment.
Retention rates have been linked to the type of admissions process used, with programs using a secondary admissions process experiencing higher retention rates.5 Additionally, ATP directors who used a secondary admissions process perceived that retention was not an issue in athletic training education.6 Possible explanations for these findings include the notion that students need time to decide on a program of study that is a good fit for them,5 the occurrence of professional socialization allows students to understand the roles and responsibilities of an athletic trainer,2,7 providing students time to explore other academic disciplines may improve commitment, and later admissions dates provide students with less time to depart.5 Further, we believe a secondary admissions process may assist candidate selection for the ATP by providing information beyond high school academics to determine how a candidate may fit within the ATP. Despite these findings, it is unclear why some ATPs choose to use a secondary admissions process while others use direct admission. Therefore, the purpose of this study was to determine why ATP directors use a secondary admissions process to admit athletic training students. We believe information gathered can help ATP administrators make informed decisions regarding program structure and admissions processes used to admit potential athletic training students.
METHODS
We chose to use qualitative methods to explore the reasons ATP directors use a secondary admissions process to select prospective students. The qualitative paradigm allows data collection to be flexible while gathering a more holistic understanding of the phenomenon.8 We used the Athletic Training Student Retention Survey for Program Directors to collect our data for this study. The survey was created as part of a larger study5 to investigate reasons for athletic training student persistence and departure. The researchers developed the survey based on the current literature on athletic training student retention9–11 and pilot tested it to improve face, content, and construct validity as well as clarity.5 Specific to this study, we asked the participants to identify the type of admissions process they use in their ATP (direct from high school or secondary after some college credit) and explain the purpose for this type of admissions process.
Participants
We asked directors from all 343 Commission on Accreditation of Athletic Training Education accredited professional bachelor's ATPs as of January 2011 to complete an online survey, the Athletic Training Student Retention Survey for Program Directors.5 We gathered responses from 177 ATP directors (51.6%). The average age of the ATP directors who responded was 44 ± 8 years, and the respondents held their position at their current institution for 8 ± 7 years (Tables 1 and 2). The breakdown of when students are formally admitted into the ATPs represented is in Table 3.
Data Collection Procedures
After securing Institutional Review Board approval, we administered our survey electronically over the Internet using QuestionPro survey software (QuestionPro Inc, Seattle, WA) with techniques similar to those reported previously.12 First, we sent a personalized e-mail to the members of our population informing them of the purpose of our study followed by a second e-mail 1 week later with the Internet link to the survey. After two weeks had passed, we sent a reminder e-mail to those ATP directors who had not yet completed the survey followed by an additional reminder 7 days later. Finally, we called those members of the population who had not responded 1 week after the last reminder e-mail had been sent. We terminated data collection after we received no new responses for 2 consecutive days.
Data Analysis
We analyzed the data using the principles of grounded theory.13 For this particular study, we focused on the response to the question asking the participants why they used a particular admissions process (primary or secondary). First, we read through the transcripts several times to get a sense of the data. Open coding followed, which allowed us to break the data down into small parts while noting similarities. We then reduced redundancy during axial coding and validated the relationship between categories to form themes during selective coding.
We maintained the trustworthiness of the data through 3 separate processes. First, the 2 primary authors analyzed the data independently as part of multiple-analyst triangulation. Both researchers used the same procedures outlined above and negotiated over the coding structure and nomenclature for the final themes until we reached full agreement. Second, we had 3 participants who completed participation review their transcripts to ensure accuracy. We also provided the randomly selected participants with the data analysis findings and asked them to verify the final results presentation. Finally, we had a peer review the transcripts and validate our coding structure and the presentation of the themes.
RESULTS
The majority (92.1%, 163 of 177) of respondents used a secondary admissions process to formally select students into the ATP they lead. The 3 most common reasons why our participants used a secondary admissions process after students had been on campus for a minimum of 1 semester were opportunities for socialization, the ability to maintain quality control, and the chance to complete general education requirements. These themes are defined and supported with quotes below. It is important to note that, although the themes are presented separately below, overlap did exist.
Opportunities for Professional Socialization
Our participants noted the importance of allowing prospective students time to decide if athletic training is the right career path for them. Typically, our participants explained this theme by noting the use of both clinical observation and introductory prerequisite courses. Several participants noted the fact that many prospective students do not have a robust understanding of the profession, leading to the importance of socialization time. One ATP director explained by stating:
We feel observation is an important step for students, many of whom do not know what the profession entails. We want students who understand what they are signing up to do and what the possible outcomes will be.
Another participant agreed, “We want to make sure students admitted to the program are a good fit and fully understand the major and if the degree is appropriate for their future plans.”
One ATP director started to make the connection between the need for socialization and the ability to select students who can complete the ATP, our next theme. She explained that a secondary admissions process is used in her ATP:
. . . to allow the students a semester to see if they like the profession as they take the prerequisite courses and to have a measure of how they will do in college before beginning our program since it is a rigorous one.
Finally, 1 participant discussed the fact that both experiences, prerequisite classes and clinical observation, allow prospective students to learn about the ATP and the profession before committing. He explained:
We have a very high retention rate, so we know it [secondary admissions process] works, and by the time the students go through the prereq courses and complete their directed observation, they have a pretty thorough understanding of the profession prior to starting in the program.
Our participants believed that including a secondary admissions process allows students to form a more clear understanding of the program's expectations and the athletic training profession by being engaged in informal and formal activities such as coursework and clinical observation hours.
Informed Decision Making
The second theme pertained to the competitiveness that a secondary admissions process provides. When students are required to apply to the program after a designated time period on campus, it gives the ATP faculty and staff the ability to make better informed enrollment decisions. The directors explained that enrollment decisions are often based on the perceived ability of the student to complete the program successfully. The secondary admissions process facilitates the selection because it allows the faculty and staff time to get to know students and judge their academic ability based on college level coursework. One participant summed this theme up by responding:
Freshman year students take academic prerequisites for admission. This enables me to determine what type of student they are and also allows me to use this as a means to select with a high degree of probability their academic potential in the program.
Another participant agreed, but also illustrated the importance of evaluating academic capabilities along with judging the prospective student's maturity level. He explained why the ATP he leads uses a secondary admissions process by saying:
. . . in order to only accept students who have shown they can be academically successful in required major courses, possess the communication skills and maturity necessary of a health care professional.
Similarly, another participant agreed. The ATP she leads uses a secondary admissions process “so that the ATP can have an objective measurement of the students' academic achievement.”
Several of our participants explained the importance of quality control and early socialization simultaneously. One ATP director supported both themes by saying that a secondary admissions process:
. . . allows us to gain a better understanding of the potential of the student. They are enrolled in two classes [Intro and Prevention and Care] as ways to assess their abilities. It also allows them to gain an appreciation for our field as many do not understand the role of the [athletic trainer]. This process has allowed us to retain our students as well (only 2 dropouts in the 6 years I have been program director).
An additional ATP director agreed. She explained the admissions process at the ATP she leads:
We require 2 semesters/1 academic year of directed observation prior to admitting students to the ATP. This give[s] perspective students an opportunity to learn about [athletic training], our program, our faculty, etc, and also gives us an opportunity to observe and get to know potential students. The situation allows the students to have confidence in their decision to enter the ATP and also allows us to make more informed decisions on who is getting in.
Our participants found worth in a secondary admissions process because it allowed the faculty and staff to offer admission to the ATP based on prospective students' performance in gateway courses. Selecting students after they have spent a period of time on campus also allows students to build relationships with faculty and staff facilitating selections based on the perceived fit of the ATP for the student.
Complete General Education Requirements
Our final theme centered on the opportunity to fulfill general education requirements. Participants wanted students to focus on general education and prerequisite requirements early in their college career, thus allowing students to focus on athletic training later in their studies. One participant explained by stating, “We want them to have their general education classes completed and the prerequisite classes completed before they start the real focus on athletic training.” Another ATP director stated that students apply to the ATP he leads after 3 semesters of coursework:
. . . to allow students to complete most of their general education classes and allow them time to complete classes that must be taken in a sequential manner (BIO 100 before BIO 200 for example).
One participant agreed that using a secondary admissions process allows the ATP to maintain a structure that facilitates ATS success. She stated:
Our general education curriculum has many courses, and in order to spread them out over 4 years and have a reasonable structure for our preprofessional phase major courses, we have a 4-semester preprofessional phase.
Finally, 1 participant noted that the length of the preprofessional phase of the ATP she leads is required to be 4 semesters. She explained stating, “Students complete state-mandated prerequisites their first 2 years in school then apply for secondary admission to the [athletic training] program.”
Our participants found value in allowing students to complete some general education courses and the required prerequisite courses before entering the ATP. At times, the length of the professional phase of the ATP was institutionally or state mandated, limiting the flexibility our participants had to determine when prospective students have the opportunity to apply to the ATP they lead.
DISCUSSION
Our results support previous research that illustrated the importance of socializing prospective students to the athletic training profession due to an incomplete understanding of the profession.2 Our participants found value in providing students with the opportunity to take introductory prerequisite courses and complete clinical observation experiences as a means to socialize students prior to formal acceptance. We believe such a practice helps limit athletic training student attrition, as demonstrated by the finding that athletic training student retention rates are higher when athletic training students are formally admitted later during their professional bachelor's career.5 Introductory prerequisite courses allow students to get a sense of what the ATP curriculum will entail, while clinical observation provides students with insight on what clinical practice entails. Providing students with early engaging experiences may increase satisfaction, interest, and overall commitment to the profession.14 Further, such experiences may also improve commitment to the ATP, as millennial students find interactive learning experiences particularly interesting15 because they can easily be linked to future clinical practice, thus illustrating importance. Prospective student decisions on whether to apply to an ATP can be predicted by the level of satisfaction with the ATP, specifically motivation,10 social integration, intellectual integration, clinical education experiences,10,11 and commitment.11 The early socializing experiences should provide students with opportunities to gain confidence, thus allowing them to maintain high levels of motivation10 and commitment. This can simply occur with meaningful interactions with preceptors, peers, and ATP faculty and staff, especially during observation hours. When the student feels integrated through feedback and involvement, they have a better socializing experience. Moreover, situations allowing prospective students to form relationships with peers, staff, and faculty can aid social integration and improve persistence rates.9,10 Engaging and stimulating experiences can facilitate intellectual integration and are important factors in positive clinical education experiences, which can also lead to student retention.9
The socialization experiences that occurred when our participants used a secondary admissions process allowed faculty and staff to make informed decisions on whom to admit into the ATP. Student performance on college level coursework and the relationships built between the key stakeholders within the ATP provide evidence of who would be a good fit and could successfully matriculate to graduation. Because ATPs are academically rigorous,16 some have defined the secondary admissions process as a “weeding-out” process11 that is necessary and inevitable10 based on the number of clinical sites ATP faculty can use to accommodate the ATP clinical education requirements. Although our participants did not go into extensive detail as to why they limit their classes other than suggesting the importance of a strong retention rate, we suspect a limited number of clinical education sites was an additional reason why selectivity exists. Faculty and staff may also not want to invest time and effort with prospective students who do not demonstrate commitment to the athletic training profession.
Finally, some ATP directors mentioned that they use a secondary admissions process to permit prospective students time to complete general education requirements. Most of our participants stated they wanted students to complete a majority of the general education courses before entering the ATP to better focus on athletic training required coursework once matriculated. Although such practices would allow athletic training students to immerse themselves in athletic training, it is important to allow students time away from athletic training9,10,17 to find life balance. It is interesting that a few participants noted that they were required to have their secondary admissions process during a specific time period as per state law. These states mandate the completion of general education requirements before students matriculate into major fields of study. We speculate that these requirements are in place to allow students to experience broad educational experiences to help guide program of study selection.
LIMITATIONS
It is important to note some limitations to the present study. We present the opinions from only a portion of ATPs across the country, and although they help shape our understanding regarding the usefulness of a secondary admissions process, they cannot speak to all ATP directors' beliefs or experiences. However, the purpose of qualitative research is to gain insight into a phenomenon18 and not to broadly generalize. Also, we did not collect specific information on the admission process, such as length, requirements, or when it begins. Gathering these details would allow for a better understanding of how and why the process is successful. Because most of our participants (92.1%) used a secondary admissions process, we were not able to develop themes for those who use direct admit procedures. Many ATPs may use and find the direct admit procedures fruitful and practical, yet we do not have data to understand their motives. We also present the perspective of the program director, only 1 member of the ATP team. Although likely that other members share a similar belief, their insights may be valuable. Future research is warranted, focusing on the comparison of admissions process type from multiple stakeholder perspectives, including students and ATP faculty. Finally, we did not ask for drawbacks to the admission process used. Therefore, only positive themes are presented. Future work should also investigate the downsides to each admission process.
CONCLUSIONS
The use of a secondary admissions process appears to help ATPs provide an early snapshot of the profession through observation and introductory coursework. Perhaps it is through this early professional socialization that students can ascertain whether pursuit of a degree in athletic training is of interest to them and something to which they can fully commit. The secondary admissions process also allows ATP directors the chance to evaluate the potential of students, which is critical to help matriculate quality students who possess the skills necessary to succeed as health care providers. Finally, delaying admissions into the ATP allows students the chance to complete general education requirements, focus on their transition to college life, and develop career goals. We believe the timing of formal admittance to the ATP is an important decision that warrants thought and discussion to provide curricular sequencing that works for both prospective students and the ATP faculty and staff. We recognize that some ATPs may have varying constraints due to institutional policies and regulations, but the benefits of a secondary admissions process could possibly aid in retention and quality control of successful students.
Contributor Notes
Dr Bowman is currently an Associate Professor in the Department of Athletic Training at Lynchburg College. Please address all correspondence to Thomas G. Bowman, PhD, ATC, Department of Athletic Training, Lynchburg College, 1501 Lakeside Drive, Lynchburg, VA 24501. bowman.t@lynchburg.edu.