Factors that Impede and Promote the Persistence of Black Women in Athletic Training Programs
Black women are dramatically underrepresented in the health care profession of athletic training. The research identifies impeding barriers such as racism, sexism, lack of support, and unpreparedness to the successful college completion of ethnically diverse students. However, there are black women who have successfully overcome those impeding barriers to become athletic trainers (ATs). Mentoring is one factor that has been identified as supportive to the retention of ethnically diverse college students. The purpose of this qualitative study was to identify impeding barriers and promoting factors affecting the retention and credentialing of black women ATs. Qualitative. Education. Ten certified ATs who self-identify as black women and matriculated through athletic training programs over the last 4 decades. The perceived factors that impede or promote successful college retention and attainment of the Board of Certification credential of black women athletic training students. There are barriers that impede and factors that promote the successful matriculation of black women athletic training students. Impeding barriers include a lack of support, sexism, and racism. Factors that promote include personal characteristics; experience with white culture; faculty, preceptor, and peer support; and the clinical education experience. Recognizing the factors that impede or promote the academic persistence of black women in athletic training programs allows athletic training educators and preceptors to improve the experiences of black women enrolled in those programs and potentially increase their participation and advancement in the athletic training profession.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Main Outcome Measure(s):
Results:
Conclusions:
KEY POINTS
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A lack of family, financial, institution, and social support can impede persistence of black women in athletic training education programs.
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Sexism and racism within the institution, classroom, and clinical experience can also impede persistence of black women in athletic training education programs.
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Personal resilience, experience with white culture, mentoring and the clinical education experience can facilitate persistence of black women in athletic training education programs.
INTRODUCTION
Ethnically diverse women remain underrepresented in the profession of athletic training.1 Failure to recruit and retain black women in the profession of athletic training may result in their continued absence from the profession. The information presented in this study will contribute to the information available to athletic training faculty and preceptors responsible for the retention and successful education of black female athletic training students (and perhaps other ethnically diverse students, male and female).
Between 2003 and 2016, the average total membership of the National Athletic Trainers' Association (NATA) was 34 635 members. During this time span, only 10%–14% of the total membership has consisted of ethnically diverse people. The number of women athletic trainers (ATs) has hovered at just over half (54% in 2016) of the total membership of the NATA for the last decade, while black women have accounted for only 2%–4% of the total female membership.1 These data are similar to the demographics of sister allied health professions. Figure 1 represents the percentage of women and black women who were members of the NATA between 2004–2016.
Citation: Athletic Training Education Journal 13, 2; 10.4085/1302131
Research has identified a plethora of reasons for poor recruitment and retention of ethnically diverse students in higher education, including those enrolled in allied health professional programs. Some of the most commonly cited reasons that challenge retention include underpreparation for college, racism,2–4 lack of comfort and confidence with the health and science fields,2 stereotyping,2–7 and a lack of mentoring.5,8–12 Despite the well-documented barriers to college retention and success, there are factors that contribute to the success of ethnically diverse students in higher education and subsequent credentialing by the Board of Certification (BOC). In 2016, 14.87% of the athletic training membership was ethnically diverse and 1027 members self-identified as black women.1 With the odds against them, there are black women who overcame the commonly cited barriers to success.
The purpose of our study is to identify the perceived impeding barriers and promoting factors that affect the retention and credentialing of black women ATs to understand how athletic training educators can better advise and mentor black women athletic training students. To achieve this purpose, 2 research questions were formulated to guide this study:
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What barriers impede effective college matriculation and attainment of the BOC credential of black women athletic training students?
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What factors promote the successful college retention and attainment of the BOC credential of black women athletic training students?
METHODS
This study is an investigation of the lived experiences and perceptions of the participants to gain new and deeper understandings of their experiences that lead to college persistence and retention through graduation. As such, the design of our study was qualitative, and criterion sampling identified participants. Qualitative research is characterized by in-depth study and is focused on understanding the participants' perspectives of how they experience the world they live in.13–15 Gay and Airasian14 and Merriam15 describe 5 characteristics of qualitative research:
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It is conducted in a real-world setting using the researcher as the research instrument for data collection and analysis.
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It pulls out descriptive data instead of numerical data.
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It brings a holistic approach to the setting and research participants.
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Data analysis is induced and interpreted by the researcher.
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It emphasizes the perspective of the research participants.
Framework
The methodology used in this investigation required an approach that would not objectify the experiences of the subjects, but rather bring voice to a traditionally silenced population of women. Thus, a black feminist theoretical framework guided this study through data collection and analysis. Black feminist theory is the study and articulation of the experiences of black women who are simultaneously situated politically and historically in society at positions based upon their race (black), their gender (female), and their class (disadvantaged).16,17
This study incorporated a second theoretical framework and standpoint epistemology critical race theory (CRT) to guide the analysis of data. Critical race theory was developed by people of color who wished to expose the flaws of racial neutrality and color blindness in predominantly white US institutions, such as administration, economics, politics, sociology, and education.18,19 Critical race theory is a form of oppositional scholarship that wishes to transform systems that oppress the ethnically diverse while continuing to advantage white, dominant society. The primary tenets of CRT drive research20–24:
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Racism is permanent and embedded in all aspects of US society. The dominant society (white) does not recognize or acknowledge the persistent presence of racism in the greater society. Individuals in the nondominant society experience the world affected by racism.
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Experiential knowledge of ethnically diverse people is collected through the qualitative method of storytelling. These stories serve as evidence in opposition to the dominant perception of the world.
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Traditional liberal practices, such as objectivity, neutrality, color blindness, and meritocracy, are ineffective in challenging institutionalized racism.
By framing black feminist theory as the guiding lens of this study and incorporating the tenets of CRT into the overall framework, the researchers intended to give voice to the black women who shared their unique experiences as ethnically diverse female ATs in a predominantly white profession, educated and trained in a predominantly white educational system. By placing black women at the center of the analysis and recognizing the intersection of race, gender, and class in their experiences, black women were brought from the indiscernible margins to the center of attention so that their voices could be recognized and heard. Bringing voice to the marginalized cultivates resistance and brings power to the silenced.25
Participants
Criterion sampling was used in our study to select participants who were most likely to possess and be willing to provide pertinent information and perspective from their experiences matriculating through their respective athletic training programs. Our participants met the following inclusion criteria for this study:
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Self-identify as female and black or African American.
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Held BOC certification as an AT.
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Employed or were employed as a BOC-certified AT (CAT).
To assist the researcher in identifying 12 potential participants for this study, the aforementioned criteria were shared with the current (at that time) and former chairpersons of the Ethnic Diversity Advisory Council (EDAC) to the NATA. Both chairpersons were black women and CATs with intimate knowledge and familiarity with other colleagues and peers who are ethnically diverse. As such, they were able to serve as experienced and knowledgeable experts and identify participants who met the researchers' delineated criteria.13
For the purposes of this study, the following key terms further defined the criteria used to select participants:
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Black or African American = people with at least 1 parent of African origin.
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CAT = a member of the NATA holding “regular certification” through the BOC.
Upon approval of the institutional review board, a comprehensive list of all women who self-identified as black (as per the NATA membership designation) or African American, were CATs and were employed actively as an AT was secured from the NATA membership directory. Inclusion on this list from the NATA membership meant that these members had given their consent to be contacted by researchers and included their preferred contact information. This membership list was forwarded to the current and former chairpersons of the EDAC to review. The 2 chairpersons collaboratively identified 17 women who met those criteria. The 17 were narrowed down to 10 by purposely selecting participants from different geographical regions, dates of graduation, work settings, and continuing education. The final 10 participants met the aforementioned criteria. Table 1 summarizes the participants' demographic information.
Data Collection
Demographic data were collected via a personal data survey (PDS) to triangulate with the information shared in the participants' interviews during analysis, thus contributing to the validity of the results. The PDS was modified from one designed and used by Abney26 as well as a semistructured interview schedule. Abney's modified PDS and interview schedule provided reliable instruments for the replication of her study of black female coaches and athletic administrators with this study of sister professionals in athletic training. The instruments in this research were slightly modified by directing the questions and terminology to ATs instead of the coaches and athletic administrators, thus measuring the perceived experiences of black women ATs.26 The Appendix outlines the PDS.
To ensure that the interview schedule modified from Abney's26 original instrument met criterion-related validity for this study, each interview question was connected back to our research questions. Additionally, the modified interview schedule was assessed for face validity by conducting the interview with 2 sample participants who were not included in the study. This process ensured that the instrument and its administration were appropriate for the participants and the lead investigator and that the questions were clear, logically sequenced, and did not lead the participants. Table 2 outlines the interview schedule of questions.
Data from the interview schedule were collected through the use of personal interviews conducted in person and by telephone. In addition to the interview methodology employed in this study, case study methodology was also used. The purpose of the case studies was to follow up and explore more in-depth descriptions of the experiences of our participants specific to the impeding barriers and promoting factors that influenced the participants' persistence in athletic training education. Deborah, Gabriella, and Moriah were 3 participants with the most descriptive stories of excessive racism and sexism as athletic training students and thus selected for the case study follow up. Table 3 outlines the topics that served as guidelines for the open-ended, semistructured interviews. Face-to-face interviews were conducted with Deborah and Gabriella during the NATA Clinical Symposia and Athletic Training Expo since we all were in attendance. A phone interview was conducted with Moriah due to the obstacle of distance.
Analysis
To identify similar or consistent themes within the responses to the questions, the lead investigator reviewed each transcript. An analysis of themes was accomplished by following the 4 steps in classifying data described by Gay and Airasian14: reading/memoing, describing, classifying, and interpreting. ATLAS.ti 5.0, 2nd edition (developed by Scientific Software Development GmbH, Berlin, Germany), was used to identify codes, which were organized against the research questions according to Anfara's code mapping method.27 Through constant comparative analysis, relationships were identified between themes to create the qualitative findings of the study. The code map added to the organization and validity of the analysis.
Trustworthiness
Trustworthiness of the data was established via member checks and peer review. The lead investigator read all the professionally transcribed texts of the individual and case study interviews while simultaneously listening to the audio recordings to check for accuracy of the transcripts against the interviews. The transcripts were sent to the corresponding participants to review for accuracy. Throughout the data collection and analysis processes, a researcher with experience in qualitative research verified that the code mapping and analysis were completed following sound methods and that the findings were logical and true in comparison to the interview transcripts.
RESULTS
The interviews with the participants and the information provided in the participant surveys outlined the impeding barriers the participants had to overcome and the promoting factors that helped them do so in their shared quest of becoming ATs. Figure 2 identifies the codes realized by the researchers.
Citation: Athletic Training Education Journal 13, 2; 10.4085/1302131
Research Question 1: What Barriers Impede Effective College Matriculation and Attainment of the Board of Certification Credential of Black Women Athletic Training Students?
The participants identified impeding barriers they had to face and overcome as black women in pursuit of the AT credential at the collegiate level. Some of the participants identified a lack of family and financial support as barriers. The women also had to overcome the impedance of sexism and racism.
Lack of Support
Even though some of the participants felt supported by their families to pursue athletic training as a career choice, not all of the participants benefited from family support. Phoebe believed that her parents were not supportive of her major in athletic training because they did not understand what athletic training was: “My parents didn't understand what I was doing. They didn't get it until after I had been in the career for a while.”
Other participants faced a lack of financial support. Deborah remembered struggling as a college student to support herself financially: “Money was an issue. I mean, but that's a normal thing for college students, you know?” Elisha remembered having a hard time working outside of her class and clinical requirements. Although money was a barrier, she did find some support from the university, but not until she struggled first: “So having to be in the [athletic] training room, and then having to go to a real job, and then having to take real classes, and being able to balance, support myself was a huge challenge.”
Hanna overcame the financial barrier she faced by paying her way through college without financial aid: “The hardest thing was I had to have 2 part-time jobs because I was paying out-of-state tuition.”
When Moriah went through her internship route program, she received work-study monies during her clinical rotations, which is a violation of the Commission on Accreditation of Athletic Training Education accreditation standards today. However, she questioned why there were so many scholarships available from colleges and universities to the other health and science majors, yet almost none available to students majoring in athletic training.
Some of the participants did not feel supported by various challenges of their academic institutions. Hanna struggled with an unidentified learning disability that became a barrier to her success, which she overcame on her own: “Back in the day, I personally was not prepared from way back because they didn't realize that I had a learning disability.” Gabriella had to overcome the barrier of an unstructured internship program. Since her institution did not sponsor an accredited athletic training program, her matriculation through an internship program was disorganized. She stated: “[B]ut early on, they didn't know what to do with me.”
Many of the participants did enjoy the close-knit bond of their peers and considered it a huge supporting factor in their successful matriculation. Moriah was an exception to this. She went through an internship program that only had a total of 5 athletic training students, including her. Because the program was so small and the students were assigned to work with different supervisors at different sports, they rarely interacted together: “So we never had a chance to interact because there were so few of us there.”
Sexism
Sexism was a common theme discussed by the participants. According to the PDS, 6 of the 10 participants felt disadvantaged in college because they were women. Three of the 10 participants felt disadvantaged because they were black women. Moriah and Deborah in particular shared experiences with sexism. They struggled with disturbing experiences with sexual harassment that, in Moriah's case, contributed to her decision to transfer from her first college. When asked about the biggest obstacles she faced as an athletic training student, the first story Moriah shared was her experience with sexual harassment from the head coach of the sport she was covering. Unfortunately, the athletic training staff that should have protected Moriah from those sexually harassing incidents did not: “The one head [athletic] trainer, he didn't feel comfortable working around minorities, period, let alone women.”
Deborah was protected by her mentor from being sexually harassed by the men's basketball team by not assigning her to work with them. The team had a history of sexually harassing the black female athletic training students previously assigned to them, causing the young women to discontinue in the program for various and related reasons. Deborah also felt that there was more black-on-black sexual harassment to deal with as a black female athletic training student. In regards to this topic, she stated: “And I've seen it. I've seen it firsthand. It happens every single day.”
Racism
The participants discussed racism as an impeding barrier to overcome. Even though only 4 of the participants shared stories or experiences with racism during the interview process, more of the participants indicated that they were subjected to racial discrimination in the PDS. Six of the 10 participants experienced racial discrimination by a college instructor. Four of the 10 participants experienced racial discrimination by a supervisor. Three of the 10 participants experienced white female peer resentment that they believed was racially motivated, while only 2 of the 10 participants experienced white male peer resentment. Interestingly, participants who went through the internship route to certification cited all of these examples. The 3 participants who felt they were disadvantaged because they were black women were also from the internship route. Also, according to the PDS, 2 of the 10 participants felt they were alienated by their peers, 6 felt stereotyped by their peers, and 4 felt unwelcome among their peers.
Moriah and Deborah shared experiences that dealt with considerable instances of racism. The same coach who sexually harassed Moriah also subjected her to racist behaviors as well. Moriah reported: “The one coach actually had his black coach come and talk to me because he didn't feel comfortable talking to me.” Additionally, as 1 of only 5 athletic training students in an internship route program, Moriah felt alienated from her peers both logistically and racially. She expressed: “I felt like I was alone and lonesome.” Moriah also experienced instances of being stereotyped as a black woman in an athletic setting. Despite wearing identification that indicated she was an AT, it was assumed by others that she was an athlete or a coach:
Even though I have on a shirt that says “athletic trainer” on it, there were other white [ATs] that just said, “Oh, where's your trainer.” Other things would be being mistaken for a coach or being mistaken for a player.
The racism that Moriah dealt with was not limited to her clinical experiences. She also remembers that the racism she experienced in the classroom sealed her decision to transfer to another university.
Deborah also remembered being subjected to stereotyping. She reported:
But we would be dressed in the same exact outfits. We would be sitting on the same bleachers. We would both have fanny-packs on, whatever. I would be sitting closest to whoever. They would go around me and go to the white male and ask him whatever they needed to ask.
Research Question 2: What Factors Promote the Successful College Retention and Attainment of the Board of Certification Credential of Black Women Athletic Training Students?
Many of the participants were able to identify factors they felt helped them to attain college success leading to their credentialing as CATs. Those things were both internal factors as well as external factors that they recognized in themselves, in other black female athletic training students, and in their environments. From the PDS, the participants ranked the following attributes as contributing to their academic success:
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Having a strong drive and determination,
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Being competent,
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Having a good personality,
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Believing in God,
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Being confident,
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Being assertive,
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Having a mentor,
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Feeling emotional support by family,
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Being patient, and
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Having a role model.
Personal Character
Damara felt that her temperament contributed to her ability to successfully matriculate through her athletic training program: “I'm very even-keeled, and I don't take a lot of things personally, so a lot of things that may bother others didn't bother me.” She also found that her self-determination and self-motivation kept her on track with her goal of becoming an AT: “Once I learned of the profession and decided that's what I wanted to be, there wasn't anything to really deter me from continuing that focus on that field. There was never another option.”
Bernice agreed that self-determination was a critical factor in her success: “I had my mind set when I left high school, so I was just determined.” Grace called her self-determination being stubborn: “I'm just stubborn, so I don't like failing at anything.” Phoebe shared in the self-determination theme contributing to her successful matriculation: “And I think that your own assertiveness comes in. I think a lot of it is self-determination.”
Navigation in White Culture
Some of the participants found that their previous experiences navigating within a predominantly white culture and environment were helpful in successfully matriculating through college at a predominantly white institution (PWI). Hanna went through her athletic training experience at a PWI in the Midwest. She found that her experience growing up in a multicultural environment aided her in being successful in college: “I grew up on the East Coast, and I grew up in a multiracial family. I grew up around a lot of diverse individuals, and so I think we seek out diverse people in support systems.”
Bernice attended high school a predominantly white high school and felt prepared by her experiences interacting with white culture to attend a PWI for her athletic training education. She offered a strong opinion stating: “If you have never flourished in a predominantly white population, then you are not going to do that fresh out of one of these public high schools in the city.” Grace grew up on military bases that were predominantly white. She also felt that her experience interacting with more diverse people helped her prepare to attend a PWI. She stated: “I was never really surrounded by a lot of people who looked like me, so it was never a big deal for me, and I was used to that.”
Mentoring
Many of the participants felt support from role models who were black women on faculty or staff at the institution but not involved in the athletic training program. Bernice enjoyed a positive mentoring experience with 2 black women on the faculty in the physical education department. She added that she also felt supported by the faculty, staff, and her peers in her athletic training program. Elisha's mentor was also a role model to her. She was a black woman who was the dean of her college and not an AT. Moriah identified a black woman who taught the chemistry lab as a role model. She was a role model for Moriah not only because she was a black woman, but because she was a teacher, which Moriah also wanted to do in addition to athletic training. Theodora remembers feeling supported by the faculty and staff ATs in the athletic training program: “I had the feeling that those people, those ATs, wanted me to succeed, and they worked really hard to help me succeed.” Hanna felt that her mentors supported her as an athletic training student: “I had great, great, great mentors there.” Phoebe remembers her mentor and staff members supporting her through her educational experience: “I didn't know of any other black [ATs]. So I'm just kind of out there and doing it and had great support from staff throughout the whole thing.”
Clinical Education
Many of the participants remembered that the clinical education experiences kept them interested and involved in the athletic training program. For Bernice, she relished working with the football team. Damara enjoyed working with her supervisors and athletes at a high school clinical rotation. She stated: “The most enjoyable memories I have are at the high school where I worked; I got a chance to work with some really good supervising [ATs].” Grace enjoyed the hands-on aspect of the clinical education experience and reported: “So I think my experience was very hands on, and it was very interactive. I liked it, so I stayed in it. I guess I had to like it.” Deborah enjoyed the challenge of the clinical education component, especially in the now eliminated internship route to certification, where students became independent learners very quickly.
Peers and Friends
Peers and friends in athletic training programs were supportive to several of the participants. Elisha remembers how important her shared bond was with her classmates and that those relationships crossed the racial divide: “But most importantly, it was being able to have a group of friends that understood what I was going through in college because we all had the same career.” Hanna remembers the bond that she shared with her classmates: “And there were a bunch of us from the East Coast that were going to school there. We hung together, and so we kind of pushed each other academically.” Theodora recalls feeling supported by her peers and the faculty: “They were very, very, very helpful. The students who were part of the program were very helpful.” Phoebe felt she enjoyed a close-knit circle in the program stating: “Because we were very tight as a small group, they really mentored us, made sure that we were capable of doing the job that they required of us. We always had nice supervision, and I just remember feeling more like family.” Bernice remembers that close-knit feeling with her peers, faculty, and staff and reports: “I just think that we had not only a close-knit peer group, but also a close-knit faculty, who really wanted all of us to succeed.” She added that she really enjoyed “. . . the camaraderie with my fellow peers.” Damara found that her peers helped sustain her. “The students that I was around or hung out with were good friends, so it allowed me a chance to be in a close-knit group of people, outside of the classroom.”
DISCUSSION
In light of the stories shared by the 10 participants and elaborated on by Deborah, Gabriella, and Moriah in their individual case studies, there are 2 answers to the 2 research questions posed in this study:
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Lack of support, racism, and sexism impede success.
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In addition to strong personal student attributes, mentoring, peers, and clinical education promote successful college completion and credentialing.
Finding 1: Barriers that Impede
Lack of Support
Based on the experiences shared by the participants in this study, several impeding barriers were identified as obstacles that they had to overcome to secure their college success and professional credentialing. Even as some of the participants enjoyed support from their families, others did not feel supported by their families. Similarly, many of the participants received scholarships to attend college or received sufficient financial assistance to offset the stress of paying for college. However, some of the participants were burdened by a lack of financial support or the need to work on top of their regular course load and clinical rotations. Institutional barriers, such as the lack of standards, organization, consistency, and policy, hampered several of the participants who matriculated through an internship route program. Additionally, many of the participants from internship routes lacked camaraderie and peer support due to the very low number of fellow athletic training students (often as few as 4–5 total students).
Unfortunately, there is abundant literature that agrees with this finding that ethnically diverse college students lack the support to overcome many institutional barriers to their success. Barriers range from overt and covert racism and sexism to the many discriminating facets of classism that may include socioeconomic status, language/dialect/accent, geography, religion, sexual orientation, disability, age, parental education, parental presence, education, culture, physical size (weight/height), and politics.3–12,28–32
Sexism
The participants of this study experienced the impeding barrier of sexism to include sexual harassment in addition to the racism simultaneously faced by black women in US society and the academy. Most of the examples shared by the participants focused on sexual harassment. In addition to the sexual harassment Deborah faced, she was also denied an equal learning opportunity (assignment to the men's basketball team) consistent with the clinical assignments of her male peers. Although denial of assignment to the men's basketball team was to protect her from the negative outcomes of sexual harassment, it still resulted in discrimination based on her gender. Ultimately, the example was part of a vicious cycle of sexism and classism. People in a higher position of authority over the offending coaching staff (all white men) should have and could have intervened on behalf of the black women athletic training students to prevent the issues of sexual harassment that were occurring with a detrimental effect on the students. The institutionalized sexism was allowed to persist within that system. Additionally, the one person who did try to intervene on behalf of Deborah was a nontenured white woman who was also oppressed by her position (classism) and gender (sexism) in this scenario, rendering her powerless to do more than the lesser of 2 evils by her actions. Her mentor could only deny Deborah an equal learning opportunity to prevent overt sexual harassment from threatening her student's future and success.
This finding is consistent with other literature that presents evidence of sexism in sports, athletics, athletic training, and other health professions.13,32–39 In the field of athletic training, Gatens et al39 conducted a quantitative study examining the prevalence and effects of sexual harassment of female athletic training students by male athletes and patients. Twenty-five close-ended Likert scale and multiple-choice questions were posed to 144 participants from 20 accredited athletic training programs recruited through the program directors. The researchers found that 43% of participants (no racial demographic specified) reported experiencing sexual harassment during their clinical education rotation. Twelve percent of the participants reported that they experienced being sexually leered or stared at by a male athlete/patient that made them feel uncomfortable. Fourteen percent of the participants felt offended by a male athlete/patient asking them out on a date. The researchers confirmed that sexual harassment is a significant problem facing female athletic training students in the clinical education environment.39
Racism
Based on the interviews, the participants did not indicate that they perceived significant alienation, stereotyping, or unwelcoming behaviors from their athletic training peers or athletes, which leads us to believe that the racialized behaviors cited in the PDS were directed at the participants primarily from classmates outside of the major. These findings are consistent with the literature that demonstrates racism persists as an integral part of US society and its academic institutions.3–5,8–12,28–31 Feagin et al40 have presented the feelings of alienation, profiling, and stereotyping experienced by black students at PWIs. Their study also revealed that black women were subjected to personal inquiries, such as how the women wore their hair.40 Solórzano et al24 found that black students dealt with racialized microaggressions involving anti-affirmative action speech (“quota” and “token”) that called into question students' right to attend college. These covert microaggressions lead to tension, segregation, and a hostile campus climate for black students.24
Finding 2: Factors that Promote
Personal Character
As black women oppressed within a maze of intersecting barriers constructed from racism, sexism, and classism, the participants of this study had to overcome these barriers to secure success (college matriculation and credentialing) with tools they possessed within themselves, determination, self-motivation, knowledge, skill, and competence. The most consistent term used to describe them was “self-determination.” This qualitative finding is consistent with the information provided by the participants from the PDS.
This finding is consistent with a similar finding by Aiken et al,7 who identified that interpersonal factors such as determination and self-motivation encouraged subjects (black women) to complete their program in nursing. The black women participants in Abney's study26 also identified the internal factors of having strong drive and determination, being confident, and being competent as personal characteristics that contributed to their success in coaching and athletics administration. Grossman and Porche41 found that high aspirations created optimism in overcoming barriers in the science, technology, engineering, and math fields. Dodge et al42 found that motivation was the strongest predictor of persistence for athletic training students. Athletic training students who were confident in themselves and committed to finishing the program were the most motivated to persist. Self-confidence and self-efficacy have been reported to strongly influence a student's commitment to continue.43
Navigation in White Culture
Another factor that some of the participants identified in themselves as athletic training students was the acquired skill of navigating in a predominantly white culture. They had the benefit of developing personal tools within a predominantly white environment before and during college. As such, they brought experiences to college with them that helped them to not only successfully deal with incidents of racism, sexism, or classism, but to establish a level of comfort and fit within a PWI that supported their successful educational endeavors.
This is similar to a finding from a study of female students of color at a PWI by Esposito,44 who found that the participants learned and developed skills for successfully navigating socially and academically through the dominant white culture of their institution. This finding was also consistent with previous studies that investigated the role of student background and previous interracial experiences of black college students on their perceived ethnic fit, adjustment, and retention at PWIs. These studies found that previous experience and interaction with students and friends from the dominant culture (predominantly white) before enrollment at a PWI increased the participants' comfort, perception of fit, successful retention, academic satisfaction, and academic performance.30,45
Mentoring
One of the most commonly identified promotional factors was the support that many of the participants enjoyed from faculty and athletic training staff members while enrolled in their collegiate studies. Whether those faculty and staff members were mentors, role models, or supervisors, they were important contributors to the success of these participants as athletic training students.
This finding is consistent with several studies in the field of athletic training that indicate the importance of the clinical preceptor to the successful matriculation and program satisfaction of athletic training students, especially during the clinical education component. Mazerolle and Dodge46 found that mentoring and role modeling by clinical receptors created a positive experience that lead to commitment to pursue the athletic training profession. Pitney and Ehlers47 found that a significant number of participants identified their clinical instructor/preceptor as their mentor. Mensch and Ennis48 found that athletic training students desired “authentic experiences” and a positive learning environment from their athletic training educators and clinical instructors/preceptors in the classroom and the clinical setting. Additionally, they found that developing strong preceptor-student relationships enhanced the athletic training student educational experience and was viewed as valuable by both students and preceptors. Curtis et al49 found that the supervising AT (clinical preceptor) was identified by athletic training students as a critical component to their development and growth. Participants in this study also identified common mentoring characteristics, such as explanation, demonstration, constructive feedback, nurturing, accessibility, confidence building, and role modeling, as desirable traits from their clinical preceptors, thus fostering a positive, enjoyable, and challenging experience that the athletic training students wish to continue to participate in (retention). A study of program directors' perceptions of student retention also included the importance of strong relationships between athletic training students and their faculty and preceptors in persistence.50
Clinical Education
Several participants recalled how much they enjoyed practicing their knowledge and skills in their clinical rotations. Many of their most favorable memories centered on the experiences they had working with athletes. Practicing their knowledge and skills in the clinical setting kept these women interested, involved, challenged, appreciated, and feeling like part of the team. This is consistent with 2 studies of athletic training students that found positive clinical integration contributed to student persistence in the major.42,46
Peers and Friends
Coinciding with the positive experiences afforded by the clinical education component was the bond that the participants remembered sharing with their fellow athletic training students. Smaller program enrollment allows athletic training students to form close mentoring relationships with program faculty and staff and with their athletic training peers. Athletic training programs can cultivate a sense of familiarity and appropriate intimacy among the students, faculty, and staff. The students spend a considerable amount of time with their peers in class as well as practicing the application of their knowledge and skills together in shared clinical rotations.
Revis-Shingles51 found similar descriptions in her study. Most of the participants in her study indicated that they also formed “tight knit” group relationships with classmates and instructors. Additionally, participants in the study by Mensch and Ennis48 identified a “family-type atmosphere” as valuable within the athletic training program. Their participants also identified the creation of positive peer relationships as important in enhancing athletic training students' learning experiences and success. Henning et al52 investigated a more formal method of peer relationship (peer assisted learning) and found that 66% of athletic training student participants practiced their clinical skills with other athletic training student peers and experienced less anxiety when practicing those skills in front of their peers.52 Dodge et al42 found that peer support contributed to athletic training student persistence. This concept of peer collaboration promotes the theory that trust, interdependence, and teamwork shared by athletic training students contributes to their individual success, perceived fit, and program completion.
Educational Relevance
These findings present athletic training educators and preceptors with information that may galvanize them to enhance the educational experiences of black women athletic training students and contribute to their retention and persistence in the athletic training profession. Athletic training educators and clinical preceptors should not underestimate the potential of the clinical experience to influence the persistence or transience of black women athletic training students. Athletic training educators and preceptors should recognize and acknowledge the presence of racism and sexism that black women in athletic training programs might face on campus, in class, and in the clinical experience and how that impedance influences their students' decisions to persist in the athletic training program or the institution itself. Educators and preceptors should also self-reflect on their own behaviors and perceptions regarding race.
During advisement sessions or other opportunities for conversation, ask students who are black women about their college experience, how they are doing, adjusting to campus, and socializing in and out of the program. Avoid stereotyping in the classroom and clinic or asking students to be the spokespersons for their race. Purposely facilitate classroom and clinical activities to promote inclusion and teambuilding between all students. Strategically present topics on inclusion in preceptor training. Educators and preceptors, regardless of race and gender, should formally or informally mentor the students who are black women in their classroom or clinical practice.53–55 Black women athletic training students should also be encouraged to seek professional mentors and join black sororities to engage in peer mentoring and social support, which was found to have a positive impact on the academic success of black women college students.55,56
Limitations
Qualitative research and the nature of its design allowed for a relatively small number of participants to be selected for in-depth study (n = 10). Therefore, the experiences of the participants may not be representative of all black women athletic training students or generalizable to the total population of black women athletic training students enrolled in athletic training programs. Also, black women experience the world from the unique standpoint of being black and female. Their experiences may not be generalizable to other students who are ethnically diverse or to black men.
The first 10 participant interviews were conducted via phone interview. This may have limited the data collection process. A 1-on-1 interview in person may have allowed for more interpersonal exchanges between the participants and the primary investigator. The purpose of qualitative research is to seek deeper, richer, broader experiences to reveal the complexity of those experiences and offer counterstories from the margins. More time, opportunity, and resources to conduct all interviews and case study interviews in person with the participants in their environments may have allowed us to learn even more that would have revealed greater complexity in the results.
Another limitation of our study was that half of the participants matriculated through the internship route to BOC certification, while the other half were enrolled in accredited athletic training programs. As such, some of the experiences of the 5 internship route participants specific to internship processes, challenges, and benefits may no longer apply for black women athletic training students enrolled in the current accredited program system. Additionally, the timeframe that the participants were athletic training students ranged from the 1970s through the 2000s, thus allowing for cultural and societal differences over time.
CONCLUSIONS
This study contributed to the limited body of literature examining the experiences of black women athletic training students and examined not only the impeding factors to successful college matriculation and credentialing, but also identified factors that promoted them beyond that impedance to find success in the field of athletic training. The participants in our study identified that a lack of family, financial, institutional, and social support impeded their path to becoming ATs. They also identified experiences with sexism and racism within the institution, classroom, and clinical experience as additional impedance to their college success, yet the participants in this study were able to overcome those impeding factors to achieve their goals of completing college and earning their BOC credential. They identified resilient personal characteristics and an ability to navigate within the dominant white culture as factors that helped them to persist in their programs and institutions. They also identified mentoring by faculty, staff, and preceptors and bonding with athletic training peers as promoting factors that contributed to their success. Perhaps most salient was the participants' recognition of the clinical education experience as athletic training students that contributed to their academic and professional success.
Athletic training educators and preceptors have the responsibility to recognize and acknowledge the impeding barriers that may exist within their programs and institutions for diverse students. They should consider mentoring their students through those impeding barriers while also building on the beneficial factors, particularly the clinical education experience, that have the potential to contribute to the success of the black women athletic training students enrolled in our athletic training programs.
Further research, including qualitative inquiry, is needed in the areas of retention of athletic training students from all ethnically diverse groups and other genders. Research questions investigating the clinical experiences of ethnically diverse athletic training students since the internship route was eliminated is another area for future research. As athletic training education moves to the graduate level as the entry level for the profession, future research investigating the didactic and clinical education experiences of ethnic and gender diverse athletic training students will be particularly important to educators and preceptors.
Percentage of women members in the National Athletic Trainers' Association.
Result codes.
Contributor Notes
Dr Siple is currently Associate Professor of Athletic Training in Exercise and Rehabilitative Sciences at Slippery Rock University.