Exploring the Development of a Mentoring Relationship Among Newly Credentialed Athletic Trainers
Mentorship has been identified as a primary organizational socialization tactic and has been directly associated with transition to practice. Understand how the mentoring relationship develops for the newly credentialed athletic trainer during the first year of clinical practice. Grounded theory. Athletic training practice settings. Thirteen athletic trainers, who graduated from a professional master's program, certified between February and July of 2016, and obtained employment between July to August of 2016, participated in this study (6 female, 7 male, 26 ± 3 years; work settings included professional sports, college, secondary and middle school, and clinic). Data saturation was met. Semistructured phone interviews were conducted with all participants during 3 specific time points (3, 8, and 12 months posthire). All interviews were transcribed verbatim and coded following the steps of a grounded theory study. Credibility strategies included researcher triangulation and peer review. All 13 participants recognized a mentor, someone who they believed serve in a mentoring capacity during their transition into clinical practice as a newly credentialed athletic trainer. The development of the mentoring relationship for the newly credentialed athletic trainer appeared to be characterized by (1) identification of a mentor who had experience and knowledge, (2) a recognition of the need to have support and continued avenues for growth as a health care professional, (3) an informal initiation of the relationship through a professional relationship by the mentee, and (4) communication that overtime was reduced in frequency. Mentors provide career support and professional growth. Newly credentialed athletic trainers should seek out mentors who can support their continued development. The informal relationship appears to be of the greatest importance during the first few months of practice, and then once comfort and self-confidence improves, the frequency of communication is reduced.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
KEY POINTS
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Newly credentialed athletic trainers use mentorship to support their transition to clinical practice.
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Informal relationships were most common, and the mentors were selected due to their relatable experiences and knowledge which could advance their clinical practice.
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Communication between the newly credentialed athletic trainer and mentor was frequent during the initial transition process, and lessened as the confidence grew for the newly credentialed athletic trainer.
INTRODUCTION
A mentor is described as someone who can guide, teach, or advise a less experienced and often younger individual at the initial stages of his/her professional journey in a specific role or profession.1,2 It has been suggested that a mentor can facilitate 2 specific types of behaviors: career and psychological functions. The career component of the mentoring relationship speaks to the mentee being successful in the workplace and meeting expectations within the organization, including organizational advancement. The psychological aspect speaks to contributions made to the mentee's personal growth and professional development.2 The mentor relationship is unique as it allows for the dissemination of experience, skills, and knowledge, which allow the mentee to successfully acclimate and enter the profession, a concept often described as transition to practice and is considered a natural part of the socialization process.
Organizational socialization,3,4 or onboarding, occurs once an individual enters the workforce in a full-time capacity and assumes the role he/she received the educational training to perform. Part of this transitional process, which is often described as a period of inductance, is characterized as a learning process, in which the new employee becomes integrated into the organization and the culture.3–5 The mentorship relationship has become a central facilitator in the organizational socialization process for the newly credentialed athletic trainer, specifically as they are in an inductance phase.6,7 The reason is simply founded on the exchange of information, which is guided by past experiences to provide support, advice, and feedback that directly aligns with growth and development.6,7
Mentoring research5,7–9 has mushroomed in athletic training over the last few years because of its importance in the transition to practice phenomenon. A mentoring relationship is described as informal and one that can be ongoing as it likely develops initially for a specific need, but continues for years due to the development of successful relationship10 and the reciprocal benefits for both the mentee and mentor.7,10 Despite the documented evidence of the presence of mentoring and the value perceived by the mentor relationship, we have little understanding about the process of development.
Mentoring relationships are classified as dynamic and evolving over time as the mentor and mentee matriculate through the phases described by the seminal work of Kram.2 The relationship is conceptualized by 4 phases: (1) initiation, a period of time when the relationship begins; (2) cultivation, the time in which there is an exchange of knowledge and experience; (3) separation, during which the mentee implements and uses knowledge exchanged; and (4) redefinition, when the relationship is reflected on and redefined. The framework developed by Kram2 provides a template for how mentoring relationships can develop; however, we have not fully explored this process in athletic training. The purpose of this study, thus, was to explore how a mentoring relationship develops between the newly credentialed athletic trainer and his/her mentor. Specifically, we wanted to better understand the formality of the relationship and the process in which it develops for the newly credentialed athletic trainer. The following questions guided our study: (1) how does the mentoring relationship develop for the newly credentialed athletic trainer, and (2) how does the newly credentialed athletic trainer identify a mentor?
METHODS
Research Design
A grounded theory11 platform provided the theoretical groundwork to understand the development of mentoring relationships in athletic training. We were concerned with discovering how newly credentialed athletic trainers develop mentoring relationships as they transition to practice for the first time as a credentialed practitioner. Grounded theory, thus, provided the structure needed to understand mentoring relationships in the first year of clinical practice.
Participants
Thirteen athletic trainers, who graduated from a professional master's program, were certified between February and July of 2016, and obtained employment between July to August of 2016, participated in this study (6 female, 7 male, 26 ± 3 years; work settings included professional sports, college, secondary and middle school, and clinic). Data saturation guided the number of participants and was reached at 13. The Table reports the individual data of our participants.
We recruited participants from professional master's programs who had gained certification after graduation and entered a full-time position upon both graduation and certification. Having a pre-identified mentor was not part of the recruitment process, as this was part of a larger study looking at transition to practice and role of mentorship.
Procedures and Instrumentation
After securing institutional review board approval, recruitment began using the Board of Certification (BOC) directory. The BOC distributed recruitment e-mails during October and November of 2016 to all 211 athletic trainers who graduated from a professional master's athletic training program and who gained certification between February 2016 to July 2016. Interested participants contacted the researchers directly to set up a phone interview and to ensure they met the inclusion criteria. Phone interviews were conducted using a semistructured format and were conducted over a 1 year period, resulting in 3 interviews (Figure 1).
Citation: Athletic Training Education Journal 14, 3; 10.4085/1403174
The semistructured interview protocol was developed using literature on mentoring8,12 and transition to practice.8,13 Three interview guides were used during the interview cycle, which allowed for us to understand the developing mentor relationships during athletic trainers' first year of full-time clinical practice. The first interview guide (20 questions) included questions related to expectations of their mentor and of the mentor/mentee relationship, communication style between themselves and their mentor, the types of meetings they have with their mentor, benefits/successes of the relationship, if this relationship has effected their transition to practice, etc. The second (17 questions) and third (11 questions) interview guides included questions regarding interactions with their mentor since the last interview, how their relationship has developed, and if their relationship has affected their transition from student to clinician. The interview protocol was reviewed by 2 athletic training educators and qualitative researchers with backgrounds in socialization, transition to practice, and mentorship. They were asked to provide feedback on content, relevancy, and clarity as it related to the agenda. The peer review process resulted in very few edits but included re-ordering and grammatical edits.
All interviews were conducted by 1 researcher, were recorded, and transcribed by an independent transcription company immediately following the interview. The first interview sessions lasted between 30 and 40 minutes, and all others were 15 to 20 minutes.
Analysis
A constant comparative approach that was inductively grounded was used to determine the emergent themes regarding the development of a mentoring relationship.11 The constant comparative method is used when developing a theory, and both coders used this method when analyzing the data.11 Our study involved comparisons within each individual transcript and then comparisons within the total sample, which allowed for an inductive evaluation of the mentoring relationship. Specifically, we used an open coding process to capture the overall meaning as shared in the transcripts, as well as to organically allow the data to highlight itself. Then on subsequent reads of each individual transcript, key findings were labeled to reflect the overall meaning (axial coding) and define the categorization, and once this process was complete, the likeminded codes were selectively combined.
Credibility Strategies
We purposefully selected peer review and researcher triangulation as our primary sources of credibility.14 The peer review process was conducted in 2 stages: (1) during the methodological development, as previously detailed, and (2) upon completion of the analyses. Upon completion of the aforementioned stepwise analysis, we asked 1 of our peers to confirm our findings. They were given several blinded transcripts and the draft of the results as agreed upon by the 2 researchers. The transcripts, uncoded, allowed them to naturally see the experiences of our participants, which were then organized by the researchers in the form of a results section. The peer confirmed the presentation of the findings. The comparative analysis approach as discussed before was completed by 2 researchers separately and then compared before sharing the coding with the peer. Beyond these 2 mechanisms, we also used data saturation to guide recruitment as a means to ensure consistency and rigor to our findings.
RESULTS
All 13 of our participants had a mentor, someone who they believed served in a mentoring capacity during their transition into clinical practice as a newly credentialed athletic trainer. The development of the mentoring relationship for the newly credentialed athletic trainer appeared to be characterized by (1) identification of a mentor who had experience and knowledge, (2) a recognition of the need to have support and continued avenues for growth as a health care professional, (3) an informal initiation of the relationship through a professional relationship by the mentee, and (4) communication that overtime was reduced in frequency (Figure 2).
Citation: Athletic Training Education Journal 14, 3; 10.4085/1403174
Mentor Identification
Mentor selection was facilitated by a desire to gain advanced knowledge from the mentor, as well as to take advantage of their past or current experiences which could translate to the newly credentialed athletic trainer's role.
Knowledge
Possession of advanced knowledge specific to the field of athletic training was shared as a reason for seeking and engaging in mentoring relationships. Participants recognized mentors as individuals who possessed more knowledge than they did. Kent said, “I would define mentorship as a relationship with somebody who has experience in the field, basically the experience to guide a younger or less experienced person, like me.” Descriptions and definitions used to describe their mentors included “knowledgeable,” “many years in the business,” and “past experiences that are helpful.” Our participants identified their mentors as individuals who were experienced in the field and that specific experience was linked to knowledge that can support their continued growth. In fact, several participants linked their increased confidence in clinical practice to the knowledge they gained from their mentors. Catherine shared, “[A] mentor is someone who can promote confidence, as I am on my own for the first time, and because my mentor has been in the field for 20+ years, she can really help me.”
Translatable Experience
Experiences that facilitated role understanding in the specific employment setting was also identified as part of the selection process. Kent acknowledged his mentor as the person “who had experience doing my role and had the most experience.” Kent wanted his mentor's knowledge and experiences as a means to support his success in his role. Sue shared, “[M]y mentor is someone who had the knowledge and skills that I needed to learn from [especially in this particular job setting].” Jennifer said, “[M]y mentor is someone who has been practicing in a similar position as to mine. She can basically understand me, and I can learn from her. That's why I picked her.” Gary recognized his mentor as someone who was an active teacher, someone who included him in on the learning process, something he valued. He also realized his specific experiences in a similar setting lended itself to his success. Gary shared:
He's my mentor because he would show me how things worked at the old school. He not only transitioned me like the other employees, but he also taught me how to do some things. He taught me how to do some evaluation type things. Gave me some tips about organization at the school and some tips about some emergency action planning that I wasn't used to.
Support and Professional Growth
Our participants described the importance of having a mentor, which was based upon the need for support and continued growth during their first year. Catherine described being “nervous” and because she “worried about making decisions on my own” that having a mentor was making it “easier [to transition].” Catherine shared about her mentor:
[S]he has basically told me I am not going to be perfect. You are not going to do things perfect, so just try to be the best you can. Follow your gut. I have been busy the first few months, but having her [my mentor] has really helped me be confident in myself, as an athletic trainer.
The concept of being “perfect” was also shared by Aaron and the reason for needing a mentor as he said:
It is just a realization that everybody ought to have a mentor, as you're not perfect, and that you need to early on be aware of it. You don't just emerge into school where it's like a fully pledged 30 year-old professional, you require some sort of grooming, mentoring, whatever you'd call it. Somebody. . . you've got to have help. If you don't have any help, you're not going to develop.
Cassandra wanted a mentor that could help her, provide support, and help her confidence grow. She shared about having a mentor, “[W]hen I transitioned to working, I knew that it was important to have somebody [a mentor] that I could reach out to and depend on and know that I could reach out to if I needed anything.” The idea of transitioning from a student to a practitioner was discussed for the primary reason for having a mentor. Jennifer acknowledged this, saying:
There is a big difference between clinical practice and reading a textbook. So the reason I knew I wanted a mentor was to have someone, someone with experiences to share, and so that I wouldn't be practicing on an island.
Amy also felt the same, that you can keep learning and gaining reassurance and support on decision making. Amy said:
I just felt coming out of school that, I mean, like I said, there's so much that you don't know and. . . there's so many things about athletic training that you learn from other people. Like you learn how to do certain special tests that a different way or how to run a practice or set up for a practice or a game or how to interact with coaches. There are so many intangible things that are—athletic training program can't teach you, so I think that's really valuable to have a mentor for.
Informal
The mentoring relationships described by our participants were described as informal as many developed these relationships through a professional platform which was unplanned and/or unstructured. Gary shared that his relationship with this mentor “spawned spontaneously out of a relationship with my supervisor.” Gary recognized that he needed support and, over time, he realized that his supervisor was the person he should turn to. He said, “I needed someone I could bounce ideas off of, and I wanted a mentor, someone older, someone with experience, and over time and interactions, I realized he was able to help me out.” We directly asked our participants to “quantify” the nature of their relationship, and many used the term “informal” or “casual.” The quantification of the relationship as informal was based upon the nature of their interactions that were more discussion based and unplanned. Mike shared, “[W]e have a casual relationship.” He also shared, “[W]e talk over the phone or text message, when needed.” Jennifer during her second interview was appreciative of her mentor, indicating that having someone to reach out to when needed was helpful. The relationship that Jennifer was describing developed casually and informally. Jennifer shared:
[B]eing a part of this study has allowed me to reflect on how useful it is to have a mentor, someone who can be super helpful during the transition. It has been really nice to have a mentor, so I am not just taking shots in the dark.
Our participants shared that the informal mentoring relationship developed through networking that occurred within their current roles (n = 7), or because of past relationships with clinical preceptors or faculty (n = 6). Those mentoring relationships that developed from our participants' roles were not directly part of the hiring process, but rather were employed by the same organization. Cassandra discussed her mentor as “passionate about giving back and helping young professionals and always has an open-door policy. She has a lot of experience.” Cassandra's mentor was a seasoned athletic trainer in her work setting, who was part of the hiring process. In contrast, those who recognized a preceptor as a mentor shared the evolution of the relationship and the comfort they found in reaching out for support. Sue shared, “[M]y mentor is willing to share. I respected her before as my preceptor, and now she respects me, now that I have graduated. We are able to communicate, casually, when I have a question.” The informality of the relationships spoke to the reality that our participants needed support, reassurance, and guidance in their new roles.
Communication
The evolution of the relationship guided the frequency of communication. During the first 3 to 6 months, communication was more frequently (ie, weekly basis), and as the relationship developed over the next 6 to 9 months, communication was less frequent (ie, monthly). Gary shared that his mentor was supportive in his transition, and that he used him “frequently” during his first interview, but in the second interview session (4 months after his first interview, 8 months into his job), he shared that “he [mentor] continues to help me out to a lesser degree now because I'm more integrated to the athletic training team that I'm working for, and I am more confident as an athletic trainer.” When asked about the frequency of the communication, Gary described it “as needed,” which was different from his first interview when he shared communication was “weekly” and “fairly consistent.” Cassandra shared that her interactions and reaching out to her mentor had “definitely decreased [since the first interview].” She reflected about why:
Once you get used to things and how things work, it kind of becomes second nature. I only really ask her things unless I need advice, or if there's something specific I don't know. So I definitely reach out about work a lot less now.
Amy's experiences are much like Gary and Cassandra, whereby the communication and need for interaction decreased over time because of comfort, confidence, and role understanding. During Amy's first interview, she described her interactions with her mentor as “daily” and that she “asks a lot of questions all day long.” During her subsequent interviews, she realized the frequency had lessened because she was comfortable. She shared, “It is not that I don't feel like I need a mentor, so now it is more I only really ask questions when I am completely stumped on something.”
DISCUSSION
It is well understood that mentorship is a primary facilitator in transition to clinical practice and in fact is often identified as the key to a successful socialization process for a young professional.8,15 Our findings continue to support this literature in regard to the utilization of a mentor to support transition to practice,5 as all of our participants recognized having one and using their mentor during their first year of clinical practice. Unique to the existing literature in athletic training, our study was able to gain a better understanding of the developmental process that occurs within the mentorship relationships for the newly credentialed athletic trainer. Kram10 acknowledged that mentoring relationships develop over time and often follow separate phases, something our results suggest can happen too. Like the work of Kram,10 our findings indicate a developmental process in the mentoring relationship that is informal in nature, yet built on specific needs related to career development and support during the first year of clinical practice.
Mentor Identification and Mentor Relationship Development
Advanced knowledge as well as relatable experience has been found previously7,16 as requirements for a mentor. Our newly credentialed athletic trainers shared that they were seeking their mentor because of the knowledge they possessed as a seasoned athletic trainer as well as someone who had experience in the specific role they had assumed in their first year of clinical practice. The initiation phase of the mentoring relationship as described initially by Kram,10 where the mentee is seeking an experienced professional to help them transition, is similar to our participants' recognition of the necessity for a mentor during their first year as an autonomous practitioner. The initiation phase2,10 of a mentoring relationship is an important part of a successful relationship and provides the scaffolding of the mentoring relationship because expectations and goals are discussed, and the type of relationship (ie, formal versus informal) will emerge. For our participants, they wanted experience and knowledge as they transitioned into clinical practice, yet they wanted a more informal relationship. This aligns well with past research,2,7,10,12,17–19 as informal relationships are often forged due to a recognition of a need for support through a mentor who is competent, in similar positions as the mentee, and possesses similar personal attributes.
Support, understanding, and advice5,16,17 are the fundamental aspects of a mentoring relationship. In fact, for our participants, seeking their mentor was about reducing the anxiety related to being an independent practitioner for the first time. The need for support and professional growth is not unique, but our participants' experiences illustrate that mentorship can support role inductance and reduce the stress that can accompany the initial transition into clinical practice. Furthermore, the informal nature of the mentoring relationship speaks to the importance of selecting a mentor who can invest time and energy to the relationship and who also is interested in supporting the development of the newly credentialed athletic trainer. Kram2,10 suggests that a natural rapport is helpful when selecting and developing a relationship. For our participants, they chose individuals with a past relationship (ie, preceptor) or a current one (coworker/supervisor) to provide mentorship, which speaks to the importance of chemistry and personal relationship aspect of mentoring.
Although there was a split between selecting a mentor from a past relationship and their current role, we believe that, because participants are likely to reach out to a mentor from the past, educational programs should be encouraged to be prudent when pairing students with preceptors. Educational programs should also prepare preceptors on the importance of serving as a mentor and role model, as a means to support transition to practice, and the likelihood that a past student may reach out again.
Cultivation, Redevelopment, and Need for Mentoring Relationship
Mentoring has been identified as a support mechanism necessary for the newly credentialed athletic trainer, as it provides an environment that cultivates feedback for continued growth as a young professional.5 For our participants, the ability to gain reassurance and confidence through feedback from their mentor was important during the first year of clinical practice. Moreover, the frequency of interactions between the mentor and mentee seemed to decrease over time, which makes sense, as comfort and confidence grows the need for affirmation lessens. The idea of legitimation has been discussed previously,15 something that a mentoring relationship appears to provide for the newly credentialed athletic trainer. Simply as feedback is gained during the socialization process, the athletic trainer gains more self-assurance, which translates to the reduction in the need for constant feedback and support.
Kram2,10 describes a period of separation and redefinition as an inherent part of the relationship. This period of time helps the mentee grow and gain confidence in his/her skills. For our participants, this was likely the period of time that reduced the communication frequency, as they were able to gain feedback on their performance, internalize it, and thus gain confidence in their abilities as an athletic trainer. Mentoring relationships help facilitate career growth/development, as well as psychological competence.2 Our results indicate that our participants were able to grow clinically, but most importantly, gained confidence as a clinician through their mentoring relationships.
Communication emerged as a finding regarding the development of a mentoring relationship, and although it was not about the skill of communication, a necessary aspect of a good mentor,7 it was about the frequency of communication. The Kram model2,10 of mentor relationships speaks to a period of time with redefinition and reevaluation; thus, for our participants, it was through a reduced need for support that led to a change in the frequency of contact.
Limitations and Future Directions
We recognize several limitations with our study. Our inclusion criteria were focused on a sample of newly credentialed athletic trainers within a variety of employment settings; thus, we are not able to fully understand the role organizational socialization plays in the development of a mentoring relationship. For example, some employers offer more formalized mentoring programs which can influence the relationships developed. Thus, we suggest future research focus on a more homogenous sample that can delve into the inner workings of organizational socialization and how mentoring occurs specific to those settings. We present our findings from the perspective of the mentee only, and therefore, our presentation of the developmental process of the mentoring relationship is onesided. We believe future studies can include both the mentor and mentee as a means to gain a holistic impression of the process and to ensure full comprehension of the complexity of the relationships. Finally, although we used a longitudinal approach to study mentoring relationship development, the work of Kram10 was done over a 5 year period. Future research should follow up with the study's participants to examine the relationship as it continued to develop after the first year of clinical practice.
CONCLUSIONS
Newly credentialed athletic trainers should be encouraged to seek out a mentor, as they can support their transition into clinical practice, not only from a psychological perspective, but also from a career developmental standpoint. Specifically, they should seek a mentor who provides support and guidance specific to the employment setting, but also who can share his/her knowledge from years of clinical practice. Selection of a mentor should be someone who not only possess knowledge, but also one who has interest in mentoring, as well as who may have similar personal attributes. A mentor can be found in the newly credentialed athletic trainer's employment setting or be a former preceptor.
Once a mentor has been decided by a mentee, they are encouraged to reach out and share their goals and needs along with why they are reaching out to their identified mentor. Ongoing communication, particularly on goals and changing needs as the mentee's confidence grows and role acclimation/inductance happens, is important to facilitate a successful relationship. The mentee should expect a reduction in the need for contact with the mentor, as they engage in the role. Because mentorship is part of the transition to practice experience for the athletic trainer, those who are identified as a mentor should commit only if they have the time and energy to do so and expect a period of time where communication is frequent.
The relationships developed between the newly credentialed athletic trainer and his/her selected mentor is viewed as informal and built upon discourse that occurs frequently during the early role transition process and lessens as confidence grows and role inductance appears to occur. Employers of newly credentialed athletic trainers should offer mentorship opportunities as a means to support their professional development and transition to their new role. This can be facilitated informally by educating the new employee on its importance during an orientation session. Moreover, during this orientation session, if the employer provides the names, current roles in the organization, and backgrounds of current employees, the newly credentialed could identify a possible mentor from the group, as many look for someone with similar background or current experiences.
Timeline of data collection procedures.
Developing a mentoring relationship.
Contributor Notes