Mentoring and Personal Relationships Are Perceived Benefits of Serving as an Athletic Training Preceptor

Participants

We gathered the e-mail addresses for 52 athletic training preceptors across the east coast from our professional relationships and sent a recruitment e-mail for our study. From this e-mail, we secured 24 participants who were serving as preceptors (average age = 32 ± 7 years, 11 male, 13 female). We used data saturation as a guide to recruitment; after an initial analysis, we ceased recruitment after 24 responses. The participants had an average of 9 ± 6 years of clinical experience and an average of 5 ± 3 years of experience serving as an athletic training preceptor. Participants represented 7 Commission on Accreditation of Athletic Training Education–accredited ATPs from the east coast. Our participants were evenly distributed between intercollegiate athletics (n = 12) and the secondary school setting (n = 12).

Data Collection Procedures

We developed an open-ended questionnaire using the QuestionPro (QuestionPro Inc, Seattle, WA) secure online survey management tool. We chose to use online data collection instead of more traditional methods (eg, telephone or face-to-face interviews) because of the flexibility afforded to the participants regarding completion of the open-ended questions. Preceptors often have limited free time due to the multiple responsibilities they fulfill. Aside from being convenient, using online journaling also offers the participant a sense of confidentiality and gives an extended amount of time for reflection before responding, both of which are difficult to provide during other data-collection methods.¹⁷

After the Institutional Review Board of the host institution approved the study, we sent an e-mail to the participants that included a brief description of the study and the link to the questionnaire. The first page of the questionnaire was an approved informed-consent form, which the participants agreed to by completing the questionnaire. The first section asked participants basic demographic information such as age and years of experience. The next section contained several open-ended questions that asked participants to journal their responses with as much detail as possible in a reflective manner. The questions were focused on gaining insight into the roles and responsibilities of preceptors, for example, “What do you like best, or what are the good things about being a preceptor?” The participants had an unlimited amount of space to use when responding. We had an athletic training educator with experience in qualitative data collection and a preceptor review the questions to ensure clarity and content before we initiated data collection. The peer and the preceptor both offered no suggestions for editing the questions; therefore, we moved to data collection.

Data Analysis and Credibility

We analyzed data using a general inductive approach¹⁴ to uncover the prominent themes associated with our research question. We ensured the confidentiality of the participants by obtaining transcripts from QuestionPro with no links to the participants' identities. Initially we read through the transcripts several times to become familiar with the responses of all the participants. After reading the transcripts several times, we began coding the data by applying labels; 2 authors (T.G.B. and S.M.M.) completed this process independently. During subsequent analyses of the data, we combined labels into categories to reduce redundancy. Finally, we developed themes from the data guided by our research question. We negotiated over the final themes until we came to 100% agreement. The negotiation involved modifying the name of the themes, but we achieved consensus on the data separation into themes.

Credibility or trustworthiness in qualitative research refers to the authenticity of the data and the interpretations.¹⁶ Creswell¹⁸ recommends using at least 2 methods to secure the credibility of a study. Based on this recommendation, we used consistency checks while analyzing the data and completed a stakeholder check and peer review.¹⁴ During consistency checks, 2 authors (T.G.B. and S.M.M.) communicated about the emerging themes during 2 meetings after analyzing the data independently. We negotiated over the coding structure and final themes until we came to full agreement. Following the agreement of the final themes, we randomly selected 2 participants and asked them to review the presentation of the findings to ensure accuracy and provide feedback for improvement. The stakeholders requested no modifications to the manuscript. Finally, we asked an athletic training educator trained in qualitative methods and who has experience as a preceptor to review the data-collection procedures, transcripts, and final themes to ensure methodological rigor, maintain the objectivity of the data, and reduce researcher biasing.

Personal Relationships

Professional satisfaction and pursuit of a career in athletic training appears to be rooted in helping people and building relationships with peers and student athletes.^19,20 Our participants' discussions support these attractors, noting that they were able to build personal relationships with their students and viewed this as a major benefit to serving as a preceptor. One participant responded that the best part of serving as a preceptor was “building relationships with the students. I have the opportunity to field questions they may not ask the instructor. It is always cool to see former students coming back to see you when they don't have to.” Another participant agreed, stating, “I like developing relationships with the students and seeing them grow in confidence and ability. I always enjoy when my students come back to visit after they finish rotations.” Finally, one participant also mentioned the rewarding feeling when students build professional relationships with the team. He remarked that one of the good things about being a preceptor was “seeing the [students] be adopted by the team and trust them enough to go to them with their injuries. Also, seeing the light ‘turn on' in the [students] and they finally understand the big picture. The relationships I build with the students are priceless.”

The importance for preceptors of developing professional relationships is similar to what students have stated they like best about being in an ATP. Previous work has found that students persisted in ATPs because of the strong relationships they developed during clinical education.²¹ Based on our results, it appears personal relationships are also important for an athletic trainer persisting in the role of a preceptor. Similarly, students noted positive interactions with preceptors as a major reason for wanting to complete a degree in athletic training.²² We agree with previous research²² that suggests positive relationships between students and preceptors may aid in socializing students into the professional roles and responsibilities of an athletic trainer especially because students identify preceptors as mentors.¹³ The effects of positive preceptor mentoring have also been found in the nursing literature and illustrate that serving as a preceptor can be rewarding.^23,24 Rewarding experiences, such as serving as a preceptor, are an important facilitator for an athletic trainer's continued professional commitment²⁵; therefore, these personal relationships can serve as a means to increase professional commitment and enthusiasm.

Challenging Atmosphere

The preceptors who participated in our study enjoyed the fact that supervising students made for a dynamic and stimulating environment. Supervising the student afforded the preceptors with the chance to engage in learning,²⁶ which was often viewed as reciprocal learning because of the communication and discourse fostered during the clinical-education experience. One participant commented that being a preceptor is enjoyable because

I think it keeps you learning new things by having to explain things and the rationale for what you're doing. Having students can help you become a better athletic trainer and communicator because if you really care about the student's future you will take your time and explain things in depth.

Similarly, a participant highlighted the importance of reciprocal learning, which has been noted in previous literature regarding the role of the preceptor.²⁶ The preceptor stated that mentoring students “keeps me on my toes, I read ten times more often now looking for new topics to talk about [with students]. The students also tell me what they are learning that has changed since I was in school.” Another preceptor stated that her skills improved when she started supervising students in the clinical setting. She stated, “I get daily opportunities to have my brain picked as to why I made a certain clinical decision. My own clinical skills are reinforced daily.” Finally, a parallel feeling was held by a preceptor who also mentioned learning from the students. He stated that serving as a preceptor

keeps me on my toes. I enjoy the challenge they bring when they ask why I do something and the new knowledge they sometimes bring to the table. [I'll give you an] example. I was unfamiliar with a setting on my e-stim machine, and one of my students was learning about it in her modalities class so she walked me through how and why to use it. Now I use it all the time.

The preceptors in our study enjoyed the positive enthusiasm students brought with them to the clinical site. Our participants enjoyed the fact that students challenged them and inspired their professional commitment through reciprocal learning and a sense of responsibility to the students. The finding that serving as a preceptor encouraged our participants to read literature relevant to athletic training has the potential to greatly affect the practitioner's standing as an evidence-based provider of healthcare. Our participants believed it was important to be current with professional literature to help them teach students new information and explain their actions. We also believe students facilitated the further development of critical thinking skills in our participants because they used clinical questioning as a means to stimulate their own learning by engaging in discourse with the preceptors. Student inquisitiveness required the preceptors to be able to provide rationale behind their patient care and implementation of specific methods and treatments. We believe this is similar to the development of a network to facilitate learning, which has been found to be a socializing factor for athletic trainers at the secondary school setting.²⁷ This was especially evident in the example above in which an athletic training student helped a preceptor understand a specific function on a modality unit.

Teaching and Mentoring

The final theme reported by the participants had to do with the satisfaction of teaching and mentoring the future of the profession. This finding supports previous work showing that interest in and love of teaching are major attractors to the role of the program director in an ATP.²⁸ Serving as a role model and mentor to future athletic training professionals was also an important factor in deciding to become an athletic training educator, similar to our participants' decision to become a preceptor. For example, one participant took particular interest in mentoring prospective athletic trainers. She stated that the best part of serving as a preceptor is “knowing I am contributing to a student becoming an outstanding athletic trainer one day. I know they will take at least one thing they learn from me with them into their career.” Two additional preceptors stated that they enjoyed when students, because of their guidance, started to make connections between areas of knowledge and synthesize those connections to solve problems. In the first example, one preceptor said, “I love having the teaching moments with the [students]. When I am able to really teach them something and see it ‘click' with them and then see them put it into practice is great.” Likewise, another participant stated that the thing she likes the best about serving as a preceptor is “mentoring the student. I have been blessed with having such great [students]. Seeing a student light up with the ‘ah ha!' moments in a procedure is very satisfying.”

The final theme—the enjoyment preceptors took in teaching and mentoring future athletic trainers—is a noteworthy finding for athletic training program directors and clinical-education coordinators. Role strain has been identified as a barrier to implementation of the clinical-education qualities necessary to serve as a preceptor.⁴ It is possible that for our participants the benefits of interacting with students has outweighed the potential role strain that might occur as they have continued serving as preceptors. During clinical education, preceptors may not have sufficient time to teach athletic training students because of their own responsibilities with patient care.⁷ However, it is important to keep athletic training students engaged during clinical education because positive interactions between students and preceptors facilitate the students' professional socialization and their persistence to graduation.²² Also, if students enjoy their clinical-education experiences, they may be more likely to stay in the program, as they see their time as being well spent.²⁹ We believe the finding that preceptors enjoy teaching and mentoring students is particularly significant, because early integration into the clinical-education site can help give students a sense of belonging and positively influence student retention in an ATP.^21,22

Recommendations

Based on the findings of our study, we recommend that program directors and clinical-education coordinators promote the benefits of supervising students to prospective preceptors as a means to recruit and retain appropriate professional role models for athletic training students. It is also important to provide preceptors with information regarding best practices in regards to clinical instruction. Specifically, preceptors need to be trained in ways to effectively communicate, engage the student in the clinical setting, and provide feedback, as these factors can improve the overall experience for both the student and preceptor. We also urge athletic training educational administrators to find unique and attractive benefits for those serving as preceptors to aid in keeping morale high and providing a positive clinical-education environment, which fosters student learning. Such things as providing free Continuing Education Units may provide preceptors with a sense of gratitude and motivate them to continue mentoring students in a positive way.

Limitations

It is important to note several limitations to our study. As is common with qualitative research, generalizing our results to other populations is a challenge. Although we secured responses from individuals serving as preceptors from several different ATPs, we used a convenience sample to recruit our participants. Researchers using different sample groups may find results that are contradictory to the ones we report. Also, using online journaling as a data-collection strategy does not allow for participant-researcher interaction to the extent that face-to-face or telephone interviewing permits. Using other data collection methods could also produce different results.