Athletic Training Student Socialization Part II: Socializing the Professional Master's Athletic Training Student

Participants

A total of 8 PM program directors (PDs) volunteered for our study. The Table provides information on the institutions represented by the 8 PDs. The participants reported an average enrollment of 37 ± 28 athletic training students in their athletic training programs. Our PDs had 8 ± 6 years of experience in their current roles as PM PDs and were 41 ± 4 years old. We purposefully recruited PDs due to their understanding of programmatic guidelines and the needs of their athletic training students in gaining professional socialization.

Table. Institution Demographic Information

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Data Collection

First, we obtained Institutional Review Board approval prior to recruiting participants. Using the CAATE Website¹⁴ and e-mail, we recruited 8 participants from 10 random PM programs across the United States. The participants faxed a signed informed consent form to the secondary author and scheduled a tape-recorded, semistructured telephone interview. We thought that telephone interviews were the best option for 2 reasons. First, it allowed us to prompt the participants for additional information. Second, our participants came from across the United States, which made face-to-face interviews difficult. The interview followed a semistructured guide, which was developed by the secondary author and reviewed by the first author as a means for peer review, face validity, and content validity. The interview guide was also reviewed by athletic training educators on 3 separate occasions for content and clarity. We finalized the interview guide when we received no additional suggestions for improvement from our pilot groups. Questions reflected the purpose of the study and existing socialization data in the literature. Sample questions included, “Describe to me about how students are socialized into your program,” and, “How are the expectations your program has for students explained to them?” The interviews lasted approximately 30 minutes, and we allowed data saturation to drive recruitment. We settled on 8 participants as no new themes emerged from the interviews. We had the interviews transcribed verbatim using pseudonyms, and we removed any identifying information prior to data analysis to maintain participant confidentiality.

Data Analysis

We used an inductive coding procedure as described by Thomas¹⁵ to uncover the most common themes from the data. The analysis process was ongoing but sequenced. Initially, we conducted a preliminary read of the data to gain a holistic impression of the findings. During the second read, we completed “memoing” by crafting field notes in the margins of the transcripts. Memoing is a common method utilized in grounded theory studies,¹⁶ which can be very helpful with connecting raw data into conceptual models during inductive data analysis. Our third read involved labeling the textual data to represent its overall meaning. During our final read, we grouped the labels together and allocated a final category.

Credibility Strategies

As previously discussed, we conducted memoing during the analysis process. Beyond this process, we employed 3 credibility strategies to establish trustworthiness of the data. We completed member checks, multiple analyst triangulation, and a peer review. Two PDs reviewed their transcripts for accuracy prior to the data analysis process. They were randomly selected and were able to confirm the precision of the transcription process.

The first 2 authors discussed the steps for conducting the data analysis prior to completion. Once in agreement, these 2 authors completed the aforementioned steps simultaneously, but independently. When finished, the authors exchanged their findings including field notes, schematics, and coding sheets. The authors were in agreement upon the completion of the process, negating the need to negotiate the findings. The third author was provided with the transcripts, field notes, schematics, and coding sheets as well to help confirm the findings. This individual, who is an athletic training educator and qualitative researcher well versed in inductive analysis, also agreed with the findings.

Formal Processes

Planned activities intended to educate the ATS on the roles and responsibilities were included as formal socialization processes. The formal processes as mentioned by the PDs and used within their programs included orientation sessions and introductory courses (eg, an introduction to athletic training course or a prevention and care course). Both mediums allowed the PM programs the opportunity to engage with the athletic training students and educate them regarding program expectations, program policies, and their professional development as an athletic trainer. One PD shared the following:

The first day we start a 3-day orientation. I go over it all [expectations, program information, etc], in detail, and I understand that everything is new. They're away from home. It's all very overwhelming, and they're stressed to the max. So I know that a high percentage of it doesn't sink in. So we review those types of things every semester.

Another PD discussed the importance of both a campus and program orientation:

We [our institution] have a strong orientation program for all graduate students, and then also students just within the College of Health Sciences, where they can make connections with the campus, make connections with other students. Then with [our] orientation process, we review the student handbook and make sure that they understand what's expected from a classroom standpoint, also what's expected from a professional demeanor in their clinical and field experience assignments. So I think just going through the manual with them is probably our biggest method for letting them know what we expect.

In order to provide early but necessary socialization for the athletic training student, PM programs commonly utilized time prior to the start of the academic year. This plan was necessary due to the limited time available during the traditional semester to cover important elementary concepts of athletic training as well as more complex topics. Basic skills, background information, and program policies were foundational to the experience as highlighted by one PD:

We bring in the first-year students a month prior to fall camp or fall sports start. And we have a 1-credit class where we teach them all the basics that they need to know as far as entry-level students going into their first experience.

The use of an introduction to athletic training course was also described because it is often the first course required of the PM program, which is presented in another PD's comments:

Well, we do an introductory course their very first semester, and we introduce them to some basic content from all areas of the program so that when they start their clinical they have a basic knowledge of rehab, a basic knowledge of modalities …

Another PD discussed the use of multiple tactics to help facilitate early socialization with new athletic training students. The orientation session provided immediate, necessary socialization whereas the mentorship program provided on-going socialization:

Right before classes start, we have an orientation [session], where the upper-level students come and we have a little social mixer kind of thing [with our new students]. They meet their mentors [assigned] in person. We make those assignments ahead of time, and they are supposed to have e-mail contact with their mentors and mentees prior to that orientation. So all that kind of stuff before they even get on campus. Then, of course, the mentorship program carries forward when they're physically on campus and starting classes and so forth. So we do that orientation and the mentorship program.

Formal processes for socialization into the role of the athletic training student at the PM program level is included with orientation sessions and introductory courses. As highlighted by the previous quote, multiple processes may be utilized to encourage learning regarding the roles and responsibilities of the athletic training student. Mentoring was discussed as a formal means of socialization; however, it appeared that many PM programs allowed the mentoring to be more casual, informal, and facilitated by peers rather than delegated by program faculty.

Informal Processes

Less structured and planned activities were discussed by the PDs as a means to engage role induction for the PM student. Social gatherings/program outings along with peer mentoring were methods employed by PM programs to assist in socializing the athletic training student. The PDs encouraged the development of peer relationships through team-building or social activities as illustrated by this PD's discussion of socialization:

We do a lot of social activities in the first semester, during the summer, during [our program's] orientation. We go to the beach and we do cookouts. I really encourage the students to socialize with each other.

Another PD discussed the development of a team mindset and friendships through a planned activity. Training for a 5K race was one particular example provided by 1 PD:

I know this incoming group that is starting in July had decided that they're going to do a 5K run together during the first weekend of their classes here at [institution name]. So the socialization starts, really, before they've started school.

Socialization between cohorts was also important for the PDs, which was often facilitated by a social gathering organized by the upper-level students. For example, this PD shared, “[T]he second years try to do some barbeques and swim parties for them [first year ATSs] during the summer as well to sort of have interactions between the two classes.” Another PD discussed hosting a program-wide barbeque as a means to encourage engagement between the two classes:

But we have the students from the second year interacting with them [first-year ATSs] at that time as well. And so they have the opportunity to not only get to know their fellow cohort members but also students who are above them a year, so they have an opportunity to socialize.

Many of these social gatherings, although informal and rooted in developing peer and mentor relationships, also allowed for the learning of important, collegial, and team-like atmosphere skills essential to the foundational behaviors of the profession.

Other PDs extended the social activities to other members of the program, which included faculty and clinical preceptors. An example of this was described by one of our participants, who shared the following:

We also have a beginning-of-the-year picnic, just kind of a social event. We invite our on- and off-campus preceptors and of course faculty and students. Then we try to have a Christmas and an end-of-the-year event every year. There are some social things going on.

Social integration through informal gatherings emerged as a means to provide the athletic training student with an appreciation for the development of communication and interpersonal skills, which are fundamental professional behaviors for the athletic trainer. Moreover, the inclusion of clinical preceptors in social gatherings gave the social event a professional socialization undertone.

Peer mentoring was also discussed by our PDs as a way to help socialize the athletic training student. A mentoring program was presented earlier in the “Results” section as a socialization tactic; however, it was more formal in nature as it was regulated by the athletic training program faculty. The mentoring presented here was more informal, as it was often driven by the upper-level athletic training students and intended to help answer questions, role model expectations, and provide peer support. One PD described their informal mentoring as a “buddy system”:

We call [our program] a buddy system. Current students in the program [facilitate the program] … it is initiated and implemented by [our] students in the program—we [as faculty] just oversee what's going on. They assign current students to incoming students. As soon as [our students] get that information on the new students … then they start making [not] frequent contact, but more informal interactions, for example, “How are things going?” [and], “Do you have any questions?”

Student involvement and interest is also important in the peer mentorship model. One PM program planned to implement a mentorship program as another socializing agent for their new students, something that would be driven by students already in the program. This PD described the activity as follows:

So we want to use a big brother/big sister program or a peer program, as well [to help our students]. [Our current students] already have talked to us, as faculty, about making sure that they can mentor the new group and help them avoid any pitfalls that they may have had [during their first year].

Informal ways to socialize the athletic training student include social outings and activities and peer mentorship. Both processes were helpful in fostering development of collegial relationships and orientating the athletic training student to the PM program.

Formal Processes

The PM athletic training program, like the UND program, utilizes orientation sessions and introduction courses as a means to formally socialize the athletic training student into the role of the athletic trainer as well as communicate program expectations.¹⁷ The use of workshops or orientation sessions are popular methods to formally socialize an individual into their role mostly because they allow for effective communication regarding program goals and objectives as well as performance expectations.²⁰ The use of workshops or training sessions comparable to the ones discussed by the PM PDs have been effective in helping athletic training preceptors learn their roles¹⁸ and, as illustrated by our findings, continue to be viewed as effective socializing agents. Although the contextual notion of the orientation/workshop session may be different with varied concepts or materials, the fundamentals are transferable in that it allows direct communication of expectations, requirements, and responsibilities to the individual. As highlighted by the UND and PM PDs, introductory courses in athletic training are also important to educating and socializing the athletic training student.¹⁷ In fact, a majority of entry-level athletic training programs are likely to utilize an introductory course as a means to socialize athletic trainer recruits. Mensch and Mitchell⁵ in their investigation of attractors to the profession capitalized on an introductory course to gain access to their participants.

In contrast, PM PDs do not require formalized observation hours at the host institution as a means to socialize the student prior to admittance into the athletic training program as compared to UND programs. Although observation hours provide the chance for an authentic experience, which can help an athletic training student develop an appreciation for the role of the athletic trainer, the dynamics of the admission process for a PM program limits this formal practice as compared to the UND athletic training program. Previous literature indicates that an initial attractor to a career in athletic training is linked to anticipatory socialization often during a period of job shadowing or mentoring during high school.⁵ It is likely, therefore, that the PM program utilizes a period of observations to formally socialize their athletic training students, but it is done as an admission criteria rather than a program supervised experience, as it may be with UND programs, and possibly why our participants did not recognize it as a socialization agent. Moreover, because the PM student is integrated immediately into clinical education once academic coursework begins; they are afforded clinical integration early in their professional socialization.

Informal Processes

Informally, PM students gain an understanding of their roles as students as well as future professionals through peer mentoring, social gatherings, and program outings. This corroborates our findings from a separate study examining UND athletic training programs,¹⁷ which also utilizes social activities and mentoring programs to promote professional development. The chance to engage with program personnel such as faculty, peers, and preceptors allows the athletic training student to develop necessary communication skills in a less stressful environment. It also provides the opportunity to gain an understanding of acceptable behaviors and interpersonal relationships that exist in athletic training. Communication skills are a foundational behavior for the athletic training professional²¹ as it permeates all aspects of the profession, including rapport with athletes, relationships with coaches, parents, and other health care professionals. Due to its importance, it is imperative that athletic training programs provide opportunities for developing this skill set.

Mentorship has been discussed as a formal and informal means to orient athletic training students as well as athletic training professionals into their roles. Our results suggest that a majority of PM programs support a more informal peer mentoring program, where athletic training students are allowed to nurture their own growth and success. Mentorship is useful because it helps integrate the athletic training student into the athletic training program and allows him or her to gain a better understanding of expectations and future roles as a health care professional.²² It appears that, for PM athletic training programs, there is less emphasis on formalized mentorship programs, which is most likely due to the age of the student as well as the potential shorter length of the program curriculum and time spent on campus. The age of the student has been identified as a strong predictor of higher retention rates in nursing students because they often are more mature and better understand their roles and responsibilities,^23,24 which provides some support to our theory regarding age and informal mentorship. Moreover, it is likely that PM students naturally rely on mentorship as a means to gain role clarity and role inductance. In reference to the research findings of Pitney,⁷ informal learning networks can offer a degree of support, which can be helpful when navigating the nuances of a new role and gaining understanding of expectations. Mentoring programs comparable to the one described by our PM PDs are commonplace in nursing education programs because they stimulate learning and development of clinical competence and confidence for the nursing student while engaged in clinical training.^25–27

Support from peers through mentorship programs or social outings/activities were identified as a means to socially integrate the PM athletic training student. This is consistent with UND athletic training programs, which utilize a similar method to socialize students into the culture of athletic training and to communicate the expectations of education programs.¹⁷ Peer-assisted learning does occur in athletic training. In fact, athletic training students use their peers as resources, collaborators, and channels for implementing their clinical skills.¹⁸ Learning from peers for the athletic training student reduces the anxiety related to the development of fundamental skills, and generally, he or she feels more at ease and more confident while practicing his or her skills.¹⁸ The findings presented by Henning et al¹⁸ regarding peer-assisted learning and the revelations of our PDs help continue to support the use of peer mentorship in athletic training programs.

Peer socialization has been considered an important aspect of learning, as it is helpful in the development of an individual's perceptions and understandings of his or her role, beliefs, and skills necessary to succeed. In our study, peer socialization manifested itself as engagement in stress-reducing activities, icebreaker activities, as well as open access to program expectations and requirements. Peer support is also important in creating social integration, a component necessary for retention in athletic training programs. For example, Herzog²⁸ reported that freshman athletic training students are more likely to persist in their academic studies when they feel socially integrated. Furthermore, positive interactions and mentorship received from faculty, instructors, and preceptors are critical in retaining athletic training students in athletic training programs,¹¹ which coupled with our findings help illustrate the need for engagement in a social context.

Limitations and Future Direction

Our study is not without limitations. Most notably is that we examined only PDs to gain an understanding of the socialization processes for the athletic training student. Nonetheless, the purpose of our study was to gain an appreciation for strategies used at PM athletic training programs to induct athletic training students into their future athletic trainer role; therefore, the PDs insights were valuable because of their role as administrators. Future investigations should include the perceptions of athletic training students regarding their experiences during their educational preparation with special attention given to the socialization process. In addition, our sample size was small, and although data saturation guided recruitment, the socialization tactics used by the PDs we investigated may not completely address all possible attempts at socializing the athletic training student. It may be important to conduct a larger study that would include the athletic training program faculty, preceptors, and athletic training students to fully articulate the socialization process for them. However, we believe the data presented in the current study is an important first step in understanding the socialization process for athletic training students in PM programs.