Salary Negotiation Dynamics for Athletic Trainers: Insights From Employers on Expectations and Organizational Influences

Instrumentation

Due to the lack of an applicable existing survey in athletic training, 2 researchers proficient in survey research methodologies and experience in researching the content area developed an original survey to achieve the aim of the study. After initial development, the survey was reviewed for content validity, using a content validity index (CVI), by 3 ATs who serve in positions of hiring other ATs within their employment roles.⁶ Reviewers were asked to assess validity relative to question clarity, relevance to the research aim, and importance to the research aim. Revisions were made based on reviewer feedback, with the final instrument having a Scale-CVI score of 0.98 for clarity, 0.98 for relevance to the research aim, and 1.00 for importance to the research aim, indicating excellent content validity across the instrument.⁶ The instrument was then pilot tested among noneligible participants to determine time to completion and to test the survey question flow and logic. Pilot data were not included in the final analyses, and no further changes were made to the survey instrument.

The final survey instrument contained items relative to organizational factors including location (US state or territory), geographic setting (urban, suburban, or rural), setting and setting into which ATs are hired (provided settings list was identical to the National Athletic Trainers’ Association [NATA] salary survey), organization type (public, private, or unsure), number of ATs that work for the organization, and employment model (direct hire, outreach, or both).

Demographics of respondents were collected, including whether they were Board of Certification (BOC) credentialed, and if so, for how many years; if they were credentialed in another health care profession, and if so, which profession; how many years they have been in a role to hire ATs; and how many ATs they have been involved with hiring. We also collected race, gender, and age of the employer. We asked if they, in their current role, have input into the salary range when hiring an AT, and if so, what data points they use to determine the appropriate range, whether they expect a prospective employee to negotiate salary when they extend a job offer, and where within the salary range (bottom one-third, middle one-third, or upper one-third) they initially offer based on those negotiation expectations. We also inquired as to whether they have ever withdrawn a job offer based on the prospective employee’s attempt or lack of attempt at negotiation. Lastly, we provided a matrix question that asked employers to identify at which salary range they would likely hire an AT for with a range of degree qualifications (bachelor’s, master’s, residency/fellowship, clinical doctoral, or academic doctoral) and years of experience (0, 1–5, 6–10, or >10), given the following answer options for each combination of degree and experience: less than $40 000, $40 000–$49 999, $50 000–$59 000, $60 000–$69 999, $70 000–$79 999, $80 000–$89 999, $90 000–$99 999, more than $100 000, or “We would not be likely to hire a person with these qualifications.”

Procedures

The survey was hosted on the Qualtrics platform and was distributed using the NATA Survey Service in January 2024. We sent the survey to 7000 athletic training members and asked them to forward the survey to whomever within their employing organization was responsible for the hiring of ATs. Follow-up emails were sent weekly for 3 additional weeks for a total recruitment window of 4 weeks.

Participants

An a priori power analysis (G*Power) was conducted to determine the necessary sample size. To achieve a moderate effect size (f = 0.5) and an α of .05, a minimum sample of 85 respondents was necessary. Inclusion criteria to complete the survey required the participant to be in a position within their employing organization to hire ATs and to minimally have participated in 1 complete hiring process of an AT in that role. Of the 7000 emailed invitations, 413 participants accessed and started the survey (6% access rate), with 324 of those completing the survey (78% completion rate). Since we were unable to target employers of ATs specifically during recruitment, it is unclear how many of the 7000 randomly selected ATs that received the email invitation met the inclusion criteria and were eligible to participate. Therefore, while access rate was calculated based on the number of participants that accessed the survey by the total number emailed, it is possible that several individuals did not access the survey because they determined they were not eligible based on the email criteria alone. Regardless, the number of respondents that completed the survey in its entirety well exceeds the a priori sample size to detect meaningful differences.

Data Analysis

Using IBM SPSS version 29, we calculated descriptive statistics to characterize the participant sample, organizational influences, and employer expectations. Multiple χ² analyses with Bonferroni adjustments were used to determine the relationships between organizational factors or employer demographics on the negotiation expectations and behaviors of employers. Due to the nature of survey research and the presence of survey logic that only presented some questions to each participant based on answers given on previous questions, not all participants answered all questions. Chi-square analyses were only performed on categorical data points that exceeded expected frequency counts of 5, and significance was determined a priori to be P < .05.⁷ In some instances, when expected frequencies of categorical responses did not meet the threshold of 5, categories were collapsed or removed to allow for statistical analysis.⁷

To achieve expected categorical counts of 5 or higher to allow for χ² analyses, we collapsed employment settings into 5 categories: secondary school (outreach or direct hire); clinic (hospital, physician practice, or rehabilitation clinic); college or university—clinical (NCAA Division I, II, or III; split appointment; college recreation; or college performing arts); college, university faculty, academic, or research; and other (industrial, professional sports, military, or sports performance). Due to the small number of identified non-White race categories, race could not be analyzed. Due to the small number of employers indicating that they did not expect negotiations, we were not adequately powered to conduct analyses on this subgroup of respondents.

Employer Characteristic Descriptives

A total of 324 employers (86 men, 58 women, 180 prefer not to respond; age = 43.8 ± 10.6 years) submitted surveys. Our sample was overwhelmingly White (4 Asian, 8 Black, 5 two or more races, 123 White, and 184 prefer not to respond). Most respondents (n = 227, 70.0%) were BOC-credentialed ATs (years of experience = 16.8 ± 9.8), and 21 respondents (6.5%) were credentialed in another health care profession (years of experience = 21.3 ± 10.2), 19 of which were dual credentialed as BOC-credentialed ATs and another health care profession. Respondents had an average of 9.68 ± 8.8 years of being in a role to hire ATs at their organization and had hired an average of 10.3 ± 12.3 ATs for their organization at the time of survey completion.

Organization Factor Descriptives

The Table details the work settings into which the respondents hired ATs. Employment organizations were represented from all 11 NATA districts, including 43 different states and 1 international location. Specific to geographic setting, 33.5% of organizations were in urban settings, 44.6% in suburban settings, and 21.9% from rural settings. About half (49.4%) of employing organizations were private, not-for-profit, and 46.7% were public; 4% of respondents were not sure if their organization was public or private. About a quarter (25.9%) of employing organizations hired ATs into an outreach employment model, 62.0% directly hired ATs into their organization, and 12.2% of employing organizations used both employment models.

TableEmployment Settings Employers Hired Athletic Trainers Into

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Salary Range and Negotiation Expectations Descriptives

Two-thirds (66.3%) of those responsible for hiring ATs and negotiating salaries are provided the salary range by someone else from their organization and have no input into the available range; 22.7% indicated that they typically have input into the salary range for a position; and 11.0% selected other in response to this question. We asked those that indicated that they did have input into the salary range to indicate which data sources they use to inform that input (Figure 1). The 3 most used data sources were peer organization data, the salaries of existing AT employees within the organization, and the NATA Salary Survey.

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More than two-thirds (67.3%) of employers expect the prospective employee to negotiate their salary. Figures 2 and 3 display employers’ expectations for salary negotiation and the associated level within the available range that they offer salaries based on those expectations, respectively. Figure 4 displays the anticipated salary ranges an AT with varying education degrees and experience levels would be offered at the respondent’s organization.

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Lastly, we also asked respondents if they had ever withdrawn an offer due to a prospective employee attempting or not attempting to negotiate the initial salary offer. Six point two percent of employers have withdrawn a job offer due to the employee attempting to negotiate, and 2.1% of employers have withdrawn a job offer due to the employee not attempting to negotiate.

Employer Expectations for Negotiation

No significant influences of organization factors (geographic setting [P = .338], employment setting [P = .481], organization type [P = .171], or employment model [P = .123]) or employer characteristics (BOC credentialed [P = .564] or other credential [P = .572], gender [P = .589], or input into the salary range [P = .688]) on the employer’s expectations for salary negotiation were found.

Offered Range

Of the 72% of employers who did expect an employee to negotiate their salary, 21.5% place their initial offer in the lower one-third of the available range, 57% initially offer in the middle one-third of the available range, and 21.5% offer in the upper one-third of the available range. No significant differences were found for employment setting (P = .271) or if the employer was BOC credentialed (P = .147) on the initial offer range. A greater percentage of rurally located organizations offer in the upper one-third of the available salary range when compared with suburban or urban geographic settings (P = .014). A greater percentage of public organizations also offer in the upper one-third of the available salary range compared with private organizations (P = .025). A greater proportion of employers who were not credentialed health care providers offered in the middle and lower thirds of the available range (P = .040). A greater percentage of employers who had input into the available range offered in the lower one-third of the available range, while a greater percentage of those who did not have input into the salary range offered in the middle one-third of the available range (P = .002).

Offer Withdrawal

No significant findings for organization factors (geographic setting [P = .481], employment setting [P = .561], organization type [P = .863], or employment model [P = .988]) or most of the employer characteristics (BOC credentialed [P = .726], had input into salary range [P = .714], or gender [P = .072]) were observed. One significant employer characteristic influence was found, with a greater percentage of employers who were not health care providers having withdrawn an employment offer due to negotiation attempts (P = .005).

Determination of Salary Range

Respondents to our survey who had input into the available salary ranges of a position relied on specific data sources to support those range proposals. Interestingly, the most commonly used sources of data (ie, NATA Salary Survey, salaries of existing employees, and peer organization employee data) to support salary ranges are all data that have aged by the time they are used. For example, the use of existing employee or peer organization data results in data points that represent a salary of someone who was hired in the past and may not reflect current market salary rates if pay raises have not kept pace with inflation or market value. This is especially true in years where inflation rates exceed average pacing, such as in the years following the COVID-19 pandemic shutdowns. Authors of 1 report from a colleges and universities human resources research center determined that, in the 2021–2022 academic year, while inflation reached 6.8%, the associated professional staff salaries increased only 2.9%, and tenure-track faculty salaries increased a mere 1.6%.⁸ Specific to market value, in an athletic training job advertisement posted on the NATA career center, the average salary of prospective positions increased by 15.3% from January to September 2024.⁹ Employers using data from 1 to 2 years ago to establish salary ranges may report a shortage of applicants or have difficulty filling vacancies if the offered salary is not representative of other available salaries on the market at the time.

The issues associated with relying on past or existing employee wage data extend beyond the challenges of identifying the appropriate market rate for new hires; this practice also perpetuates existing pay discrepancies. While wage gaps vary state to state, specific, pervasive pay gaps exist for all women in the workforce, especially for women of color.¹⁰ This perpetuation of discrepancies is the same reason that legislation containing salary history bans in hiring practices exists in 16 US states and Puerto Rico. Salary history ban legislation prohibits the employer from relying on an individual’s current or past salary when making hiring or salary decisions.¹¹ However, such legislation is not universal, nor does it prohibit the employer from using other peoples’ salaries in the hiring and compensation decisions. Employers and prospective employees using existing salary data points to determine appropriate salaries for a position should make a point to avoid the use of gender, race, or ethnicity as filters for data on current salary rates to avoid perpetuating pay discrepancies in the workforce. Organizations, including the NATA, that publish salary data that includes gender, race, and ethnicity should clarify that these data points should be used to identify and advocate for the elimination of salary discrepancies and should not be used to perpetuate such discrepancies.

When using existing data, employers are encouraged to use a combination of existing salary data points and current market analysis of available positions. Existing salaries that are not more than 24 months old can be mathematically manipulated to reflect current rates, although this is not recommended for data that are more than 2 years old.¹² This same recommendation can apply to ATs who are gathering data for positions they plan to apply to.

Lastly, it may be helpful for prospective employees to request an employee value proposition (EVP) from a prospective employer to fully evaluate the total value of the offered position beyond the initially offered salary. An EVP is a form of organizational quality improvement that relies on feedback from existing and exiting employees as well as recruitment and retention feedback to present a comprehensive overview of the value provided by the organization to the employee.^13,14 Employee value propositions typically include an overview of compensation that explains salary scales, timelines for promotions and raises, and how employees are evaluated in addition to descriptions of the workplace culture, the work environment, and how work-life balance is supported; the types of training and education provided to employees in support of career goals; and the totality of the benefits package offered by the employer.^13–15 While not currently widespread in athletic training employment settings, we believe the use of EVPs would benefit both the employer and employee in determining appropriate salary levels against the backdrop of the other components of an employment offer.

The Initial Offer

Most employers, regardless of whether they expected the prospective employee to negotiate salary, make their initial salary offers in the lower or middle one-third of the available range, indicating room for negotiations for most job offers in athletic training. The concept of anchoring effect is the likely explanation for the low-end offers made when hiring an employee.^16–18 An anchoring effect in salary negotiations is the psychological propensity to be overreliant on the initial salary offer (the anchor), which results in the subconscious adjustment in expectations and subsequent adaptation in a proposed counteroffer, even if the prospective employee recognizes that the initial offer was unreasonable, affecting the final salary agreement.^16–18 For example, if a prospective employee is hoping to be paid $55 000 and the employer initially offers $40 000, the prospective employee might be more likely to counter at $48 000 instead of their preferred salary because the initial offer has anchored the perception of a reasonable salary for the position. By strategically offering a low anchor (initial offer), employers can potentially sway the negotiation toward the lower range of the salary, thus achieving their objective of hiring the employee for a lower salary.^16–18

To mitigate the influence of the anchoring effect, prospective employees can implement several recommendations ahead of engaging in salary negotiations. First, the applicant should thoroughly research market rates for the geographic location, setting, and type of organization that they are applying to.¹⁸ Of note, when interpreting this research, please refer to the aforementioned recommendations regarding updating data based on its age. One mechanism to mitigate a low anchor effect is to address unreasonable anchors directly by stating that the offer the employer has proposed is not in line with market value or the area’s cost of living.¹⁹ This approach should be supported with data, as objective information is essentially the antidote to low anchors.²⁰ If the approach of calling out the anchor and providing data is implemented, prospective employees should complete this process by proposing an appropriate salary range, thereby establishing a new anchor for the position.

We did find some influences on the employing organization and employer that affected the initial salary offered. Rural and publicly funded employing organizations were more likely to make salary offers in the upper one-third of the available range. In the existing literature relative to salary ranges of rural employers, the focus is almost exclusively on the payment of migrant workers in agricultural positions, and therefore, the existing body of evidence does not provide much insight into this finding. However, 1 hypothesis is that rural employers understand that they may need to put forth greater effort to woo prospective employees to move to a rural location and therefore offer in the upper limit of the available range to entice a candidate to take the position. Alternatively, another hypothesis may explain both the rural and public organization findings. Public entities often pay less than private ones, specifically in the collegiate setting. Since public organizations are funded through state and federal government mechanisms, and tuition prices are lower, therefore capping the budget available of such groups, whereas private institutions can generate and address budget needs through increased tuition prices and fees.²¹ When we asked participants about where in the available salary range the initial offer was typically provided, we did not ask about what the available range was. Therefore, it is also possible that both rural and public organizations had lower available ranges and offered on the higher end of that available range to compensate for how low the lowest available part of the range was.

Employers who did have input into the salary range were more likely to offer in the lower end of the available range, while those who did not have input into the salary range were more likely to offer in the middle of the available range. Again, a dearth of literature exists regarding how initial salary offers are determined in health care professions. One theory would be that those who had input into the range were successful at increasing the available range before making an offer and offered at the lower end of the elevated range, and those that did not have input may have offered in the middle of the range to compensate for a perceived low available range. If this is the case, employing organizations should be encouraged to include the input of the individual who will be making the initial offer when establishing the available salary range, as the resulting level at which they make the offer might offset perceived cost savings of keeping salary ranges lower. It is important to note that the lack of literature in some of the areas discussed in this section has resulted in relying on conjecture to interpret some of the findings and that more research is needed to definitively understand these results.

Expectations for Negotiation and Offer Withdrawal

Most of our participants indicated that they expect prospective employees to negotiate their salaries during the hiring process. Unfortunately, most ATs do not negotiate when receiving an offer of employment.³ Researchers have determined that, when ATs do not negotiate, they are often driven by fear of the employer withdrawing the job offer, of offending a future colleague or supervisor by negotiating, or of not negotiating correctly because they did not know how to negotiate.² This is consistent with findings outside the field of athletic training, with job applicants identifying their most common fears about negotiation: (1) fear of the employer’s perception of them, (2) fear of the offer being withdrawn, (3) fear of conflict, (4) fear of the employer’s superior power, (5) fear of the negotiations becoming emotional, and (6) fear of negotiating poorly.²²

As our findings indicate that employers expect prospective employees to negotiate, fears of offending an employer should be assuaged. If an offer is not negotiable, the employer should indicate so when providing the offer, and if that is not established, the employee should proceed with negotiating. Notably, as fear of offer withdrawal is one of the reasons ATs choose not to negotiate, our participants overwhelmingly indicated that they do not withdraw offers due to the prospective employee attempting to negotiate.² However, we did find that, when the employer was not an AT, they were more likely to offer in the lower one-third of the available salary range and more likely to withdraw the offer due to attempted negotiations. It is likely that, when the employer is not an AT, they may not fully understand the role of the AT or the scope of their skillset. When ATs find themselves negotiating with someone outside of the profession, they should spend time discussing the role and ensuring the person they are negotiating with understands what ATs are and do before discussing comparative data points.²³ After providing this information, then the prospective employee should proceed with data-driven requests that provide justification for salary targets.^23,24

Limitations and Suggestions for Future Research

As with all research, ours is not without limitations. The nature of survey research relies on honest responses from participants, and it is possible that acquiescence and response biases could have influenced the respondents’ answers. We do not know the percentages of employers that are not ATs across the profession and as such cannot describe the representativeness of our sample to the total population, which could limit the applicability of our findings. It is also possible that provided answer options on the survey could be interpreted differently by employers, which might also limit the generalizability of our findings. Lastly, the closed-ended nature of our survey, while allowing for comparison across groups, does not present the totality of the employers’ expectations and experiences. Future researchers should aim at collecting qualitative data to characterize employers’ experiences and perspectives more completely. Ideally, researchers should study both employer and employee experiences after a negotiation to allow for triangulation and comparison of the interaction. Notably, future researchers should aim at studying employers of ATs who are not health care providers to better understand their perceptions of ATs and how to best approach salary negotiations with this population of employers.