Perceptions of Leadership Opportunities and Effectiveness Among Athletic Trainers: A Comparison Across Racial and Ethnic Groups

Key Points

• Regardless of race and ethnicity, most athletic trainers desire and actively pursue leadership positions.

• Most athletic trainers in this study held leadership positions within their departments or institutions, while significantly fewer attained leadership roles with state, district, or national-level professional organizations.

• African American athletic trainers see race and ethnicity as a leadership barrier, while White athletic trainers do not.

• Racial and ethnic minority athletic trainers, especially African Americans, find current athletic training leadership less effective than White athletic trainers.

• Efforts to diversify leadership should focus on equity through diverse selection and appointment processes and fostering allyship.

Leadership plays an integral role in the advancement of the athletic training profession. According to Carr et al, leadership within athletic training can be viewed from 2 distinct perspectives: leadership roles tied to an individual’s employer or volunteer leadership roles pursued independently of employment, such as professional service on a committee.¹ Many athletic trainers (ATs) are appointed leadership roles within their organizations as an extension of their immediate roles and responsibilities. However, professional leadership roles such as those at the state, district, or national level are voluntary, requiring ATs to pursue nomination, election, or participation in a specific committee.

The National Athletic Trainers’ Association (NATA) is a professional membership association founded in 1950 with the mission of representing, engaging, and fostering the continued growth and development of the athletic training profession and advocating for ATs as unique health care providers.² At the end of 2024, the NATA represented over 35 477 ATs.³ Membership of the NATA is composed of 11 geographic districts, each with a director elected by the district’s members. The 11 district directors comprise the NATA’s Board of Directors (BOD) along with the NATA’s President, Vice President, and Secretary/Treasurer.⁴ In addition to the BOD, the NATA retains 28 committees, councils, or commissions in which members may volunteer and be appointed to serve relative to their professional interests.⁵ The NATA works in collaboration with other nonmember organizations including the Board of Certification, which focuses on AT certification and consumer protection; the Commission on Accreditation of Athletic Training Education, which focuses on accreditation and the provision of quality education; and the NATA Research & Education Foundation, which focuses on research and scholarship for those in the profession to form the Athletic Training Strategic Alliance.⁶ As an organization, the NATA plays an important role in guiding the profession; thus, its leadership is important, as it provides strategic vision and direction for the athletic training profession.

Leadership within athletic training is not only about guiding the profession but also about fostering innovation and responding to the needs of its diverse membership. Effective leadership is essential for ensuring that the profession remains adaptive, forward-thinking, and aligned with the evolving needs of both clinicians and the communities they serve. Previous researchers have associated organizational leadership diverse in race and ethnicity with positive outcomes such as improved decision-making quality, enhanced creativity, and greater overall performance.⁷ The cognitive diversity hypothesis is a management theory that posits that the variety of perspectives arising from cultural differences among team or organizational members fosters creative problem-solving and drives innovation.⁸ People with diverse backgrounds and experiences often see the same problems from different perspectives and thus propose novel and effective solutions.⁹ Proposing a range of solutions for a single problem can increase the chance that one of the proposed solutions or a combination of them will adequately solve the problem. Robust problem-solving processes are valuable to organizations because they can better equip them to adapt to changing conditions. For example, authors of 1 study indicated that nearly half of the revenue of companies with more diverse leadership comes from products and services launched in the past 3 years.⁹ In an increasingly challenging and multigenerational business environment, this type of magnified innovation means that organizations are better able to quickly adapt to changes in member demand.⁹

Recent efforts to increase racial and ethnic diversity in athletic training leadership are beginning to take shape slowly. In 2017, 7.5% of BOD members and committee leaders for the NATA self-identified as racially and ethnically diverse.¹⁰ Likewise, 11.4% of NATA committee members identified themselves as either Black, Asian or Pacific Islander, American Indian or Alaskan Native, Hispanic, multiethnic, or other.¹⁰ After the implementation of numerous initiatives related to diversity, equity, inclusion, and access (DEIA), in 2023, the proportion of racially and ethnically diverse individuals serving on the BOD or as committee leaders has increased to 10.5%.¹⁰ Similarly, the proportion of racially and ethnically diverse NATA committee members has risen to 14.9%.¹⁰ However, it should be noted that, when members of the NATA Ethnic Diversity Advisory Committee are excluded, the percentage of racially and ethnically diverse committee members drops to 13.6%.¹⁰

To further advance DEIA initiatives in athletic training, it is crucial to determine whether desire, pursuit, and attainment of leadership differs among ATs of different ethnic groups. Additionally, it is important to explore how ATs perceive their race and ethnicity as a barrier to obtaining a leadership position. Lastly, assessing how well current leadership is perceived to meet the needs of ATs across racial and ethnic demographics is key. Therefore, the purpose of this study is threefold: (1) to examine racial and ethnic differences in ATs’ desire, pursuit, and attainment of leadership positions in the athletic training profession; (2) to determine racial and ethnic differences in ATs’ perceptions of race and ethnicity as a barrier to obtaining leadership positions; and (3) to investigate racial and ethnic differences in perceptions of the effectiveness of current athletic training leaders in meeting their needs. Understanding these dynamics can give important insights into members’ perceptions of leadership which can guide the NATA as well as other members of the Athletic Training Strategic Alliance in the development of programs and services that better service members and address their specific needs, ultimately enhancing engagement and satisfaction. Furthermore, data obtained can promote diversity in leadership that not only aligns with broader professional values of equity and inclusion but also enhances the effectiveness and innovation of the NATA by leveraging a wider range of perspectives and experiences. Thus, the findings in this study could be vital for driving meaningful change and ensuring the long-term success and relevance of the NATA.

METHODS

RESULTS

A total of 488 participants completed the survey for a 14.7% response rate. A summary of participant demographics can be found in Table 1. Participants were approximately 41 years of age, on average (SD = 11.68), and most identified as woman (n = 270) and White (n = 288). Participants were most frequently employed in secondary schools (n = 148), followed by colleges or universities (n = 123) and higher education institutions (n = 38). As for race and ethnicity, participants most frequently identified as White (n = 288), followed by African American (n = 114), and Hispanic (n = 28).

Table 1.Participant Demographics

View Fullscreen

Desire and Pursuit of Leadership Positions

Descriptive statistics for the desire for and pursuit of leadership outcomes by race and ethnicity can be found in Table 2. Overall, participants expressed a desire to obtain a leadership position in athletic training, with 34.9% (n = 168) indicating obtaining a leadership position as desirable and an additional 21.0% indicating it as very desirable. While 24.3% (n = 117) of participants were neutral in their desire to achieve a leadership position, 10.2% (n = 49) reported a leadership position as undesirable and 7.7% as very undesirable. Similar findings were indicated for the pursuit of a leadership position, as 7.5% rated the pursuit of a leadership position as essential in addition to 18.9% (n = 91) who ranked pursuit as a high priority and 32.8% (n = 158) who ranked pursuit as a medium priority. About a quarter (25.4%) of participants rated the pursuit of a leadership position as low priority, and merely 13.5% (n = 65) rated it as not a priority at all.

Table 2.Descriptives for Desire and Pursuit of Leadership Outcomes by Race^a

View Fullscreen

Independent samples Kruskal-Wallis tests revealed significant differences in the desire to obtain a leadership position among racial and ethnic minority groups (P = .011), with African American participants reporting stronger desires than racial and ethnic minority individuals in the other category (P = .010). For the pursuit of leadership, no significant differences were observed between racial and ethnic minority and White groups (P > .054). Pairwise comparisons further detailed these findings, highlighting that the observed differences in desire were primarily between African American participants and those racial and ethnicity minority individuals classified as other.

Attainment of Leadership Position

More than half (56.5%) of participants overall indicated they had held a leadership role at some point throughout their athletic training careers; 36.8% (n = 177) held departmental positions and 27.2% (n = 131) held institutional positions. As for positions within athletic training professional organizations, 20.2% (n = 97) held leadership positions at the state level, 16.4% (n = 79) held leadership positions at the district level, and 13.1% (n = 63) held leadership positions at the national level. Descriptive statistics for leadership roles (at each level) by race and ethnicity can be found in Table 3. While the χ² analysis for departmental leadership roles by race and ethnicity revealed a significant χ² statistic (χ² [3] = 8.79, P = .032), cell comparisons revealed no significant pairwise comparisons (all P values >.05). For the institutional level outcome, the χ² test was statistically significant (χ² [3] = 10.59, P = .014), and pairwise comparisons showed that Hispanic individuals had more institutional leadership roles than African American individuals (P < .05). The χ² statistic was also significant for state-level leadership (χ² [3] = 9.04, P = .029), with pairwise comparisons showing that White individuals held state leadership roles more often than African American individuals (P < .05). The effects for district and national leadership roles were not statistically significant (all χ²’s < 4.02, all P values >.260).

Table 3.Descriptives for Leadership Roles (at Each Level) by Race^a

View Fullscreen

DISCUSSION

Although leadership has been extensively studied across various professions, research on leadership within athletic training remains limited. Even less explored is the intersection of leadership with race and ethnicity, underscoring the distinct contribution of this study to the field. It is important to note that race and ethnicity are social constructs, shaped by historical, cultural, and societal contexts, rather than biological determinants. Previous researchers have argued that physical diversity, reflected in characteristics such as race and ethnicity, enhances performance by enabling team members to contribute diverse cognitive attributes shaped by their experiences and demographic backgrounds.¹² This cognitive diversity, encompassing differences in unobservable traits such as attitudes, values, and beliefs, can help to cultivate a culture in which every voice is appreciated.¹³ The cognitive diversity that may be fostered by increasing racial and ethnic in athletic training leadership teams can encourage diverse thinking approaches, leading to well-rounded solutions that are crucial for both individual and organizational success.¹³ Recognizing this, in this study, we first sought to investigate ATs’ desire for, pursuit of, and attainment of leadership roles across racial and ethnic groups. Most ATs across racial and ethnic groups expressed a desire to obtain a leadership position, whether within their organization or through service at the state, district, or national level. Similarly, most ATs, regardless of race and ethnicity, prioritized the pursuit of a leadership position, at least to some degree. As a natural condition of the job, ATs have an effect on the people they work with. Their role in building relationships, along with navigating the challenges and rewards of collaboration, may naturally foster leadership ability and, thus, we suspect a desire for and pursuit of leadership opportunities.¹⁴ We believe this supports our finding that ATs appear to want and be equally committed to seeking out leadership roles, regardless of their racial or ethnic background.

Most ATs in this study reported having held a leadership position at some point in their athletic training careers; however, these roles were predominantly within their department or institution. In contrast, a significantly smaller percentage of ATs indicated attaining leadership roles within their state, district, or national professional organizations. Regarding roles within professional athletic training organizations, disparities were observed primarily between White and African American participants, with White ATs more frequently holding state-level leadership positions than their African American counterparts. Although, in this study, we did not explicitly assess aspirations for service roles with state, district, and national athletic training organizations, the strong overall desire for leadership suggests ATs from racial and ethnic minority groups likely aspire to district and national leadership opportunities. Encouragingly, the persistent racial and ethnic disparities in the leadership of athletic training professional organizations may be showing signs of improvement, underscoring the need for continued efforts to promote equity and inclusion at all levels of leadership.

Efforts to enhance diversity within athletic training leadership have led to small but measurable improvements, including increased representation in state, district, and national leadership roles and the establishment of initiatives focused on DEIA. However, disparities persist, as racial and ethnic minority ATs remain underrepresented in key decision-making positions such as President, Vice President, Secretary/Treasurer, and BOD roles within AT professional organizations. These disparities highlight systemic barriers that continue to shape leadership pathways. A critical factor influencing leadership representation is the perception of race as a barrier. Findings from this study revealed an overwhelming percentage of African American participants viewed race and ethnicity as obstacles to leadership, whereas most White participants did not share this perspective. These differing views may help keep leadership disparities in place, as built-in systemic biases such as informal hiring and selection processes, along with unconscious stereotypes, can affect who gets chosen for leadership roles and who has opportunities to advance.

Researchers have suggested organizations that explicitly communicate openness to diversity can help mitigate these barriers by fostering respect, psychological safety, and trust, which are essential for supporting minority professionals in their leadership aspirations.¹⁵ Leadership self-perceptions and ambitions are crucial precursors to leadership emergence, making it essential that diversity initiatives not only address structural barriers but also support leadership-relevant intrapersonal processes among racial and ethnic minority individuals.¹⁵ Authors of studies have shown that, when minority professionals envision working in organizations that support diversity, promote positive relationships between differing groups, and ensure fair and equitable treatment, they feel more confident in their ability to take on leadership roles. They may also be more likely to aspire to leadership positions and hold more positive expectations regarding leadership success.¹⁵ To make lasting change, leadership development in athletic training should go beyond simply increasing diversity and focus on removing systemic obstacles and psychological barriers that make it harder for minority professionals to step into leadership roles. By fostering inclusive organizational climates that actively acknowledge and support diverse ATs, our professional organizations can create pathways for equitable leadership opportunities and cultivate a profession in which all ATs, regardless of race or ethnicity, can aspire to, achieve, and thrive in leadership roles.

Addressing racial and ethnic disparities in leadership requires intentional strategies that target the roots of bias and exclusion. In the context of leadership, one of the most pervasive stereotypes about African Americans is the assumption they lack competence to be effective leaders.¹⁶ This stereotype is often reinforced in situations in which the requirements for leadership roles are unclear, the evaluation of necessary skills relies on subjective judgment, or the responsibilities of the role are not standardized.¹⁷ Such contexts can amplify racial stereotypes, as discretionary decision-making in appointments to leadership or promotions tends to increase the likelihood of stereotyping, biased evaluations, and attribution errors.¹⁷ To prevent this and improve the pathways to leadership for ATs from racial and ethnic minority groups, organizations at all levels of athletic training should strive to develop clear, objective, and transparent criteria for leadership roles that outline specific qualifications, skills, and deliverables required for appointment and promotion. By setting clear criteria, organizations can limit ambiguity and reduce the influence of biases and stereotypes.

Implicit biases also shape personal representations of what constitutes effective leadership, often excluding racially and ethnically diverse individuals from being viewed as prototypical leaders.¹⁸ These personal representations determine the extent to which an individual accepts and responds to the ideas of others as leaders.¹⁹ The similarity-attraction theory suggests that the more similar 2 people are, the more prone they are to prefer, trust, and accommodate one another.^20,21 Current leaders may hold implicit biases that lead them to favor colleagues who share similar racial or ethnic backgrounds. These dynamics collectively reinforce the perception and often the reality that race or ethnicity alone can impede one’s advancement to leadership roles, creating significant barriers for ATs from racial and ethnic minority groups. To address these biases, organizations should implement diverse interview and selection committees for leadership appointments. Members from varied backgrounds bring different perspectives, which may counteract tendencies like homologous reproduction. Individuals from diverse backgrounds may challenge traditional, often narrow definitions of leadership that disproportionately favor the majority group. This allows for a broader appreciation of leadership styles and qualifications, making the process more inclusive. Having a diverse panel could also signal the organization’s commitment to equity and inclusivity, fostering trust among racially and ethnically underrepresented candidates. This can encourage ATs from racial and ethnic minority groups to apply for leadership roles within their organization as well as at state, district, and national levels with confidence in knowing they are less likely to face barriers related to unfair biases during the selection process.

Racial and ethnic minority ATs in this study, particularly African Americans, also reported feeling that their needs were less often met by current athletic training leadership. Previous researchers have found that individuals are more likely to trust and support leaders who share their race, ethnicity, or cultural background.²⁰ This dynamic may explain why White participants in this study felt more understood by predominantly White leadership, while participants from African American, Hispanic, and other racial and ethnic groups felt less supported. Leadership evaluations are often shaped by in-group prototypicality, in which individuals view leaders from their own group as more effective and aligned with their needs.²² This bias is reinforced by historical contexts in which leadership roles have predominantly been held by White individuals, normalizing White leaders as the standard for effective leadership. Consequently, White leaders are more likely to be perceived positively by other White individuals, while racial and ethnic minority individuals may not associate White leaders with universal leadership traits and feel their unique needs are less understood and addressed.¹⁸ Addressing these divergent perceptions is essential for fostering equity, improving representation, and ensuring leadership pathways are accessible and inclusive for all individuals, regardless of race or ethnicity.

Lastly, it should be acknowledged that racial and ethnic minority individuals often find themselves concentrated in leadership positions with limited opportunities for advancement or that do not fully leverage their skills and potential.¹⁷ In the case of athletic training leadership, this may present as racial and ethnic minority ATs being limited to or concentrated on committees dedicated to DEIA. This systemic steering highlights the urgent need for allyship from White individuals in leadership or other positions of power.²³

Allyship can be broadly defined as the active and consistent practice of leveraging one’s privilege to advocate for and support marginalized groups, particularly those historically excluded from positions of power.^24,25 Within athletic training leadership, allyship requires intentional efforts by advantaged individuals to challenge systemic barriers, confront bias, and create pathways for racial and ethnic minority ATs to access leadership opportunities. Effective allyship demands more than passive support, as it requires accountability, action, and measurable efforts to ensure equity within leadership pipelines.²⁴ To foster equitable opportunities, allies should actively ensure racial and ethnic minority colleagues are considered for high-visibility and decision-making roles. This can help racial and ethnic minority ATs develop essential leadership skills, expand their professional networks, and demonstrate their potential for higher-level leadership roles. Assigning diverse colleagues to projects that challenge their abilities and align with their career goals, rather than limiting them to diversity-related initiatives, can further enhance their preparedness for leadership positions. Allies can also explicitly support and reinforce the contributions of their diverse colleagues, ensuring their ideas are recognized and valued in professional spaces. Beyond mentorship, allies should engage in sponsorship by actively recommending racial and ethnic minority ATs for promotions, high-profile projects, or leadership positions. An effective strategy used in academic medicine is for allies to condition their participation in high-impact committees or panels on the inclusion of diverse colleagues.²³ This approach can reshape leadership norms, making them more inclusive and representative.

Alternatively, racial and ethnic minority ATs may perceive an absence of allyship from their colleagues when they remain silent bystanders; this could contribute to the isolation and exclusion of racial and ethnic minority ATs in leadership and reinforce systemic inequities.²³ In contrast, upstanders committed to proactively engaging in socially mindful interactions create environments where racial and ethnic minority professionals feel supported and empowered.²³

By actively challenging inequities, White allies and other individuals in privileged positions can increase access to leadership roles while benefiting from the diverse perspectives their colleagues bring to the profession. True allyship in athletic training leadership is not just about opening doors and providing access but about ensuring all professionals, regardless of background, have a rightful seat at the table and the opportunity to effectively lead. Publicly advocating for initiatives that support physical and cognitive diversity fosters a culture of accountability and encourages other leaders to engage in similar allyship behaviors. By implementing these strategies, White allies can actively dismantle systemic barriers, create pathways to equitable opportunities, and contribute to the advancement of racial and ethnic minority ATs in organizational and professional leadership. Ensuring diverse leadership in athletic training is not only a matter of equity but also a strategy for fostering innovation, improving decision-making, and strengthening the profession’s adaptability. When leadership reflects the full diversity of its members, the profession benefits from a broader range of perspectives, leading to more effective solutions and responsiveness to evolving challenges. By committing to allyship and structural change, athletic training organizations can cultivate inclusive leadership that drives progress and ensures the profession remains forward-thinking, representative, and prepared to meet the needs of all its members.

CONCLUSIONS

Regardless of race and ethnicity, most ATs aspire to leadership positions and many achieve these roles. However, ATs predominantly serve at departmental or institutional levels rather than higher ranks within professional organizations. This may highlight the need for more accessible leadership opportunities within the NATA and the greater Athletic Training Strategic Alliance. African American participants overwhelmingly perceived race and ethnicity as an obstacle to attaining leadership positions in athletic training, a sentiment that was not shared by their White counterparts. Likewise, racial and ethnic minority ATs, particularly African Americans, perceived current athletic training leadership as less effective at addressing their needs as ATs. Addressing systemic biases and in-group favoritism is crucial for rectifying perceptions held by racially and ethnically diverse ATs and for improving diverse representation in athletic training leadership, and fostering a more equitable and inclusive professional environment. Intentional strategies, such as diversifying leadership selection processes and fostering allyship from those in positions of power, are critical to continuing to improve pathways to professional leadership for racial and ethnic minority individuals. By ensuring leadership reflects the diversity of the profession, athletic training can better meet the needs of all its members and foster more inclusive and effective leadership.