Athletic Training Educators’ Experiences Teaching Concepts of Negotiation in Professional Programs
Athletic trainers are among the lowest-paid health care professionals, despite having comparable education and training to peer health care professionals. To improve working conditions and compensation for new professionals, athletic training programs (ATPs) may need to integrate salary negotiation strategies into the curriculum. However, evidence is limited regarding the extent to which ATPs currently address this topic. To explore the prevalence and type of negotiation strategy instruction in ATPs. Cross-sectional. Web-based survey with open-ended questions. A survey was sent to 218 directors of Commission on Accreditation of Athletic Training Education–accredited ATPs; 7 emails were undeliverable. Of the 211 remaining recipients, 51 accessed the survey (24.2% access rate), and 44 completed it (86.3% completion rate). An open-ended survey, validated for content, was developed and used to gather data. Textual responses were analyzed using consensual qualitative research, with a multianalyst team and auditor for verification. Of the programs surveyed, 11 did not teach negotiation strategies and 33 did. Three themes emerged across responses: (1) challenges to implementation, including time and space in the curriculum, the fact that this content was not required, lack of personal experience in negotiating, and lack of resources to aid in the content delivery; (2) the importance of negotiation instruction, which highlighted how this content could advance the profession, the need for students to be able to advocate for themselves, and how this content contributed to job satisfaction; and (3) specific content taught, including covered topics, how topics were delivered, timing of delivery, and resources used to deliver the content. Most ATPs who responded to our survey included negotiation strategies, focusing on when and how to negotiate during hiring and calculating appropriate salaries. Key barriers include limited curricular time and faculty’s lack of personal experience or knowledge of negotiation.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
KEY POINTS
Most of the programs who responded to our survey do teach concepts of negotiation formally within their respective curricula. The educators who responded to this survey felt that teaching negotiation strategies was an important topic to address and viewed it as their professional responsibility to educate students on this topic and to help provide professional preparation in this area.
Challenges and barriers to implementation were identified by participants who did and did not teach negotiation in their program. The barrier of time was identified as a challenge when finding curricular space and availability because the content of negotiation is not a component required by the Commission on Accreditation of Athletic Training Education. Participants also highlighted that their own lack of experience or knowledge with negotiation was a barrier to their teaching it effectively.
When asked about the specific content taught, the topics included term of employment or benefits that can be negotiated; how to break down salary relative to cost of living; the art of compromise, bargaining, and other interpersonal skills; language to use during negotiations; and the timing of when to broach negotiations during the hiring process.
INTRODUCTION
Despite recent changes to align educational and credentialing requirements, the athletic training profession continues to have lower median incomes compared with peer health care professions.1 Salary discrepancies, or inadequate salaries, can contribute to decreased job satisfaction and burnout, and ultimately the perpetually low salaries of athletic trainers (ATs) may result in decreased retainment of ATs in the profession.2 Burnout and retention of ATs have been recent concerns within the profession, particularly highlighted after the COVID-19 pandemic.3 A previous study by the Society for Human Resource Management found that across the nation, employees, regardless of age group, indicated that compensation accounts for 60% of their job satisfaction.4 Although some researchers in athletic training have shown that compensation is a contributing factor to job satisfaction, to date there is no evidence indicating to what extent those 2 constructs are linked.2 To help combat inadequate compensation, ATs should be properly prepared to negotiate salaries and other benefits included in a job offer or within their current role with their employer.
The accreditation standards for professional athletic training programs (ATPs), including requisite curricular content, are established by the Commission on Accreditation of Athletic Training Education (CAATE).5 Although there are requirements for ATPs to prepare graduates to be able to effectively advocate for themselves and the profession, negotiation strategies are not explicitly required.5 This leaves the decision to include such content at the discretion of the ATP faculty and administrators, and as such it is not currently known if ATs are equipped with appropriate negotiation skills as they enter the workforce.
A study by Cavallario et al surveyed ATs to examine their experiences with salary negotiation.6 The researchers revealed that more than half of surveyed ATs had not attempted to negotiate their salary during their most recent hiring process.6 Of note, the findings indicated that ATs with less employment experience were the least likely to have negotiated.6 This makes early-career professionals one of the groups most in need of guidance about the negotiation process and its impact on lifetime earnings potential. Unfortunately, this problem may disproportionately impact some demographics in the profession. Cavallario et al also relayed that although women were equally likely to negotiate, ATs who were women were less successful at negotiating than ATs who were men.6 Already there is an obvious decrease in the number of women in athletic training after age 28, and the increasing pressures of financial stability will only further contribute to the burnout and attrition seen across the profession.7 With the significant role salary may play in professional retention, it is important to ensure ATs are equipped with the proper tools to negotiate the salary they deserve as professionals.
There is a clear need to better prepare ATs for negotiation to partially address the problem that has plagued the athletic training profession for decades. Given existing data, it would be most beneficial, with the greatest long-term personal financial benefit, to prepare students to negotiate before their entry into the profession. It is currently unknown if and to what extent negotiation strategies are being taught in professional athletic training education programs. Therefore, we aimed to explore the prevalence and type of negotiation strategy instruction occurring in professional ATPs.
METHODS
We used a cross-sectional, web-based survey that included closed- and open-ended questions for this study. The sponsoring university’s institutional review committee determined this study to be exempt research.
Participants
We recruited educators from the CAATE-accredited professional graduate ATPs to participate in this study. The survey was designed to be completed only once per program, so we sent a single survey link to each program director. If another member of the program’s core faculty besides the program director was better able to complete the survey about the concepts of negotiation taught within the program, we requested that the program director forward the survey link to that individual. At the time of this study, 218 professional graduate ATPs met our inclusion criteria (ie, active and in good standing with the CAATE as a graduate-level professional program) and were sent the recruitment email.
Instrumentation
After an extensive literature search and the determination that a preexisting instrument to achieve the study purpose did not exist, we developed a survey, which was hosted in the Qualtrics platform (Qualtrics LLC). The survey included 10 demographic questions and 1 or 5 open-ended questions, depending on whether the program taught concepts related to negotiation in its professional program (Figure). Due to the use of the skip logic feature of Qualtrics, participants did not respond to every survey item, depending on how they responded to earlier survey items. If a program’s curriculum did not include negotiation strategies, respondents were prompted to answer only one question to expand on why these concepts were not included. If a program’s faculty did teach negotiation strategies, they were prompted to answer 5 more questions on various aspects of how this was implemented into the curriculum.
Citation: Journal of Athletic Training Education and Practice 21, 1; 10.4085/1947-380X-24-064
After survey development, the survey was reviewed for face and content validity by 3 athletic training educators. All 3 individuals had experience delivering curricular content to professional graduate athletic training students. Using an established validation process, each content reviewer assessed the readability and comprehensiveness of each survey item, evaluated the inclusivity of the demographic question response choices, and provided an estimated time for a participant to complete the survey.8 Based on reviewer feedback, minor changes were made to the wording of 2 survey items, and the survey was estimated to take 10 to 15 minutes to complete, depending on the thoroughness of responses provided. Due to the open-ended nature of the survey items, a reliability assessment of the instrument was not warranted.
Procedures
We requested a list of program directors of professional graduate ATPs from the CAATE office in November 2022 and received a list of 218 potential contacts. In December 2022, a recruitment email was sent to all potential participants; 7 email addresses were deemed as undeliverable. Therefore, the recruitment email was successfully sent to 211 program directors. Due to varying institutional schedules regarding holiday breaks, the survey was open for completion for a 9-week period; data collection was closed in February 2023. A total of 5 reminder emails were sent to those who had not completed the survey throughout the data collection period. To maintain compliance with exempt-research guidelines and survey best practices, voluntary consent was implied upon completion of any portion of the survey and participants were not required to respond to a survey item if they did not desire to do so.9,10
Data Analysis
All participant responses were included for data analysis as long as the individual responded to at least one survey item. Descriptive statistics (ie, frequencies, percentages, means and standard deviations) were calculated using SPSS (version 29; IBM Corp) for all demographic items, and textual responses provided for the open-ended items were analyzed using the consensual qualitative research (CQR) approach, as described by Hill et al.11,12
A central tenet of CQR is the use of a multianalyst team to ensure consensus during data analysis. For this study, the data analysis team consisted of 4 athletic training researchers. Three members of the research team (R.N., J.M.C., C.W.B.) were involved in every phase of data analysis, and 1 member (K.D.) served as the external auditor. One data analysis team member was new to the CQR approach and therefore went through the CQR training process described by Hill et al before data analysis.11
Analysis of the textual response data included 3 central phases: domain identification, core idea extraction, and a cross-analysis to construct common themes across participants.11,12 Domains were extracted from the first reading performed by each of the researchers. During this first phase, each researcher read through all the participant responses to identify key themes. The data analysis team then came together to review the theme list and develop a consensus codebook. During the second phase, the researchers used the consensus codebook to further code each textual response to align with the appropriate categories and themes. Once agreement among the 3 researchers was achieved, a cross-analysis was performed, and the data were separated by respective categories and themes. Finally, the external auditor conducted a comprehensive review of the coded data to ensure researcher bias was minimized and that the findings appropriately reflected the collective participant voice. Finally, we used the Consolidated Criteria for Reporting Qualitative Research to ensure a comprehensive reporting of the qualitative findings for this study.13
RESULTS
Descriptive Findings
Of the 211 professional graduate ATPs that were successfully sent a recruitment email, individuals from 51 programs accessed the survey (access rate = 24.2%). Individuals representing 44 programs in 24 states completed the survey in its entirety (completion rate = 86.3%). Respondents included 28 women and 16 men (age = 45.1 ± 8.8; years of AT experience = 22.4 ± 8.4; years as an educator = 17.4 ± 8.9; years in current position = 10.7 ± 7.7). The respondents were primarily program directors (n = 35, 79.5%), followed by core faculty members (n = 6, 13.6%) and clinical coordinators (n = 3, 6.8%). Of the 44 respondents, 42 indicated having only a professional graduate ATP (95.5%), and 2 reported having both professional and postprofessional ATPs (4.5%).
Ultimately, 11 participants, 25% of the total respondents, reported they did not teach negotiation strategies within their professional ATP. All 11 of these responses were provided by the ATP’s program director.
A total of 33 out of 44 respondents (75%) reported that their ATPs included negotiation strategies within the content taught. Of those respondents, 31 were employed solely within professional programs and 2 identified as teaching in both professional and postprofessional programs. Within this group, 24 were program directors, 6 served as core faculty members, and 3 were clinical coordinators. Four respondents did not provide answers to the open-ended questions, but the information provided relative to whether their program taught the content area was included.
Participants of this survey responded to 1 or 5 open-ended questions depending on their initial response to whether their program’s faculty included negotiation strategies in the curriculum. After phased data analysis, 3 common themes emerged: challenges to implementation, the importance of teaching this content, and which content was regularly included.
Qualitative Findings
Although we used a deductive approach to analyzing the data (ie, we did not use the survey questions to guide the data analysis process), the 3 prominent themes that emerged after analysis aligned with the survey questions. Participants discussed (1) the challenges they encountered teaching negotiation strategies to athletic training students, (2) the importance of teaching negotiation strategies, and (3) the specific content they focused on while teaching students about negotiation strategies.
Challenges
A common theme among our participants was the challenges of implementing instruction on this topic; this theme was consistent regardless of whether the respondent’s program included these concepts. Within the theme of challenges, 4 subcategories were identified: time, not a requirement in athletic training education curriculum, lack of personal experience, and lack of resources.
Time
Participants highlighted the amount of time and space needed to incorporate a topic not already included into the program’s curriculum. One respondent felt that there were other professional skills that required “greater focus” than negotiation strategies with the limited time they had outside of the required CAATE content. One respondent indicated, “The perception has been that there is not enough time in the curriculum to teach the skill.”
Time was also related to the timing of when these strategies were taught within the curriculum (ie, fall of first year, spring of second year). Of those that did teach negotiation, a quarter of respondents indicated they taught it within the last professional semester (n = 12 of 33, 36%). The timing of teaching these topics can be difficult; one participant described how it might be “disconnected” if it was not implemented when the students were “actively job seeking at that time.”
Not Required Content
Our participants highlighted that within their curricula, skills required by the CAATE took precedence. For example, one participant wrote, “To date, we have put a greater focus on other professional skills in the limited curricular time we have beyond the required content associated with CAATE Standards.” Another stated, “It is not part of the CAATE standards nor described in course texts. At same time there is limited information on the topic in AT.” The lack of a requirement to include this information made it difficult for some of our respondents to justify spending the curricular time on the topic.
Lack of Personal Experience
Our participants also described that their own lack of experience or knowledge on the topic, combined with a lack of established resources or guidelines, limited their ability to instruct on this topic. One respondent said, “It’s also a difficult topic to discuss because I haven’t ‘walked the walk’ myself so a lot of the content is hypothetical and best practice, but not based on authentic experience.” Another participant indicated that this was why they did not feel that they could teach it themselves, “
I haven’t tried to teach this content because salary negotiation isn’t something I feel confident in. I’ve only negotiated 4 salaries in 26 years, so I rely on Career & Professional Development and hiring managers to provide my students with resources and a practice opportunity.
Lack of Resources
Lastly, our participants indicated that the lack of prepared resources specific to athletic training was a challenge that they were forced to overcome. One athletic training educator said,
One challenge is that there is a lack of athletic training, or even health care, specific resources that we can provide to students relative to negotiation. Also, financial planning is not an inherent type of expertise our faculty have, so first, we have to teach ourselves about it before we can teach students, and second, we walk a line between giving negotiation and career advice and not overstepping into true financial planning.
Importance
Our participants who did teach this topic overwhelmingly acknowledged the importance of this content. Several categories became apparent within the theme of importance, including the importance of advancing the profession, the importance of being able to personally advocate, and contribution to job satisfaction.
Advancing the Profession
Participants recognized that salaries were an issue facing the whole profession, and they acknowledged that new graduates negotiating their salary had the potential to improve salaries across the whole profession. One respondent said,
In order to continually progress our profession, this skill is crucial for our graduates. The reason we still have ATs, particularly at the collegiate level, making $30 000 is that students think they have to accept this pay. New AT graduates need to be informed and assertive when negotiating not only pay, but also expectations/responsibilities.
Personal Advocacy
Our participants felt by addressing this topic they would empower the students with the ability to negotiate and advocate for themselves and for the profession of athletic training. One faculty member wrote, “People need to learn to advocate for themselves, for their skills, and for the profession.”
Many identified the strategy of negotiation as a professional life skill that needs to be honed through knowledge and practice. One faculty member expressed:
We believe it’s important to teach negotiation because that is a skill that needs to be developed like any other psychomotor skill performed within the profession. We also believe we have a professional responsibility to the profession to help our students learn how to advocate for themselves and demonstrate their value through negotiation. We know starting salary has large implications on future earnings so teaching negotiation where they are prepared to do that in their first job is essential for their future earning potential.
Several respondents noted that they, along with previous students from their programs, wished they had learned these skills in their professional education. One faculty member noted that many former athletic training students missed out on this content:
I consider this an important life skill, regardless of profession. This is something I wish I had learned. I posted on an AT social media group asking for hiring managers who could role-play the hire and offer process, many current ATs expressed a desire to participate as it is something they don’t know how to do.
Job Satisfaction
Many program faculty wanted their students to learn how to show their “worth” and “value” as an AT to future employers. They felt that by teaching the students to be able to effectively advocate for themselves they might be able to influence aspects of the terms of employment, which would influence their overall job satisfaction. One participant wrote,
It is important for students to be prepared to enter the workforce and successfully obtain their first job, and negotiating for salary and benefits is an important aspect of this. Obtaining fair salary and benefits can help improve job satisfaction and reduce burnout, which is important. Also, I feel that new graduates are often taken advantage of regarding part-time and “cheap labor” with internship and per diem positions, and having these discussions helps them select job opportunities that are less likely to take advantage of them.
Program faculty reported both self-advocacy and professional advocacy as reasons why they taught negotiation strategies. When new graduates are armed with the skills of negotiation, they are able to help address the issue of low salaries that are too often seen in the profession. By preparing students to present their value, education, and training to a new employer, they were able to help in the advancement of the profession and hopefully remain in the profession long-term.
Content
The participants who indicated that they taught negotiation were then asked to detail the topics they covered relating to negotiation, the timing of the content delivery in the curriculum, and resources they provided to the students. The responses to these questions contributed to the theme of content, and during analysis this theme was further broken into 4 distinct categories; topics, delivery, timing, and resources.
Topics
Participants described the concepts taught within their curriculum, and the topics circled around employment terms or benefits that could be negotiated; how to break down salary relative to cost of living; the art of compromise, bargaining, and other interpersonal skills; language to use during negotiations; and the timing of when to broach negotiations during the hiring process. One participant detailed,
We teach students how to find data related to average salaries in the area and cost-of-living expenses so they have data to support their asks in the negotiation process. We also teach them how to demonstrate value and articulate that information to the particular stakeholder that they are communicating with to ensure they are appropriately communicating in a means they would understand. We also spend time discussing what types of things they should consider negotiating for, specifically asking for specific things beyond just an increase in salary (eg, professional development funds, licensure/certification maintenance fee funds, etc).
The most highly discussed topic by respondents was negotiation regarding employment terms within a hiring process or while in a current position. A few programs highlighted other negotiation opportunities like budgeting, patient care, and conflict resolution. Several respondents described preparing the students from the beginning of the interview process, which included preparation of professional documents like resumes and cover letters and learning how to show one’s worth and value to a future employer. Most addressed the appropriate time and place to negotiate and what aspects of terms of employment could be negotiated. Several talked about determining the cost of living in an area and using that information to support the asks in a negotiation. Although salary remained a consistent focus of the negotiation topics, many programs made it a point to address other benefits that might be overlooked during a negotiation process.
Delivery
The delivery of this content in these classes ranged from traditional lecture methods to simulations using negotiation in mock scenarios. The most frequently used mode of content delivery was discussions, reported by 11 of 33 programs. The use of discussions was often in conjunction with other modes of delivery like presentations, readings, and/or case studies. The use of case studies in class discussions was noted by various programs to implement problem-based learning in a group setting. For example, one participant described, “Students are provided specific examples of negotiation situations and they need to work collaboratively with individuals of similar conflict management types to offer a solution.”
After class-based discussions, the use of simulations requiring negotiation, mock interviews, and development of job application documents were the most widely used techniques for content delivery. One faculty member described the method of using a mock interview, and their process mirrored the various steps throughout a job application process:
They do a job search and choose a position of interest. They write a cover letter and resume to fit the chosen position. They are assigned an AT who has hiring authority, ideally in a setting that matches the position of interest, but sometimes they have to pretend. The assigned AT completes a mock interview, then, at a separate time, extends an offer that includes a mock salary negotiation. The assigned AT gives feedback on the interview and salary negotiation.
Other methods of content delivery described by the educators included podcasts, self-reflection, guest presenters, and mentorship opportunities.
Timing
Some participants indicated that they taught this information in the last professional semester of the program, and negotiation strategies were most often taught in administrative-type classes (n = 12 of 33). One faculty member indicated,
We teach this content in the first half of the students’ last semester in the program. It is tied to a course that also includes resume writing, interview skills, and cover letter drafts, so it relates to the other content in the class. They get about 3–4 hours of content in this area.
Occasionally, participants indicated a wider spread of timing for this delivery. One participant said, “This is covered in 2 seminar classes. Salary and benefits is introduced during the first year in the program. A final review of ways to negotiate for these things is covered in the final semester.”
Resources
The most widely disseminated resource described as being used by our participants was the National Athletic Trainers’ Association (NATA) Salary Survey (n = 9 of 33). Cost-of-living information and/or cost-of-living calculators were also a common resource distributed to students (n = 6 of 33). Books/textbooks, online resources, and shared personal experiences by the educators were also mentioned as resources made available to students. Three programs did not provide any negotiation resources to their students.
DISCUSSION
Most professional ATPs we surveyed included some version of negotiation strategies in their program’s curriculum. Those who did teach this content highlighted the professional importance of teaching these strategies to students and shared similar content-related areas taught on the topic of negotiation. However, the responses from both groups displayed similarities in the challenges and barriers to the implementation of negotiation strategies into their program’s curriculum.
Importance in Education
The current literature reports mixed experiences of negotiation practices in those ATs who practice clinically and those who are educators.6,14 Educators appear to have had more experience and to feel comfortable attempting negotiations; however, those practicing clinically do not express the same comfort or attempts. This finding also speaks to the expectations of the employer relative to negotiation, as salary negotiation might be more commonly expected in the academic setting.6,14,15 The clinical setting represents a significant work setting in which students will work after graduating, with secondary schools, clinics/hospitals, and universities/colleges/junior colleges accounting for approximately 60% of the professional work settings for ATs.16 Athletic training educators who participated in our study felt that teaching negotiation strategies was an important curriculum topic, as it teaches skills that are imperative for professional and personal advocacy. Although there currently is no explicit requirement for ATPs to teach salary and employment negotiations within the CAATE standards, our findings suggest that many program faculty hold a common belief that there is a professional responsibility to prepare the students in athletic training education programs with these skills.5 Importantly, many of our respondents indicated that they felt this content was necessary in order to advance the profession of athletic training. Theoretically, then, the inclusion and assessment of this content could potentially suffice to demonstrate compliance with the CAATE standard requiring that graduates be able to “advocate for the profession.”5 Programs that currently do not include negotiation within their curricula should consider revision of planned content delivery to include negotiation, and the justification could be made that it is in fulfillment of CAATE standards relating to personal and professional advocacy.
Notably, negotiating ultimately requires the negotiator to convince and guide decision-makers to allocate resources and rewards to the benefit of themselves. Such a power differential can be intimidating, especially to novice clinicians who may not be as confident in their value. This challenge is reminiscent of research findings regarding challenges that newly credentialed ATs face, in which novice clinicians identified struggling with confidence and communication during conflict resolution.17 Several of our participants clearly identified the parallel of these challenges and addressed them through the inclusion of interpersonal skills and conflict resolution content, which likely affects multiple challenges that newly credentialed ATs face. This could be recommended as a starting point for program faculty seeking to address negotiation but facing the challenges of not having the time or personal experience to instruct it. By initiating instruction that bolsters students’ confidence in interactions that might include power differentials or conflict management, the building blocks for negotiation will be laid.
Job satisfaction was another important reason our participants chose to teach negotiation strategies. As they noted, job satisfaction is related to retention of ATs, and is a current concern in the profession.2,18 It is well established that compensation is a factor directly linked to job satisfaction.4 It is important to impart focus on the negotiation of salary; however, there are various elements of employment terms and work-family conflict that also contribute to job satisfaction.2 Higher levels of work-family conflict have been linked to lower levels of job satisfaction, and in the profession of athletic training it has been found that these conflicts experienced by ATs have a stronger effect on the overall assessment of their job compared with those of other working professionals.2 Other organizational aspects that can affect job satisfaction include work hours, travel, job stress, and salary.19–23 Overall, job satisfaction is an influential factor in retention.19 Retention is a focus and concern in the profession of athletic training, and by preparing our students with the tools to influence their overall job satisfaction, we can also address retention.24 When faculty deliver negotiation content, they should be encouraged to address how financial strain will impact their personal and professional lives. If faculty approach negotiation instruction through a whole-picture lens of which financial factors and terms of employment will most impact job satisfaction, students might be better able to grasp the long-term implications of not negotiating.
The importance of negotiation content was frequently discussed among participants as the strong rationale for the inclusion of negotiation in the curriculum despite its not being an overtly required topic. Educators should embrace flexibility and creativity when selecting topics for inclusion that may not be explicitly listed in standards, but that might serve to fulfill specific obligations to the student or the profession. Faculty can potentially address multiple profession-wide challenges by instructing on the foundational concepts that support negotiation skills, such as interpersonal communication and conflict management in situations with power differentials or in which the student must overcome a lack of confidence. Faculty should also discuss how job satisfaction impacts the emotional and mental health of an employee and how financial strain contributes to, or detracts from, job satisfaction.
Content Areas
Because this content is not explicitly required to be taught, variability was present in the type of content included by athletic training education program faculty. Interestingly, there was less variability in the timing of teaching negotiation strategies within the curriculum, with most respondents highlighting its inclusion toward the end of the preparation of the athletic training student, usually when students were in the process of looking for a job.
Salary negotiation specifically was the most reported topic taught, and faculty indicated that the content taught was augmented with resources like the NATA Salary Survey.25 Less often discussed by our participants were some of the other employment terms that could be negotiated, such as moving expenses, continuing education or professional development funding, paid time off, and health, dental, and vision insurance.6,25 As the topic of negotiation is further developed and included in the professional preparation of ATs, it will be important for program faculty to educate students on all employment terms that can influence financial standing.6,25
Another aspect of negotiation that some faculty did identify is the physical conversation that happens, often during interviews, about salary. Other educational programs, like business programs, find teaching negotiation strategies important and implement these topics through various teaching techniques. Educational techniques have been developed and successfully implemented throughout educational programs in those professional fields, including simulations, role-play, observational learning, and case studies.26–29 The 2 most commonly used techniques in teaching negotiation strategies in business are simulations and role-play.26–28 These are strategies that are already being used in athletic training education to test students in clinical scenarios using standardized patients or simulations.30 These scenarios are commonly supplemental in athletic training education in place of scenarios that are more difficult for real-life practice in clinical experiences.31 Similarly, business schools use role-play exercises to expose their students to simulations in which they will need to negotiate salary.28
Observational learning has also proven to be a valuable technique in learning negotiation skills. Compared with 3 other prominent types of negotiation strategies (didactic, information revelation, and analogic learning), it resulted in better outcomes in negotiation simulations.29 Although observational learning proved its benefit over didactic lectures in the study by Nadler et al, didactic lectures in combination with supplemental activities has also proven to be a useful application.28,29,32 These didactic lectures can be accompanied by PowerPoint presentations, case studies, practice-based readings, readings on theories of negotiation, self-assessment tools, discussions, and observational learning to better support learning.28,29,32 Within athletic training education, it has been demonstrated that even stand-alone, lecture-based negotiation instruction proves beneficial to students’ understanding of negotiation and their confidence in their ability to negotiate.33 Although not definitively proven at this point, it is believed the tactical approach to teaching negotiation strategy, a combination of lecture and anecdotes in which the lecturer provide real-life examples and lessons learned from them, can be a useful tool to enhance learning on the topic.32 Additionally, the use of analogic reasoning has been proven to facilitate better knowledge transfer, and this can be implemented through the study of multiple case studies to compare principles within each case.29,32,34,35 Faculty attempting to include negotiation within their courses should consider a multimodal instruction approach in order to best facilitate learning of negotiation techniques.
Challenges and Barriers to Implementation
Our findings suggest that time, the lack of a requirement from the CAATE, limited personal experience, and resources are the main sources of challenges to implementation. Time was defined by the respondents as not having time or space in the current curriculum to teach the topic of negotiation strategies. Many respondents felt they did not have the time to incorporate these lessons into the curriculum or the time to design a lesson plan to teach these topics. Others felt that there wasn’t a “good” time to teach the topic, wanting to ensure the information was timely for those going out into the workforce. Likewise, time has been highlighted as a barrier to inclusion of other content areas in curriculum and in professional development opportunities.5,36,37 However, as noted previously, educators have found that students benefit from even just 3 hours of content on this topic, so the amount of time dedicated need not be a prohibiting factor.33
Lack of personal experience was the most widely reported challenge to teaching negotiation strategies in this study. This finding is consistent with another study by Cavallario et al that found most ATs practicing in the clinical setting had never negotiated their salary or other terms of employment during their hiring process.6 However, a similar study by Cavallario et al evaluated athletic training educators on their negotiation practices, and most reported that they did negotiate salary or other employment terms.14 The disconnect is likely explained by employment settings, as the expectation of negotiation is higher within higher education.14,37 However, this barrier is an inherent component of serving as an educator, as the content we are teaching is constantly evolving, and rarely have educators been instructed on new content as a part of their formal education. For example, when the CAATE released the 2020 standards for professional programs, they contained a host of skills to be taught to students that had never previously been included as required content, and although this raised concern from educators,38 these skills have successfully been incorporated into the requirements without significant issue.39 Faculty should be encouraged to consult with experts within their institution’s business programs, if applicable, or human resources departments, or consider a preceptor who has previously negotiated. These experienced professionals could be invited as guest speakers, thus eliminating the impostor syndrome associated with teaching content that the educator is not confident in. A final recurring challenge expressed by the respondents was a lack of resources, particularly athletic training–specific resources. The most-used negotiation resource reported in this study is the NATA Salary Survey, a survey completed every 2 years that is reliant on voluntary participation from members of the athletic training profession.25 The purpose for developing this survey was to provide NATA members with the data to negotiate with current and prospective employers.25 However, the survey is not broken down into variables that can be used for practical application in situations that require negotiation.25,40 The NATA has also developed a salary negotiation infographic that was published in January of 2019, and in November 2022, a NATA Timely Topics release was published discussing the topic of salary negotiation.41,42 The NATA recognized in its Timely Topics release that salary negotiation is an area of weakness in young ATs, and needs to be developed.42 Aside from the minimal resources supplied through the NATA, the US Bureau of Labor Statistics Occupational Outlook Handbook is another salary-specific resource that provides information on athletic training salaries alongside salaries in similar health care professions.1
It is promising that there is recent recognition by the major member organization for ATs, but athletic training–specific resources are grossly lacking. However, in their place broader negotiation strategies and teaching techniques can still be used to teach negotiation strategies to athletic training students. Although resources can assist in the instruction of a concept, a lack of resources should not deter educators from attempting other approaches to teaching this content.
Relative to athletic training education–specific resources, Cavallario et al provided content and free web resources to support the teaching of this content in an Educational Technique paper published in 2024.33 Additionally, a Board of Certification–approved continuing education course that presents information on negotiation preparation, strategies, and approaches, including evidence from both employers and employees, will be available beginning in July 2025. This cost-free educational resource can be accessed by ATs and athletic training students by selecting the online course through the Athletic Training Practice-Based Research Network website (http://ceus.atpbrn.org).
Limitations and Future Research
The results of this study should be interpreted within the context of its limitations. The completion of the survey was limited to those program faculty who chose to complete the survey. Most CAATE-accredited athletic training education programs did not participate in this study, as our sample represents only a little more than 20% of professional ATPs. It is possible that our survey yielded a greater percentage of respondents from programs that do teach negotiation strategies as a result of social desirability bias or the desire to conform to positively viewed outcomes, whereas the opposite may be true of the smaller percentage of respondents from programs that do not teach this content. The survey also relied on accurate self-reporting of information, and specifically because we asked one faculty member to represent the entire program, it is possible that information on what other faculty members do at the institution is not represented in these findings. Future researchers should aim to determine effective approaches to teaching this content to athletic training students and identify resources that are beneficial to teaching this content. Additionally, future researchers should investigate which concepts of negotiation influence successful negotiation attempts to establish which content should be taught in educational programs. Once established, professional membership organizations should seek to include such content in future continuing education opportunities to ensure that seasoned professionals are able to benefit from the content as well.
CONCLUSIONS
The majority of ATP educators who responded to this survey did include negotiation strategies in their athletic training education program’s curriculum. Program faculty who do and do not integrate negotiation strategies face similar challenges and barriers to implementation, such as lack of athletic training–specific resources; time/space in the program’s curriculum, especially because the content is not required by CAATE; and limited personal experience to draw from. Many programs do, however, incorporate these strategies into their educational program, as they believe this is an important topic to teach the students and that it is a part of their professional responsibility to teach these skills. The acquisition of negotiation skills may help students improve their future levels of job satisfaction by addressing various employment terms that can be negotiated. This is an important contribution to the profession to reduce attrition.
Flow of open-ended survey items.
Contributor Notes