Context: Research suggests that women do not pursue leadership positions in athletic training due to a variety of reasons, including family challenges, organizational constraints, and reluctance to hold the position. The literature has been focused on the National Collegiate Athletic Association Division I setting, limiting our full understanding.

Objective: To examine factors that help women as they worked toward the position of head athletic trainer.

Design: Qualitative study.

Setting: Divisions II and III.

Patients or Other Participants: Seventy-seven women who were employed as head athletic trainers at the Division II or III level participated in our study. Participants were 38 ± 9 (range = 24−57) years old and had an average of 14 ± 8 (range = 1−33) years of athletic training experience.

Data Collection and Analysis: We conducted online interviews. Participants journaled their reflections to a series of open-ended questions pertaining to their experiences as head athletic trainers. Data were analyzed using a general inductive approach. Credibility was secured by peer review and researcher triangulation.

Results: Three organizational facilitators emerged from the data, workplace atmosphere, mentors, and past work experiences. These organizational factors were directly tied to aspects within the athletic trainer's employment setting that allowed her to enter the role. One individual-level facilitator was found: personal attributes that were described as helpful for women in transitioning to the role of the head athletic trainer. Participants discussed being leaders and persisting toward their career goals.

Conclusions: Women working in Divisions II and III experience similar facilitators to assuming the role of head athletic trainer as those working in the Division I setting. Divisions II and III were viewed as more favorable for women seeking the role of head athletic trainer, but like those in the role in the Division I setting, women must have leadership skills.

Key Points
  • Female head athletic trainers described themselves as leaders who were persistent in achieving their career goals.

  • The Division II and III settings are focused less on the concept of winning at all costs and, therefore, are attractors for women seeking the role of head athletic trainer.

  • Mentors and previous work experiences supported female athletic trainers who sought head athletic trainer positions.

Female athletic trainers (ATs) are less likely than their male counterparts to advance to the position of head AT.1−3 Although women in other professions also struggle, stereotyping and discrimination in collegiate athletics appear to stymie a woman's pursuit of this role.1,2  Contributing to this disparity of women in leadership roles in athletic training is a lack of aspiration or interest in the role,1,2  lifestyle preference (that is, wanting to have balance4), and a disinterest in providing medical care to the football team (a traditional role for the head AT).1 

Despite these factors, women have advanced to the position of head AT, with higher numbers found in the National Collegiate Athletic Association Division II and III collegiate settings. In the most recent Acosta and Carpenter report,3  an estimated 32.4% of all head ATs were women, a 17.5% increase since 2012. The data recounted in the report were from a 37-year ongoing national longitudinal study that tracks women's participation in intercollegiate sports. By level, Division I had the smallest percentage (19.5%), and Division III had the largest (40.5%).3  Explanations for a lower percentage of female head ATs at the Division I level include those previously mentioned but also a paucity of mentors and the struggles women face in balancing their roles as AT and mother.2  Although the Division I level still appears to present a barrier for women, Divisions II and III seem to attract a greater number of women as head ATs. This may suggest that Divisions II and III offer organizational benefits not seen in the Division I setting.

Often the literature examines only the challenges or barriers that exist for women aspiring to be leaders in athletics1,2  and rarely focuses on factors that may support or facilitate women in leadership roles. Mentoring and role models have been suggested as helpful for women aspiring to higher-ranking roles,5  and in athletic training, these enabling strategies have received some support.6,7  Personal attributes, such as leadership and communication skills, have also emerged as facilitators to achieving higher-ranking positions1,2  and may help female ATs gain positions as head ATs. Our purpose was to expand upon the knowledge of women's experiences in leadership positions within collegiate athletics and to specifically examine those factors that can serve as catalysts to the role of head AT. Mazerolle et al2  used a holistic lens to examine the experiences of women in the Division I setting as head ATs, and we were intentionally looking at women in the same role outside of the Division I setting, as Acosta and Carpenter3  demonstrated a greater number in the Division II and III settings. We asked the following questions:

  • 1.

    What facilitators exist to help female ATs transition to the role of the head AT in Divisions II and III?

  • 2.

    What are the perceptions of female head ATs about engaging in a leadership role in collegiate athletic training outside the Division I setting?

  • 3.

    What role does level of competition play in female head ATs' experiences of pursuing and maintaining their leadership positions?

Research Design

We used a qualitative design to better understand the experiences of female ATs who were currently head ATs in Divisions II and III. This design was purposeful as it allowed us to explore experiences from the standpoints of those engaged in the role under investigation. Qualitative research design allowed the female head ATs to articulate their personal stories and experiences related to their professional advancements to the role of head AT. The data presented in this paper were gathered for a larger study and, therefore, the methods presented here are comparable with those described by Mazerolle and Eason.8 

Participants

After gaining institutional review board approval, we purposefully recruited 77 female ATs who were head ATs at the Division II or III level. Our recruitment procedures were detailed extensively in Mazerolle and Eason,8  as the data presented here were from a larger study that examined women in athletic training leadership positions outside the Division I setting. On average, the female ATs were 38 ± 9 (range = 24−57) years old. They had 14 ± 8 (range = 1−33) years of athletic training experience and 9 ± 8 (range = 1−30) years as a head AT.

Data-Collection Procedures

We recruited participants from the sample as outlined previously.8  Recruitment was via e-mail, whereby we sent individual messages to potential participants detailing our study and the steps necessary to complete the study's protocol. The institutional review board of the University of Connecticut approved the study. Completing the structured, online interview implied consent. Once a participant consented, we asked her to provide demographic information regarding personal (age, marital status, etc) and professional (years as an AT, hours worked per week, etc) characteristics. We then asked each participant to reflect upon her development as an AT and career path as it led to the current role. The open-ended questions were used previously by Mazerolle et al2  to research female head ATs in the Division I setting. The questions used in this investigation were reviewed by an expert in gender studies, particularly with respect to women pursuing leadership roles in sports and collegiate athletics. No changes were made to the original questions2  upon completion of the peer-review process. (The questions are presented as an appendix in Mazerolle and Eason.8) The link to the questions remained active for 1 month; that is, an initial e-mail was sent, with a reminder e-mail to the participants at 1 week and 3 weeks after the initial recruitment e-mail.

Data Analysis and Trustworthiness

Data were analyzed using a general inductive process.9  The systematic process included multiple readings of the data to methodically examine and eventually pare down the data to the emergent themes. Our purpose and research questions guided the analysis and allowed us to remain focused. We decided to report only those findings that represented 50% of the participants' experiences, a cutoff used by Mazerolle and Eason8  as well as by authors of other qualitative studies who took the general inductive approach to analyzing data.

We used 3 strategies to secure trustworthiness: data saturation, peer review, and multiple-analyst triangulation. Saturation was secured through our purposeful sampling procedures. Our peer was independent of our data-collection procedures and was selected because he possessed a strong understanding of sex discrimination, leadership, and athletics. We had our peer reviewer confirm our analyses following the previously discussed methods. The 2 authors completed independent analyses before comparing the findings as presented here. The multiple-analyst triangulation revealed the 2 major ideas of facilitators and barriers to the role of the head AT, which are further explained here and in Mazerolle and Eason.8 

Our analysis revealed 4 facilitators (Figure) to assuming the role of head AT in this setting. We describe each catalyst in the subsequent sections with supporting quotes from participants. The facilitators were primarily entrenched in organizational aspects of the collegiate athletics environment, with 1 major facilitator at the individual level.

Figure. 

Facilitators to the role of head athletic trainer for women.

Figure. 

Facilitators to the role of head athletic trainer for women.

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Workplace Atmosphere

It was evident from participants that the workplace atmosphere was a key factor to their seeking or accepting a position as head AT. They described the atmosphere as “not all about athletics,” “balanced mindset of athletics and academics,” and “not as much pressure to win.” Participants believed that they could succeed in the role of head AT because the workplace climate was focused on a balanced perspective, rather than “win at all costs,” which was viewed as negatively affecting their stress, level of commitment, and job expectations. One woman shared, “I love the balance of academic[s] and athletics. The particular school is an engineering school where the academics are a strong influence.” Similar reflections were made by many others, including the following:

“The climate is different in Division II in that we don't have a ‘win at all cost' mentality.”

“DII has a motto of life in the balance of academics and athletics.”

“Competition is serious, but there is a sense of reality.”

“It's not D1 money ball, win at all costs.”

Another participant described how the atmosphere resonated with her personally and made her job more attractive:

For me, DIII athletics is where you can really find the essences of the “student-athlete.” These athletes have priorities in order, academics first, then athletics. They are every bit as committed and passionate about their participation in athletics as DI athletes; however, the beauty is they don't have athletic scholarships and money clouding their vision.

The ability to find a balance was also important for this group of women. Although the job was described as demanding (in hours and expectations), they also perceived a bit more flexibility in their work schedules:

[T]here are various reason as to why my current employment setting is favorable, to include I have flexibility in my schedule, I'm able to govern my department as I see fit with very minimal arguments.

Others described the workplace as “family orientated” or “family friendly,” which contributed to their enjoyment of and ability to succeed in their roles. One woman said, “[F]amily atmosphere is the reason I am here today.” Others commented, “[T]his DIII position is less time consuming than some other higher ranks. I get more free time to enjoy with family and friends than my DI counterparts,” and “[T]o be honest, the family-friendly atmosphere of everyone wanting to meet my husband and son shortly after starting here has been great,” and “[The] current setting is very family oriented, and the job is very flexible for athletic training.” Another participant directly related her longevity in her role to “having been able to raise my 2 kids in a very friendly, fun environment.”

Mentors

The importance of mentorship as a facilitator to the role of head AT for these women was evident. One AT shared her opinions on guiding future women into the role: “I believe (at the organizational level) that a mentoring program of those females who are head athletic trainers with current assistant athletic trainers who have a desire to seek a position of head athletic trainer is important.” Her reflections speak to the need for a formalized mentoring program to help future women aspiring to this role. Another woman had similar thoughts on how the profession can cultivate more female head ATs:

. . . creating a women in athletic training group so we can support each other, network to get the jobs we want and deserve. I attended the National Association of Collegiate Women Athletics Administrators (NACWAA) Institute for Administrative Advancement 2 months prior to getting my head athletic trainer job and firmly believe the tools I learned there helped me land my current job. We need to do the same within our profession.

Other participants, however, discussed informal mentorship as crucial. Informal mentoring was viewed as showcasing the successes of women currently in the role of head AT as a means to encourage others to follow the same career path. Take, for instance, the comments of 1 participant who wrote, “[W]e need to highlight the success of female head athletic trainers and what they have done to get there, how did they make it work.” Similarly a few others noted, “[E]ducating others on the successes of women in this role,” and “[H]onoring and acknowledging those of us who are already head athletic trainers or just women in the profession with families on a national level.” Another participant observed that mentors in the workplace, especially female leaders, can help support the careers of others. She stated, “. . . mentors that have been with me since I have started, 2 other head athletic trainers in our conference. Also, my current athletic director has taught me a lot about being a female leader.” Direct mentorship emerged as a facilitator for some of the participants. One woman evaluated her development as a head AT:

. . . working with and for both the head ATC at [XXX] school and the head athletic trainer at [XXX]. Being able to work with, observe, and learn how they held themselves and the type of leadership they had gave me a base to hold myself up to. Also, being able to call them and ask them for advice during my first year and even before I applied for the position gave me the confidence.

A similar testament was shared about the influence mentors had in their transitioning into the role of the head AT:

I was fortunate to have 2 very outstanding mentors. My head athletic trainers at both my undergrad and grad schools were, in my opinion, the epitome of what an athletic trainer should be. They were smart, assertive, and compassionate. Both were excellent teachers.

Several participants recognized the disparity in female role models in leadership positions. However, many indicated that having a mentor, regardless of sex, could help prepare women to succeed as head ATs. In fact, for those who identified mentors as a key facilitator in the transition to the position of head AT, sex was not mentioned as key, but rather support, guidance, and role modeling were critical. Two participants had analogous thoughts on mentoring:

“[F]ind a solid mentor, it does not have to be a female, they are key in helping you guide your career and making decisions.”

“Look for women mentors who are successful in these positions. A male mentor is better than none, but that cannot begin to have the same perspective that women would.”

Past Work Experience

Previous work experience was commonly cited by participants as important to providing women with the skills necessary to step into the role of head AT. That is, by developing fundamental skills, such as communication and organization, participants were prepared to be head ATs. One woman explained,

I think my everyday experiences as an athletic trainer, learning to communicate effectively with coaches, administrators, and athletes, have prepared me for my role as a head athletic trainer.

Other responses included “on-the-job training,” “my experiences as an athletic trainer in my previous employment settings,” and “being an assistant for 8 years was essential. I constantly read journals and any administrative books I could find.” Diversity in past experiences, as well as valuing those work-related responsibilities, was also mentioned by several as facilitators to the role of head AT. One woman shared her professional growth:

[G]aining clinical experience in multiple settings as a student (in undergrad and grad school), and in the summers, in addition to my full-time work experience has helped me to see how different programs are run.

Experiences, even if assessed as negative, were valued in the transition to the role of head AT for some of the women, “[A]s assistant athletic trainer at [XXX], I learned what I wasn't going to do as a head athletic trainer. Even though it wasn't a positive experience there, it was a learning experience.”

Personal Attributes

Leadership emerged as the most important attribute for those seeking or assuming the position of head AT. Although not all participants actively sought their current positions, they did acknowledge that they were leaders. One participant commented,

I believe I am a person who is a natural leader and is also a very hard worker and creative naturally. I believe these traits make me a natural fit for a head athletic trainer position.

Another also directly related her leadership skills as a facilitator to her success:

I believe that my leadership abilities have made me a successful head athletic trainer, as I have educated the student workers, advanced the state of the equipment and functionality of the ATR [athletic training room], and have advocated for our budget to fit the needs of the institution.

Another participant linked the role of head AT and her strengths as a person. In response to wanting to be in her current role, she wrote:

The reason I have always wanted to become a head athletic trainer is the fact that it suits my personality. I enjoy being a problem solver and creating efficient ways to complete tasks. To be perfectly honest, I am a leader and not a follower and find it frustrating to be in a position where I cannot make decisions of how things are going to operate within the athletic training department.

Like the previous women, another participant linked her enjoyment of decision making to her role as a head AT: “I do like being in charge and having the responsibility of the department and assisting the student-athlete population.”

Persistence was described as an important element to becoming a female head AT. Several participants attributed their current role to their dedication and continuance. When asked about advice for women aspiring to a leadership or supervisory role, they said, “[G]o for it,” “[D]on't give up,” “[D]on't let anything get in your way,” and “[R]emain committed.” Another woman conveyed, “[W]ork hard, pursue your goals, and don't look at gender as a factor. I don't identify myself as a woman first, but as an athletic trainer.” Working hard was also a part of the persistence participants wrote about: “[G]o for it (being a head athletic trainer), and continue to work hard.”

At the start of the study, we set out to answer 3 questions related to the experiences of female ATs currently serving in the role of head AT in Divisions II and III. Mentoring, previous work experience, and leadership abilities helped participants achieve the role of head AT. Women in this role found the atmosphere conducive to their growth as leaders and head ATs, mostly because of the “sense of balance” and “reality.” Persistence, dedication, and leadership skills were also deemed necessary for pursuing and attaining the role of head AT in these settings.

Workplace atmosphere emerged as an element that helped participants successfully navigate their roles as head ATs. The work-life balance literature has suggested that workplace atmosphere is critical in helping to retain ATs, as fulfillment of a balanced lifestyle improves satisfaction and professional commitment.10,11  Obvious differences exist among the levels within collegiate athletics,12,13  but subtle differences are often noted between the Division I setting and the others, including, as highlighted by our findings, the concept that Divisions II and III are not as cumbersome, demanding, and limiting of one's time. Our data were rich in descriptions of a “balanced mindset” between academics and athletics that promotes a “family-friendly” philosophy. So just as the idea that motherhood and time demands limit the pursuit of and role continuation in the head AT role, those women who find the “right fit” are able to juggle their roles and thus succeed as a mother, AT, and leader. Goodman et al14  reported that female ATs remained committed to their jobs because they found the right fit; at the ground level, Divisions II and III may provide the blend of expectations that allows women to successfully navigate the roles of mother and head AT and not have to choose to be better at one over the other.

Similar to the results of Eason et al,15  our results support the effect mentorship can have on female ATs in regard to their professional development and career planning. Social learning theory suggests that learning is a cognitive process that occurs in a social context and can take place purely through observation or direct instruction, even in the absence of direct reinforcement or motor reproduction.16  Bandura16,17  proposed that learning can occur simply by observing the actions of others and that it is not all a result of associations formed by conditioning. By adding a social element, he argued that people could learn new information by watching other people. Social learning theory is important in order to understand the value of mentoring and role modeling. Mentoring and role modeling are important concepts of work-based learning, which constitutes the development of skills and practical knowledge.

According to Bandura,17  individuals do not possess any inherent behavior patterns at birth apart from reflexes and, consequently, learning occurs by observing other people. Athletic training students and novices learn and acquire practical skills and knowledge from interacting with mentors and role models. For the novice AT, the introduction and orientation to the diverse roles of the AT can be an overwhelming experience. The novice needs a period of guidance and direction to acclimate to the environment and responsibilities. However, it is not just clinical skills that novice ATs learn from their mentors. Young women in particular need to learn how to balance their work and personal lives and, unfortunately, women mentors or role models in the profession who can teach the young professionals how to manage their lives are lacking.15  It is especially important to examine the potential benefits of mentors and role models on female ATs due to reports of a trend for women to leave the profession at the age of 28.18 

As previously discussed, a scarcity of female mentors successfully navigating careers as head ATs may negatively influence a woman's pursuit of the role.2,15  Yet our participants, like those in Eason et al,15  were able to identify a mentor who, regardless of sex, was able to stimulate career advancement. The mentoring relationship is founded on career development and advancement of one's goals; thus, regardless of the mentor's sex, women can pursue their goals with the aid of mentoring, which allows them to develop the skills necessary to be effective in their desired roles. Although participants benefitted from both male and female mentors, they recognized the need for more formalized mentoring of young female ATs. This speaks to the idea that organizational support is crucial for success and is independent of sex roles or stereotyping. Our participants wanted more women role models, but the current shortage was not viewed as a detriment to the hope that more women will one day seek leadership roles within athletic training. Several participants recommended engaging in mentoring, regardless of the sex of the mentor, to aid in development and pursuit of higher-ranking positions in athletic training. Similar to the participants in the Eason et al15  study, although it would be potentially more effective for women to mentor women, this was not viewed as the only variable influencing career planning. Direct mentorship from women leaders may not always be available; however, as described by our participants, continued promotions of those women who are succeeding can indirectly affect women aspiring to the role of head AT. Informally, this can instill hope in women that it is plausible to navigate a successful career as leaders and administrators while balancing other demanding roles such as motherhood.

Participants believed that they were able to attain their positions because of their leadership abilities; Mazerolle et al2  also found that leadership skills were direct facilitators to achievement of the head AT role. Many attributes are associated with individuals who hold higher-ranking roles within organizations, but leadership skills were viewed as paramount.5,19,20  Our participants believed they had innate leadership qualities and could take charge and make decisions when needed. These personal attributes, which are often viewed as qualities attributed to males, contradict traditional role theory and may have contributed to their achieving higher-ranking positions. This possibility is interesting, as women must possess multitasking and time-management skills to succeed as mothers and essentially the head of the household when it comes to the domestic and household duties commonly associated with traditional gender roles. Borrowing from the concepts of work-life enrichment theory,21  women leaders may gain strengths from their engagement in multiple roles; thus, being a working mother may afford her the ability to accomplish her goals in both domains.

Participants also addressed how influential their experiences in previous positions were in attaining their current head AT positions. Job success and challenges, regardless of position, are affected by how different the current job is from an individual's previous assignments and past experiences. This notion of experience and previous job similarity may help explain the higher numbers of men in leadership positions. Ohlott et al22  found that, despite their female participants being better educated than their male participants (ie, a higher percentage of women held graduate degrees), the males were more likely to report that their current positions were similar to previous jobs they had held. It has often been suggested that it is difficult for women to break the corporate “glass ceiling” and advance to the highest levels of an organization.23−25 However, this glass ceiling metaphor may be better described as a labyrinth. Throughout their careers, women are afforded different developmental opportunities than their male counterparts. Women are less likely than men to be assigned to jobs that develop leadership.25  However, our participants' felt their previous jobs enhanced their leadership skills and made them more prepared for their role as head AT. It is possible that it was their own persistence in seeking out roles and tasks that would benefit them in future leadership positions.

Limitations and Future Directions

We used an online platform to collect our data. Although this allowed participants the time to reflect on our questions, we were unable to follow up on individual responses. Follow up using online data collection is not possible as the platform allows for anonymity; thus, individual responses are not linked to a participant. Data saturation guided our recruitment; therefore, we feel confident in the responses of participants. We do believe that, in the future, focus group sessions and individual interviews may allow for greater interactions and more follow up.

Mentorship emerged as a critical aspect for the promotion of women to leadership roles in athletic training; however, there is little literature on whether this can truly affect the retention of women in these roles. Future researchers should investigate how mentorship, formal or informal, can influence career planning for women. Leadership attributes were revealed as important facilitators to the role of head AT, something also found previously,2  but this topic has yet to be fully explored. Leadership conferences and workshops could potentially serve as a means to spearhead the mentoring needed for the female AT aspiring to or currently serving in the role of head AT. Several organizations support the development of women in sports (ie, Women's Sports Foundation, National Association of Collegiate Women Athletics Administrators), particularly as it relates to the pursuit of leadership roles; therefore, future investigators could examine the effects of these organizations and initiatives on professional development.

More women are employed in head AT positions in Divisions II and III, likely due to a more balanced philosophy as opposed to a focus on winning at all costs. This mindset fosters a more reasonable workplace environment that allowed participants to feel as though they could maintain balance rather than be overwhelmed and unbalanced. Regardless of the level within collegiate athletics, a head AT must possess leadership attributes. Being able to make decisions is necessary in this role; thus, having the ability to do so is fundamental to success. Our findings also suggest that women pursuing leadership roles can succeed outside the Division I setting because of organizational facets (a less demanding subculture of sports) and individual factors (leadership skills), supporting the idea that a multilevel lens is needed when examining topics in sports and athletic training.

We thank Laura Burton, PhD, and John Borland, PhD, for their roles as peer reviewers.

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