Context

Athletic trainers' (ATs') job satisfaction has been extensively researched, yet little is known about how satisfaction relates to organizational culture.

Objective

To examine ATs' level of job satisfaction with and organizational-fit perceptions of their employment setting.

Design

Cross-sectional study.

Setting

Web-based questionnaire.

Patients or Other Participants

A total of 5704 ATs (full-time employment, nonacademic appointment) were contacted via email; 841 participants began our survey (access rate = 14.7%), and 285 completed it (5.0% response rate; 33.9% completion rate). Demographic characteristics were men = 107 (37.5%), women = 178 (62.5%); age = 34.8 ± 9.9 years; and employment setting = 34.7% (n = 99) from National Collegiate Athletic Association Division I, 18.9% (n = 54) from Division II, 29.5% (n = 84) from Division III, and 16.9% (n = 48) other.

Main Outcome Measure(s)

Participants responded to an online survey consisting of demographic questions, a 36-item Likert-scale Job Satisfaction Survey, and the Cable and Judge revision of the O'Reilly, Chatman, and Caldwell 40-item ranking Organizational Culture Profile survey. Multiple linear regression models for total or subscale job satisfaction were used to analyze the data. All models adjusted for the same demographic measures, and the independent variables of interest were created from the organizational culture survey responses.

Results

Coworkers (minimum [min] = 9, maximum [max] = 24, ρ = .79), communications (min = 9, max = 24, ρ = .78), and work itself (min = 4, max = 24, ρ = .71) were most correlated with the total job satisfaction score (min = 96, max = 175). Of the respondents, 54% selected adaptability, stability, and taking individual responsibility as 1 of their 2 most characteristic attributes in the organizational culture profile. In addition, 83% of respondents indicated being aggressive, receiving high pay for good performance, and being distinctive or different from others as their 2 least characteristic traits.

Conclusions

The job satisfaction of these ATs was affected most by organizational factors, such as coworkers and communication, as well as by individual attributes such as adaptability, stability, and taking personal responsibility.

Key Points
• The sampled athletic trainers' identified occupational culture characteristics were related to their calculated job satisfaction scores.

• Moderate agreement in occupational culture characteristics was present across the sample.

• Job satisfaction scores were fairly consistent across and within the athletic trainers; most of the job satisfaction subscale scores were positively correlated with the overall job satisfaction score.

Athletic trainers (ATs) are health care professionals who provide a range of services, including prevention, emergency care, clinical diagnosis, therapeutic intervention, and rehabilitation. For ATs employed in diverse medical settings, dissonance may occur as they attempt to fit within organizational cultures. A limited number of researchers15  have addressed ATs' experiences with work-life balance and workplace satisfaction and the relationship between individual ideal characteristics of organizational culture and job satisfaction.

Organizational culture is the shared values and beliefs that represent the workplace.6 Organizational fit represents an individual's ability to conform to an established system or organizational culture.7  Many factors affect organizational culture, including the management styles exhibited in the workplace. A supervisor's style can yield a positive environment, affecting related worker satisfaction, retention, work-life balance, and ultimately fit.3  Managers can quantitatively assess culture, focusing on the central values relevant to individual identity and the respective organization's value system.7  This may promote person–organization fit, reduce employee stress, and foster supervisor support.8  Organizational elements positively correlated with a satisfactory organizational climate include family friendliness, managerial support, and other factors that promote work-life balance.1  Organizations invest in resources (ie, work-life philosophies, policies, procedures) that support working professionals, seeking to achieve equilibrium in valued areas.9  These elements are essential given the negatively associated variables (ie, long hours, low compensation, and lack of advancement opportunities) noted by ATs that can affect organizational commitment and longevity.1,10

Job satisfaction is the degree to which people like their jobs.11(pvii) Measures of job satisfaction represent employees' attitudes toward aspects of their job.11  Individual, organizational, and sociocultural factors have the potential to influence employee satisfaction and, in the case of ATs, their intent to leave the profession.13,12  Understanding job satisfaction factors and retention is essential given the job outlook for ATs, which is growing at a much higher rate than that of other occupations.13

Many ATs' job settings require work hours that far exceed the traditional 40-hour workweek and cause work-life conflict.10,14  Workload incongruence is one of the many individual variables contributing to AT burnout.15  A large volume of work hours, high student-athlete-to-AT ratios, and lack of staff ATs contribute to an increased workload.10  The most common management model for employing ATs in the collegiate setting is the athletics model,2  in which the head AT reports directly to the athletic director.1  In the medical model, ATs fall under the direct report of a physician, often in the university's student health center or medical center. Those ATs who are employed in the medical model tend to work more reasonable hours than those employed in the athletics model.1

Several notable factors influence job satisfaction.11  One factor that significantly affects ATs' job satisfaction is supervisor support and management style.1,5,16  Supportive supervisors encourage time off,2,16  create autonomous work scheduling,5  promote family-friendly climates,4  and promote work-life balance.1  A management style that embraces a family-friendly culture, allowing for workplace integration and understanding of family or personal roles, leads to work-life balance. A trusting relationship between a supervisor and an employee leads to the absence of micromanagement, facilitating a feeling of autonomy.4,5,16  In addition, flexibility in the work schedule promotes work-life balance and fosters a positive work environment.1,5  Supervisors should act as role models to reinforce policies of work-life balance.1,5  Moreover, a lack of supervisor support has been noted as a significant barrier to maintaining professional commitment in athletic training, thereby potentially leading to less job satisfaction and greater attrition.10  However, the relationship between particular organizational variables and the specific elements of job satisfaction remains unknown.

Through the current research study, we explored individual perceptions of ideal characteristics of organizational culture as measured by adaptations of the Cable and Judge revision of the O'Reilly, Chatman, and Caldwell Organizational Culture Profile (OCP)7  and Spector Job Satisfaction Survey (JSS).11  Thus, the purpose of our study was to examine possible relationships between elements of job satisfaction (ie, supervisor, pay and benefits, and coworkers) and characteristics of organizational culture (ie, adaptability, tolerance, and autonomy). We hypothesized that job satisfaction scores would be affected by OCP variables.

### Participants

All participants (N = 285) were certified and actively employed as full-time ATs. Employment setting, preceptor status, and certification data were gathered. Recruits consisted of ATs from all divisions of the National Collegiate Athletic Association (NCAA), as well as the National Association of Intercollegiate Athletics (NAIA), and the National Junior College Athletic Association (NJCAA).

### Procedures

This study's data were collected from ATs in the United States using self-administered surveys distributed via Qualtrics. The survey and procedures used in this research received appropriate institutional review board approval before participant recruitment. The survey was constructed following the guiding principles of Dillman et al17  for internet surveys. The survey instrument was delivered electronically along with subsequent reminder(s) to 5704 ATs. A database of email addresses was created by an undergraduate research assistant using an email extractor extension in the Google Chrome internet browser. Of the 5704 emailed ATs, 841 began our survey (access rate = 14.7%) and 285 completed it (5.0% response rate; 33.9% completion rate).

### Survey Instrument

The survey consisted of 3 sections focused on (1) demographic variables (age, employment setting, and years certified); (2) job satisfaction11 ; and (3) organizational culture.7

#### Job Satisfaction

The constructs of interest were measured and defined using the Spector 36-item JSS.11  Respondents reported their level of agreement with the items using a 6-point Likert-type scale (1 = disagree very much, 2 = disagree moderately, 3 = disagree slightly, 4 = agree slightly, 5 = agree moderately, 6 = agree very much). Each of the 9 JSS facets is described in Table 1.11  The sum of all Likert-scale answers with respect to the listed facets of job satisfaction led to a total job satisfaction score (range = 36–216), and subscales of job satisfaction were computed by summing only the items within each facet (range = 4–24). Interpretations of the total scores were 36–108 for dissatisfaction, 144–216 for satisfaction, and 108–144 for ambivalent.11  Interpretations of the subscale scores were 4–12 for dissatisfied, 16–24 for satisfied, and 12–16 for ambivalent.11  The scale displayed a median of 4 (minimum = 2, maximum = 6) across all subscales and participants with a standardized Cronbach α of 0.71, suggesting acceptable internal consistency across all items.18  Our participants' scores were then compared with the US norms.11

Table 1

Job Satisfaction Survey Facet Descriptions

#### Organizational Culture

Organizational culture was defined as similar or shared cultural assumptions and values between workers and the organization. We measured this variable using the Cable and Judge revision of the O'Reilly et al 40-item ranking for OCP.7  Whereas the resulting rankings described an individual's most to least characteristic attributes, summary rankings could describe ATs' organizational culture profile. Participants were given 40 characteristics that could be used to describe themselves. They were asked to consider “how characteristic this attribute is of me” and to create a hierarchical list with the “most characteristic of you” on top and the least characteristic on the bottom. The rankings are structured such that only 2 items may be “most characteristic,” 2 items may be “least characteristic,” and 8 items must be “neither characteristic nor uncharacteristic.” The focus was on the most and least characteristic attributes: we identified the 3 overall top and bottom attributes according to median rankings and then created binary variables to indicate whether an individual selected at least 1 of those overall top or bottom attributes (0 = no, 1 = yes). The Spearman correlation, a measure most appropriate for ranked values, showed moderate agreement across individual rankings with a median correlation of 0.34 across all 40 items and 285 responses.

### Statistical Analysis

All statistical analyses were performed using R (version 4.0.0; Core Team).19  We downloaded the participant data directly from Qualtrics software (version 2020) into an Excel spreadsheet (version 16.0; Microsoft Corp). The variables of interest were job satisfaction and organizational culture. Multiple linear regression models for total or subscale job satisfaction were used to analyze the data. All models adjusted for the same demographic measures, and the independent variables of interest were created from the organizational culture survey responses.

Each of the variables considered in this study was initially described and explored via means, medians, SDs, ranges, counts, and percentages. Relationships between total job satisfaction and its subscales were assessed by Pearson correlation coefficients, and comparisons with US norm values were performed using 1-sample independent t tests. We also conducted multiple linear regression models to test the relationship between the JSS scores and the OCP variables. All regression models included a dependent variable of either total or 1 of the subscales of job satisfaction and were adjusted by the demographic variables. The OCP indicator variables were included in separate regression models to examine their adjusted independent relationship with JSS, resulting in 72 models (9 job satisfaction constructs multiplied by 8 OCP indicators). We report and interpret the models that identified interesting and significant relationships between job satisfaction and the OCP indicators.

Demographic data were collected to adjust the overall conceptual model (Table 2). The study adjusted for the respondent's age (age), employment setting (division, level: NCAA Division I [reference], Division II, Division III, and other [NAIA, NJCAA, not indicated]), and the number of years certified by the Board of Certification (years certified: <5 [reference], 5–9, 10–14, 15–19, and 20+). Reference categories were selected because they were either temporally first or the largest. The sample composition with respect to these demographic variables was as follows: median age of 32 years; 34.7% (n = 99) from Division I (Football Bowl Subdivision, Football Championship Subdivision, and nonfootball), 18.9% (n = 54) from Division II, 29.5% (n = 84) from Division III, and 16.9% (n = 48) other (NAIA, NJCAA, and not indicated); and 25.6% (n = 73) certified <5 years, 33.3% (n = 95) certified 5–9 years, 13.0% (n = 37) certified 10–14 years, 10.5% (n = 30) certified 15–19 years, and 17.5% (n = 50) certified ≥20 years. We used medians throughout this article as they are more robust to outliers and provide a better representation of the center of skewed distributions. For example, the age distribution was skewed right because most of the ATs were in the 25- to 35-year-old age range, but the maximum age was 70. Therefore, the median was used instead of the mean. These demographic variables were selected for maximizing the model fit (R2) with total job satisfaction as the dependent variable and only the demographic variables as independent variables. Adjusting for men and women did not improve the model fit.

Table 2

Participants' Demographics

### Demographics

Summary statistics associated with the demographic variables used in the multiple regression models are displayed in Table 2. These measures suggested that our sample was mostly young ATs, though there was a long right tail to the age distribution, which indicated the presence of some older ATs as well. Most ATs came from Division I or Division III programs, with fewer from Division II, NAIA, and NJCAA or not indicated. The distribution of years certified indicated that a majority of the sampled ATs had been certified for fewer than 10 years, and the next largest category was 20+ years certified.

### Job Satisfaction

The mean total sample JSS score was 137.2 (median = 137, minimum = 96, maximum = 175), with an SD of 13.5, suggesting ambivalence concerning job satisfaction. All subscale scores fell within the ambivalent range (108–144) except for satisfaction with coworkers and work itself, which fell within the range of satisfied (144–216). Whereas these results were largely consistent with US norm values in terms of classification as dissatisfied, satisfied, or ambivalent, 1-sample independent t tests indicated differences from the mean US norm values, albeit some subscale scores were below and others were above the US norms. Nearly all P values were significant at the .05 level.

The Figure displays a Pearson correlation matrix of the total and subscale job satisfaction scores. These measures give information about how the subscale job satisfaction scores related to the total job satisfaction score. Coworkers (ρ = .79), communications (ρ = .78), work itself (ρ = .71), conditions (ρ = .56), and promotion (ρ = .52) were the most correlated with the total score.20  Because these were all positive correlations, they indicated that as satisfaction with these subscales increased, total job satisfaction increased. However, salary was slightly negatively correlated with total job satisfaction, which demonstrated that as salary increased, total job satisfaction decreased. Of the subscale scores, salary, supervision, and benefits had the weakest correlations with total satisfaction.

Figure

Pearson correlation matrix of the total and subscale job satisfaction dependent variables.

Figure

Pearson correlation matrix of the total and subscale job satisfaction dependent variables.

Close modal

### Organizational Culture Profile

Each attribute of the OCP's ordered median rankings is shown in Table 3. The overall top and bottom attributes are indicated with superscripts. We used the median rather than the mean because the median is robust to outliers. These rankings suggest the traits of ATs in our sample from most to least characteristic. The largest gaps in rankings separated the top 3 and bottom 3 (most and least characteristic traits) from the rest, reflecting strong alignment in these items. The most characteristic attributes were adaptability, stability, and taking individual responsibility. Of the respondents, 54% selected at least 1 of these as 1 of their 2 most characteristic attributes. Adaptability was chosen as 1 of the top 2 by 42%, stability by 19%, and taking individual responsibility by 8%. Three traits were most commonly chosen as the least characteristic: being aggressive, being distinctive or different from others, and receiving high pay for good performance. Among the participants, 83% cited at least 1 of these 3 as their 2 least characteristic traits; breaking these down individually, 44% cited being aggressive, 33% cited being distinctive, and 22% cited receiving high pay for good performance. Fairly strong agreement existed between those who indicated most and least characteristic items: 44% selected adaptability, stability, or taking individual responsibility as the most and being aggressive, being distinctive, or high pay for good performance as the least characteristic. More consensus was present for the bottom characteristics than the top characteristics, as evidenced by the percentages (in the text) and the ranks (in the table: the distance from 1 to the top attribute rank versus the distance from 40 to the bottom rank attribute). The contents of Table 3 could be considered a sample OCP for ATs.

Table 3

Ordered Median Rankings of Each Organizational Culture Profile Characteristic

The parameter estimates from the multiple regression models examining the relationships between our OCP variables and the dependent total job satisfaction variable are presented in Table 4. Only models that displayed significant relationships were included. Positive estimates in this table suggest that those who selected the indicated attribute as 1 of their most or least characteristic attributes had higher scores for total job satisfaction than those who did not select that attribute, whereas negative estimates suggest the opposite. As an example, total job satisfaction scores for individuals who selected the attribute of high pay for good performance as least characteristic were 3.62 points lower on average than those who did not pick this trait as least characteristic. Relationships among job satisfaction subscales were always in the same direction (ie, positive or negative estimates) as indicated by the total job satisfaction models. The only additional OCP attribute with a significant subscale association was stability (positive association with job satisfaction, specifically the supervision subscale). Subscales with significant associations were promotion, supervision, contingent rewards, conditions, coworkers, and communications. Finally, significant associations among the demographic variables were as follows: For every 1-year increase in age, the total job satisfaction score increased by 0.36 points; total job satisfaction scores for individuals who had been certified for 15 to 19 years were 7.02 points lower than those who had been certified for <5 years; and total job satisfaction scores for individuals who had been certified for ≥20 years were 10.08 points lower than for those who had been certified for <5 years.

Table 4

Parameter Estimates for Organizational Culture Profile Variables That Were Significantly Associated With Total Job Satisfactiona

Our aim was to analyze job satisfaction and organizational fit among ATs working in a variety of clinical settings. Both the job satisfaction total scores and the subscales were explored with the ranking of the OCP variables. Overall, participants' total job satisfaction score indicated ambivalence, with the lowest subscale scores for promotion, salary, and benefits. This score was slightly lower than that in the US population norms11  and previous athletic training research.21  However, the results coincided with the previous literature12,21,22  in demonstrating that pay and benefits were important employment attributes. The lower total score appeared to be driven by the supervision and benefits subscale scores, because all others suggested more satisfaction than shown in the US norms. Yet these were not among the most correlated with the total score, as seen in the Figure.

### Demographic Results

As age increased, so did an AT's level of job satisfaction. Nonetheless, participants in the 2 categories reflecting the longest time since certification, 15–19 years and ≥20 years, displayed less job satisfaction than those certified for <5 years. This could be attributed to the “honeymoon phase” that occurs at the beginning of employment, when everything is new and fresh. It is reasonable to conclude that ATs tend to stay in their jobs if they are more satisfied; thus, employers should focus on leveraging strategies that affect job satisfaction within the workplace.

### Promotion and High Pay for Good Performance

Increased pay has been directly correlated with increased job satisfaction, and undesirable pay was a common area of concern in an earlier study.22  We found it interesting that respondents who selected high pay for good performance (Table 4) as 1 of their least characteristic traits reported less total job satisfaction on average. Also, those who ranked high pay for good performance as their least characteristic trait showed less satisfaction on the subscale of promotion (JSS). This could be attributed to the need for a specific combination of variables, such as dissatisfaction with pay and a perception of pay inequity, to be present.23  It would support the notion that job dissatisfaction is likely to be exhibited when an individual believes that his or her pay is both below expected standards and inequitable considering the expended output.

A lack of adequate compensation and employment benefits for the workload has often been cited as a contributor to low job satisfaction.5,21,22  The NATA 2018 salary data24  reflected an average national salary of $57 203, approaching a$13 000 increase from the 2008 salary of $44 235. With a cumulative inflation rate of 16.6%, the average salary would have increased25 by only$5612 to an annual salary of $51 591. Hence, although inadequate salaries can lead to low levels of job satisfaction and more work-life conflict, average salaries do appear to be increasing at a higher rate than in other health care professions such as nursing. According to the US Bureau of Labor Statistics,26,27 the mean annual wage for a registered nurse increased by$9907, from $65 603 in 2008 to$75 510 in 2018. If the salary increases for registered nurses had simply kept up with inflation, the average salary25  would have been \$76 513 in 2018.

### Contingent Rewards and High Pay

Participants who ranked high pay for performance as 1 of their least characteristic traits reported less satisfaction on the subscale of contingent rewards (JSS). Contingent rewards are defined as rewards (not necessarily monetary), recognition, and appreciation given for good performance.11  These findings are consistent with previous research,22  which indicated that overall job satisfaction was positively correlated with pay satisfaction and pay level. Contingent rewards and pay are often the lowest items on the job satisfaction subscales and are the greatest predictors of intention to leave.12,21  The job demands of ATs often do not match the pay and benefits.14  This work overload and role strain with little reward and noncompetitive salaries can lead to decreased professional commitment and a lower level of satisfaction.10

### Supervision, Adaptability, Stability, and Taking Individual Responsibility

Participants who selected at least 1 trait among adaptability, stability, and taking individual responsibility as 1 of their most characteristic attributes demonstrated higher satisfaction on the subscale of supervision (JSS). A management style that provides flexibility and autonomy allows employees to create balance in their lives and promotes satisfaction with their jobs.5,16  Mazerolle and Goodman5  found that a management style that supported employee empowerment by affording ATs the ability to make their own decisions and schedules improved work-life balance.

### Coworkers and Individual Responsibility

Athletic trainers participate in, or yield, many areas of responsibility (ie, teaching, clinical, administrative), and engaging in multiple roles increases the likelihood of dissonance.28  Those ATs who had responsibilities that were incompatible with their skills or values were noted as being at higher risk for intent to leave.29  In this study, participants who selected individual responsibility as 1 of their most characteristic traits reported higher total job satisfaction and higher satisfaction on the coworkers subscale (Table 4). This finding supports the notion that a broader level of control over one's responsibilities leads to great satisfaction with one's work.5  In addition, our outcomes support those of earlier investigators4,16  who determined that a supportive workplace was represented by coworkers' relationships and supportive supervisors. Resilient environments yielded positive relationships among coworkers, which often were expressed as support and shared views, attitudes, and behaviors.30  Coworkers were key in positively affecting the organizational climate via stress reduction.4  A shared culture of respect, cooperation, positivity, collegiality, and value of the family were coworker characteristics highlighted as essential to a positive and supportive work environment.4

### Total Job Satisfaction, Contingent Rewards, Conditions, and Communication

Role identity has been recognized as an important factor in distinguishing one's identity.31  Personal fit and role alignment increased the likelihood of ATs being satisfied and finding worth in their role.32  Thus, personal identity, skills, and strengths congruent with role expectations theoretically yield greater satisfaction with one's work.32  Our participants who selected being distinctive or different than others (Table 3) as 1 of their least characteristic traits reported greater total job satisfaction. In addition, those who ranked being distinctive or different than others as 1 of their least characteristics showed higher satisfaction on the subscales for contingent rewards, conditions, and communication.

### Limitations and Future Directions

Several limitations were present in this study. The response rate for the survey was 5.2% and depended on voluntary responses, which increased the risk of selection bias, a common limitation with job satisfaction surveys. This could have skewed the results toward those individuals with a preexisting bias against their job or employer. In addition, data collection occurred during spring 2020, and low response rates could have been attributed to the COVID-19 pandemic. Some of the ATs we sought to contact may have been furloughed and not accessing their work emails during the study's time frame. Low response rates could also be attributed to additional stressors being placed on ATs at home and work. Notably, more women responded (62.5%) to the survey than are represented in the profession (55.9%), according to the 2018 NATA data.24  Furthermore, our sample had a higher percentage of nondiverse respondents (88.8% white) and more younger clinicians (median age = 32 years) with fewer years certified (0–4 at 25.6% and 5–9 at 33.3%). However, we adjusted for age and years certified when conducting the statistical analyses. Adjusting for men and women did not improve the model fit. More AT respondents were employed in the Division I setting (34.7%), and we adjusted for this factor as well. Continuing analysis of organizational fit and job satisfaction in emerging job settings is needed for ATs and will permit comparison of our findings with those for preceptors in athletic training programs.

Several individual and organizational factors best predicted ATs' job satisfaction. Related results addressed and supported the need to examine job satisfaction from various perspectives, including organizational fit variables. First, individuals without a pay-to-perform drive appeared to be less satisfied with the contingent rewards and promotion components of their jobs. These ATs were less likely to be content with their employment if the only advantage was monetary in nature. Next, ATs who could adapt, take individual responsibility, and offer stability reported higher satisfaction with their supervisors. The ATs with these characteristics were more satisfied with employers who did not micromanage and who encouraged autonomous work. Finally, individuals with the characteristic of taking personal responsibility described higher overall job satisfaction as well as satisfaction with their coworkers. The ATs who prioritized tasks and responsibilities appreciated work environments that supported their personal needs and professional obligations. Supportive work environments can be achieved by creating a workplace culture anchored in cohesiveness, with employers who delegate shared responsibilities. Employers can take a wide variety of actions to improve ATs' job satisfaction, such as advocating for work-life balance. These organizational variables extend far beyond monetary rewards into an employer's management style, leading to an environment that allows for flexible work schedules, autonomous work environments, and job sharing.

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