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Abstract

Context: Athletic trainers (ATs) who complete accredited residency training in a specialty area are considered clinical specialists, yet more information is needed to determine whether they are practicing within the higher capacity expected of a specialist. While some quantitative evidence demonstrating the value of residency-trained ATs on patient satisfaction, patient throughput, and the financial impact specific to the physician practice setting exists, residency training is not limited to only ATs who want to provide services in physician practice. Moreover, as accredited athletic training residency programs continue to emerge, it is increasingly important to understand key stakeholders’ perceptions of residency-trained ATs as well as their experiences working with these clinical specialists. Understanding the employers’ perception of the value of athletic training residency training is especially important since these individuals are involved in the hiring decisions of a clinical practice setting. Therefore, we aimed to explore employers’ perceptions of, and experiences working with, residency-trained ATs. Methods: We followed a consensual qualitative research design and recruited a purposeful sample of participants. We contacted our professional network of employers who have hired a CAATE-accredited orthopaedic-focused residency-trained AT to participate voluntarily. We achieved data saturation following individual videoconference interviews with 14 employers (4 physicians, 10 ATs; 11 men, 3 women; average age=42.0±7.2 years; clinical experience=17.2±7.4 years) working in the hospital/outpatient center (n=8), sports medicine/orthopaedic clinic (n=3), or college/university (n=3) setting. Following development, the 10-item, semi-structured interview guide used for this study was reviewed by 3 residency experts for content validity and piloted with 1 employer that met the study criteria to ensure clarity and flow of the interview questions. Following transcription, a 4-person analysis team coded the data into themes and categories. Three researchers coded the data and met regularly throughout a 3-phase consensus process. We ensured trustworthiness of the data via member-checking, multi-analyst triangulation, and the use of internal and external auditors. Results: Two predominant themes emerged during data analysis: employer perceptions of residency-trained ATs and employer experiences working with residency-trained ATs. Employers perceived that residency-trained ATs could assimilate into the practice setting faster than their non-residency-trained AT counterparts. Employers highlighted that residency-trained ATs had a better depth and breadth of knowledge of athletic training practice and could practice at the top of their scope more quickly after orienting to the practice setting. Employers also perceived that residency-trained ATs experience increased compensation and faster career advancement than the non-residency-trained ATs at the same employment sites. Employers described how residency-trained ATs increase the efficiency of the practice setting, allowing greater throughput and increasing patient accessibility to providers. Employers discussed that residency-trained ATs improved patient satisfaction scores in the practice setting and were also able to increase awareness of athletic training with other providers in the setting. Translation-to-Practice: Our findings indicate that employers can discern differences between residency-trained ATs and non-residency-trained ATs. Residency-trained ATs add value to practice, and their residency training likely prepares them more adequately for assimilation into practice than professional education alone. Positive outcomes of hiring residency-trained ATs included increased patient satisfaction, increased practice efficiency, and added economic value to the care team. Since residency training aims to develop clinical specialists, employers of ATs should aim to hire a diverse group of clinicians that includes both generalists and specialists. Mentors of athletic training students should guide them to accredited athletic training residency programs if becoming a clinical specialist aligns with the student’s professional development goals. Disclosure: The findings presented in this abstract are from a study funded by the NATA Foundation (#1819EGP01).

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