Athletic Trainer Services in Public and Private Secondary Schools

Abstract

Context: The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored. Objective: To compare the level of AT services in public and private secondary schools.Design: Concurrent mixed-methods study. Setting: Public and private secondary schools in the United States.Patients or Other Participants: A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private).Main Outcome Measure(s): School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis.Results: A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators.Conclusions: Both public and private secondary schools lacked ATs, but higher percentages of total AT services and fulltime services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector.Key Words: sports, athletes, medical coverage Key PointsThe public secondary school setting provided more athletic trainer (AT) services than the private school setting. Although AT services were lacking in both public and private secondary schools, the number of student-athletes in each sector with access to medical care was similar. Barriers to employing ATs in public and private settings were budgetary constraints, school size, and lack of awareness of the AT's role. An additional barrier unique to the public sector was rural location.

A Comparison of Emergency Preparedness Between High School Coaches and Club Sport Coaches

“…Just over half of high school coaches reported that an AT was present at their practices at least some of the time versus nearly 80% who stated that an AT was present at their competitions at least some of the time. These coverage levels are similar to those observed earlier [5][6][7][8]30,31 : between 34% and 70% of high schools used the services of an AT, but the level of coverage provided (full time, part time, etc) varied widely based on school and community characteristics. Significant resources have been expended with the goal of increasing medical coverage at the secondary school level, and although improvements can still be made, these efforts have increased access to AT services in high schools during the past 20 years.…”

“…Emergency preparedness and training of high school coaches have been investigated extensively. [6][7][8][9][11][12][13][14]20 However, to our knowledge, this is the first study to compare emergency preparedness and training among high school coaches and coaches of high school-aged club teams.…”

“…Financial restrictions have been repeatedly identified as the primary barrier to hiring an AT, purchasing AEDs, and providing training to school personnel. 6,9,10,25 At the high school level, these funds are typically appropriated through the school or school district budget, which in turn is funded via federal, state, and local taxes. Conversely, the funds available to club teams and organizations stem primarily from fees paid by participants.…”

“…Over the past few decades, as a result of legislation, regulation, and self-assessment, high schools and high school associations have improved their training and preparedness for responding to emergencies and injuries. In the United States, 34% to 70% of high schools used the services of an athletic trainer (AT), [5][6][7][8] 48% to 94% had at least 1 automated external defibrillator (AED) on campus, [7][8][9][10][11][12][13] and 38% to 84% had established an emergency action plan (EAP). [7][8][9][11][12][13][14] These improvements in emergency preparedness are very important, as the implementation of an EAP by trained medical professionals that led to prompt use of an AED dramatically increased survival rates after sudden cardiac arrest in adolescents.…”

Incidence reporting via online high school concussion surveillance by certified athletic trainers and school nurses, 2015–2018

“…In New Jersey, a survey reported about 95% of public secondary schools had certified athletic training services, of which 91% served the school full time (Pryor et al 2015). For comparison, 70% of U.S. public secondary schools had athletic training services, although only 37% of them served the schools full-time (Pryor et al 2015;Adams et al 2019), and among public and private U.S. secondary schools combined about 58% had athletic training services, with 28% full-time (in NJ, 68 and 36%, respectively) (Pike et al 2017;Pike et al 2016). The present study, which had a greater involvement by certified ATCs than school nurses, documented a small difference in reporting symptoms by school nurses versus school ATCs.…”