Organizational-Professional Conflict in the Collegiate and Secondary School Practice Settings: A Sequential, Mixed-Methods Study

Abstract

Context: Athletic trainers (ATs) are employed in various settings, which may use 1 of 3 organizational infrastructure models: (1) the sport/athletic model, (2) the medical model, and (3) the academic model. These different settings and organizational infrastructure models may result in varying levels of organizational-professional conflict (OPC). However, how OPC may differ across infrastructure models and practice settings is not known. Objective: To examine the prevalence of OPC among ATs in various organizational infrastructures and explore ATs’ perceptions of OPC, including its precipitating and mitigating factors. Design: Sequential explanatory mixed-methods study with equal emphasis on quantitative and qualitative components. Setting: Collegiate and secondary school institutions. Patients or Other Participants: Five hundred ninety-four ATs from collegiate and secondary schools. Data Collection and Analysis: We conducted a national cross-sectional survey using a validated scale to assess OPC. We then followed the quantitative survey with individual interviews. Trustworthiness was established with multiple-analyst triangulation and peer debriefing. Results: Athletic trainers experienced low to moderate degrees of OPC with no differences across practice settings or infrastructure models. Poor communication, others’ unfamiliarity with the AT’s scope of practice, and lack of medical knowledge were precipitating factors for OPC. Organizational relationships founded on trust and respect for one another; administrative support in that ATs were listened to, decisions were endorsed, and appropriate resources provided; and autonomy given to the AT were key components to preventing OPC. Conclusions: Most ATs experienced primarily low to moderate OPC. However, OPC continues to permeate professional practice to some extent in collegiate and secondary school settings, regardless of the infrastructure model used. The findings of this study highlight the role of administrative support that allows for autonomous AT practice as well as effective communication that is direct, open, and professional to decrease OPC.