By Laura Smith
Laura Smith is an Assistant Editor at Athletic Management.
Training & Conditioning, 13.9, December 2003, http://www.momentummedia.com/articles/tc/tc1309/addingdepth.htm
In 1972, when East Stroudsburg University Athletic Trainer Lois Wagner handed a freshman a roll of tape, she didn’t think she was making history. She simply saw a student-athlete who displayed an uncanny ability to tape ankles. Freshman Marsha Grant-Ford didn’t think they were breaking down barriers, either. But several years later, she became the first African American woman to become certified as an athletic trainer.
“I was an athlete and I had gotten hurt, and I ended up hanging around the athletic training room. I thought it was pretty neat,” says Grant-Ford, ATC, PhD, now an Assistant Professor of Athletic Training at Montclair State University. “With Lois, East Stroudsburg had a woman athletic trainer on staff at the time, and while I was there, they hired a black male athletic trainer. So I thought, women do this, black people do this—I’m in the right place. Little did I know how unusual that situation was. Elsewhere, there were very few women, and there were even fewer black people.”
Times have changed when it comes to the presence of females in athletic training: Women now make up roughly half of the NATA’s membership. However, the years have done little to change the fact that there are very few ethnic minorities entering the profession. Of the NATA’s certified members, 85 percent are Caucasian, three percent are Asian or Pacific Islander, three percent are Hispanic, and two percent are black. (The remaining seven percent haven’t specified their ethnic backgrounds.)
“The lack of diversity in our profession has been there for as long as we’ve been collecting data,” says Frank Walters, PhD, ATC, Director of Athletic Training for the District of Columbia Public School System. “The million dollar questions are why, and what can we do to change it?”
In recent years, the NATA and others within athletic training have stepped up efforts to answer those questions. We’ll discuss how the lack of diversity inhibits athletic training’s ability to serve athletes, the latest thinking on some of the factors involved, and how athletic trainers at every level can become part of the solution.
WHY DIVERSIFY?
One of the most compelling reasons for adding more minorities to athletic training’s professional ranks is the huge ethnic diversity among student-athletes. Across all three NCAA Divisions, 35 percent of student-athletes are non-white. At the Division I level, non-white athletes make up 50 percent of the football and men’s and women’s basketball rosters.
“The percentages of ethnic minorities within athletic training aren’t that much different than those in health care fields that serve the general population,” says David Perrin, PhD, ATC, Dean of the School of Health and Human Performance at the University of North Carolina-Greensboro. “But the numbers within the student-athlete population don’t reflect the general population. Given the population we serve, we should be doing much better.
“Being a more diverse profession would allow us to better understand the needs of the athletes we deal with,” Perrin continues. “For the same reasons a female student-athlete might be more comfortable discussing certain concerns with a female athletic trainer, a minority athlete might feel more comfortable sharing information with a minority athletic trainer. The more diverse the profession becomes, the greater the chances are that an individual department will have a diverse staff and be able to meet that need.”
Failure to understand and connect with student-athletes from underrepresented groups can have a detrimental effect on treatment outcomes, according to Grant-Ford. “When you’re trying to serve a diverse population, failing to understand and appreciate their differences leads to patient noncompliance,” she says. “A student-athlete who is not comfortable in your athletic training room is not going to fully listen to what you’re telling him or her, and may not even come back. And that means an outcome that is less than optimal.”
“Without enough people in the profession to reflect the population you’re serving, you’re going to have blind spots in terms of how to best work with different athletes,” says Karen Stinson, founder and CEO of Professional Development Group, Inc., a Minneapolis-based consulting firm that addresses diversity in the workplace. “Professions that lack diversity often have a narrow perspective to work with, and that can really hurt them. The worst part is, you won’t know what you don’t know—an athlete may not respond well to your care, and you won’t realize what you’re missing.
“This doesn’t mean each student-athlete must be treated by an athletic trainer of his or her own ethnicity, obviously,” she continues. “But the benefit comes when there is enough diversity that someone else on your staff can tell you, ‘I think you may get better results with this other approach.’”
Student-athletes aren’t the only ones who are affected by athletic training’s lack of diversity. “There is a sense of enrichment that comes from the cooperation of a diverse group of people all working toward a common goal,” says Daniel Nevarez, MS, ATC, Assistant Athletic Trainer at California State University-Northridge. “It benefits not only the majority members who interact with minorities, but the minorities themselves. It makes everyone’s lives richer. In athletic training, we’re missing out on that.”
HIGH SCHOOL OUTREACH
In attempting to crack the tough question of why there isn’t more diversity, many have suggested that the profession is failing to attract ethnic minorities at the high school level. One reason is that urban schools with relatively large numbers of students in ethnic minority groups are chronically under-served when it comes to athletic training. These students are less likely than their peers in suburban schools to see an athletic trainer at work, so athletic training doesn’t even make their list of career possibilities. And if they do encounter an athletic trainer, they may not see that person as a role model.
“Whether or not anyone says it out loud, when ethnic minority high school students consider careers, they look at who’s already there,” says Carlton Anderson, ATC, Head Athletic Trainer at the University of North Carolina-Charlotte. “And if they see people they can relate to, they’re more apt to strike up a conversation, ask some initial questions, and get started down a particular career path.”
“It’s a self-perpetuating cycle,” Walters adds. “The lack of ethnic minority athletic trainers means students don’t get to see them, and because they don’t see them, they don’t know the field exists or they aren’t attracted to it. And so the current demographics will persist unless we can break that cycle.”
To start breaking the cycle, many athletic training educators are rethinking their recruiting. For example, Jolene Henning, EdD, LACT, ATC, who directs the Athletic Training Education Program at the University of North Carolina-Charlotte, is using a grant from the NATA’s Ethnic Diversity Advisory Committee (EDAC) to develop a new recruiting brochure for distribution in Charlotte-area high schools and to hold an exploration day when students can visit her campus to see athletic training close-up. The effort doesn’t specifically target minorities, but “we’re making sure the brochure will appeal to minorities, and the exploration day will provide them with a chance to see the diversity we have among our current students and instructors,” Henning says.
A similar effort is taking place at Kent State University, under the direction of Kimberly Peer, EdD, LATC, ATC, Athletic Training Education Program Coordinator. With an EDAC grant and university funding, Peer is targeting 10 Akron- and Cleveland-area high schools with an athletic training presentation at each site, followed by a camp for juniors and seniors. The camp will be held in Gund Arena, and students will have a hands-on opportunity to learn taping skills and talk with Kent students about applying to college. Students who express an interest in the field will be matched with an athletic training student at Kent State. “We’ll bring them to campus to sit on the sidelines with their mentors during contests so they’ll get to feel what the job is actually like,” Peer says.
“High school athletic trainers in other areas of the country could initiate something similar,” Peer continues, “by contacting the nearest accredited program, inviting them in, and organizing a time for them to meet with interested students.”
High school athletic trainers can also get involved in less formal ways. Veronica Ampey, MS, ATC, Coordinator for High School Health Care at Georgetown Day High School and Chair of the EDAC, takes National Athletic Training Month in March as an opportunity to educate high school students about the field. “We’ve held blood pressure screenings, injury evaluations for non-athletes—a variety of activities to get them to stop by the athletic training room,” she says.
Grant-Ford suggests forging connections with parents of high schoolers, who are often pivotal in their children’s career choices. “Athletic training isn’t widely recognized in a lot of ethnic minority communities,” she says. “So if you’re a mom or a dad and you have a child who is interested in a career in medicine, you tell them to be a doctor, or a nurse, or maybe a physical therapist. ‘Athletic trainer’ doesn’t make the list. High school athletic trainers can help to change that.”
Another idea is to consciously seek out minority students. “Go beyond the student-athletes you see every day,” says Walters. “Find out what pre-professional groups or clubs your school has. Ask the biology teacher or the guidance counselor to recommend some students.”
Athletic trainers who are minorities themselves can be great mentors for minority students, but those who are not ethnic minorities can also be successful mentors. “I got interested in athletic training in high school because an athletic trainer took an interest in me when I was an injured athlete and took me under his wing,” says Anderson. “I’m black and he’s white, but that wasn’t what mattered. What mattered was that he cared about me, he had confidence in me, and he told me that I could do this job.”
“Cross-cultural mentoring doesn’t have to be complicated,” agrees Walters. “It just requires a genuine desire to get to know this individual student and an understanding that you might find some differences in this student’s experience from your own.”
Cross-cultural mentoring can break down, however, when mentors feel the student must do things exactly as they did them, or when they fail to understand the special needs that a student of color from a lower economic profile might bring with them. “The student might not be able to be in the athletic training room every day—they might only be able to be there one day a week,” Walters says. “When they do come in, they might have their little brother or sister with them, because they are the one responsible for him or her after school. Ask yourself if you are willing to have a broader perspective and get creative. What can you do with this little kid they bring in? Show them how to do something, make them a water boy. When you’re mentoring a child of a different ethnic background, the color of your skin isn’t what’s going to matter, as long as you can understand and accept things that might be different from what your own experience has been.”
Another way certified athletic trainers can help is to consider serving in different settings, including inner-city schools. “Putting yourself in an unfamiliar environment can be scary, but athletic trainers who can put aside their concerns and misconceptions find that serving in an inner-city school is no different than serving anywhere else, and you can have a great impact,” Walters says. “There’s at least one minority individual, and possibly several more, who have pursued athletic training careers because they were exposed to it here. It’s a long process, but it does work.”
RECRUITING & HIRING
While attracting high school students to the field is an important first step, the second step is for college head athletic trainers to rethink their hiring strategies. This starts with successfully recruiting minority applicants.
Scott McGonagle, MS, ATC, Head Athletic Trainer and Athletic Training Education Program Director at the University of Miami, does this by networking. When travelling, he tries to meet as many athletic trainers as possible, including those in minority groups or who know people who are.
“I introduce myself and get to know them,” McGonagle says, “so that if I need someone, I can pick up the phone and call people who are in touch with the minority athletic training community and say, ‘I have an opening, do you know anyone?’”
McGonagle uses his existing staff to expand his network as well. “Whenever we’re hiring, I turn to my staff and say, ‘Who do you know?’” he says. “All of them understand our mission: to get the biggest mix of people possible in the candidate pool, and then hire the best person from that mix. So they take the time to think about a wide variety of people they can call to make that happen.”
Having a reputation for valuing diversity can make word of mouth your biggest recruiting asset. “If there truly is a value placed on diversity at a particular school, minorities will hear that these are good places to work,” Nevarez says. “You’ll start getting more diverse applicants because the word will get out. ”
Building such a reputation takes creativity. Grant-Ford suggests, for example, not insisting on a Master’s degree, but telling someone with only a BS that the department will help them earn the advanced degree. “If you value diversity and you haven’t had diversity, you might need to sweeten the pot for a period of time to attract someone to your university to give it a try,” she says.
McGonagle also keeps an open mind when looking at resumes and references. “A lot of people want to see a name they recognize on someone’s resume, or a big-time name, and if they don’t, they write the candidate off,” he says. “If I find a candidate who doesn’t have a big name on their resume, but who fits our bill, I will always talk to them.”
Once you’ve managed to expand your pool of minority candidates, there are some nuances to be aware of during interviewing. First, according to Grant-Ford, be aware of the messages the candidate may be getting from other members of your staff, or even administrators or receptionists they encounter during their interview. “Even if you’re committed to diversity, negative messages they get from others can make the environment less than welcoming, and make them think twice about your program,” she says. “You need to address anyone who’s sending those messages and make sure that everyone is on the same page with regard to diversity.”
It’s also important to put some thought into how you’re going to address the issue of ethnic diversity during an interview. “Don’t shy away from bringing it up,” Grant-Ford advises, “but choose your approach carefully. It’s very easy to make someone feel like a token or a quota by stressing the fact that you’re looking for ethnic diversity.”
Nevarez agrees. “No one wants to feel as if they’re being considered for a job because of the color of their skin, and approaching the issue carelessly can give that impression,” he says. “It’s important to communicate to your staff and to the candidate that you’re interviewing this person because of their skills, because they have great experience, because you liked their references.”
However, you can tell the candidate, “‘You probably noticed that there isn’t a lot of diversity here right now,’” Stinson says. “‘We have a plan to create a more respectful and inclusive environment for everybody. Here are some things that we’re doing.’
“It may be that you have a diversity council to work on the issue, or you’re looking at your policies and procedures to make sure they’re fair for everybody. And then tell them, ‘We’re not putting the pressure on you to make these changes. We want you to know we’re committed to doing it, and you could help us.’
“But you really have to be committed and have a plan in place,” she cautions. “If it’s just words, you may hire someone, but you won’t retain them.”
CLIMATE CONTROL
Having a “plan in place” starts with a commitment from the head athletic trainer. “A head athletic trainer is in a power position,” Stinson says. “The attitudes of the rest of the staff are going to flow directly from the tone that person sets.”
“As a head athletic trainer, you need to take an honest look at yourself and make sure you aren’t operating from any preconceived ideas about what people from other ethnic backgrounds are like,” Anderson adds.
If you’re not sure how to analyze your own and others’ actions, you may want to consider diversity training. However, Stinson warns that these are effective only if you start by setting clear goals for what you want to accomplish, and follow up after the training is done.
“The next step is to get everyone on your staff together and lay out your expectations. This is especially important if it hasn’t been done before in your department,” Stinson says. “Call a meeting and say, ‘We’re going to be focusing on having an environment where everyone is respected and can function to their full potential, and here is what I expect from you.’”
Putting expectations in writing can help as well. “We suggest that departments develop a set of core values or operating principles regarding diversity,” Stinson says. “They should be as simple and as clear as possible. For example, at ProGroup, one of ours is, ‘We recognize the diversity of our organization as a strength to be accepted and appreciated.’ Others are, ‘We will listen with respect to each other and clients and will be clear and honest in all communications,’ and ‘Good intent is assumed and we act in ways that build trust.’
“Post the core values in obvious places around the athletic training room, weight rooms, locker rooms, and offices,” she continues. “Use your meeting to go over the list, and ask your staff if they would like to add anything.”
Stinson teaches clients about a concept she calls the “appreciation scale,” which is an essential part of setting expectations. “When we meet someone who is different from us, we respond to them in one of five basic ways,” she explains. “At one end of the scale is appreciation. Next is acceptance, then tolerance, then avoidance, and last is repulsion. The key to setting expectations is understanding how we behave toward someone we appreciate. It’s a host of little behaviors that add up: Do you greet them when they walk into the room? If you appreciate them, you do. If you tolerate them, you might not. What if the person makes a mistake? What do you assume about their intentions? Appreciation says you assume good intent. Tolerance or avoidance says, ‘I don’t think they’re really trying.’
“The key is to realize that you are responding on the basis of one of these values to everyone you deal with,” she continues. “In the workplace, it’s essential to set the bar at appreciation. Once you understand what that behavior looks like, you communicate to your staff that the norm in your environment is that everyone will be treated that way.”
The way you interact with diverse student-athletes will also send a clear message to your staff about expectations. “Do you treat them with respect, or do you speak down to them?” Anderson says. “Do you act comfortable around them, or minimize your time with them?”
“Take the time to learn about different populations’ needs,” adds Grant-Ford. “For example, by educating yourself about the alternative medical treatment a Native American athlete gets at home, you demonstrate respect, intelligence, and commitment. It tells your staff that diversity is something that’s important to you.”
Lastly, setting the tone requires providing ongoing feedback. “Commend people who are following your expectations, and call people on it when they don’t,” Stinson says. “You have to be consistent, and committed, and even courageous to have those conversations, but it’s part of your job.”
Ampey agrees. “When someone makes a mistake, it’s important to use those teachable moments,” she says. “It may be a sensitive issue, but simply say, ‘These are the things we are not going to tolerate and here’s why.’”
The physical environment of your athletic training room can foster a positive climate. “If you have posters on the walls, make sure there are all kinds of people pictured on them,” says Grant-Ford. “If you work in an area where many people speak a language other than English, have copies of literature in their language. All of these things may seem small, but they add up to the overall environment, and they do matter.”
Making your athletic training program inclusive also means not putting the burden of change on a minority staff member. And this last piece of advice may be the most important for long-term change.
“We call it the ‘double whammy,’” Grant-Ford says. “All of a sudden, because you’re the only one there, you’re expected to sit on every committee, speak at every function, and serve as the minority representation on every issue. As athletic trainers, we’re already doing multiple things just to succeed at our jobs, but your department can make you feel guilty if administrators don’t think your doing enough about the diversity issue.
“Even though many minority athletic trainers will be enthusiastic about doing what they can,” she continues, “employers need to remember that the responsibility for change is still theirs, not the employee’s.”
For more information on programs offered through the NATA’s Ethnic Diversity Advisory Council, including grants and mentoring, visit www.edacweb.org.
To read more about how athletic trainers can effectively serve an ethnically diverse student-athlete population, visit www.momentummedia.com/articles/tc/tc1106/sensitivity.htm
SIDEBAR
Especially For Educators
Directors of athletic training education programs are in a great position to help make athletic training a more diverse profession. Here are some suggestions on how to get started.
Recruit on your own campus. Kimberly Peer, EdD, LATC, ATC, Athletic Training Education Program Coordinator at Kent State University, makes contact with on-campus groups for ethnic minority students and informs them about the major, learns which academic advisors work with minority students and provides them with materials, and asks to make presentations on the athletic training major to freshmen survey or careers classes. “When we catch kids early on in their first semester, even those who didn’t know anything about the major coming in can get in their first year rotation,” Peer says. “Since we’ve been making this effort, we’ve noticed an increase in minority Kent students coming into our program.”
Make diversity a curriculum staple. “Addressing diversity across the board in athletic training classes will draw more minority students to the profession, because they’ll see that we’re a field that values diversity,” says David Perrin, PhD, ATC, Dean of the School of Health and Human Performance at the University of North Carolina-Greensboro. “It will also produce athletic trainers who are more educated and more appreciative of diversity, and they will be our ambassadors and mentors to diverse youngsters who will be drawn to the field.”
It’s important to make diversity an ongoing curriculum component, however, not just a one-time class. “We cover it in a lot of areas—basic competency classes, professional development classes, practicum,” says Peers. “It needs to be built into the fabric of the curriculum, not a token lecture.”
Recruit a diverse faculty. “Students of color are drawn to programs where they see people of color teaching,” says Dan Hibbler, PhD, Research Associate and Assistant Professor at Florida International University, who studies sports and ethnic diversity. “If they don’t see that, they may decide that’s not the institution for them. And it may turn them off to the field altogether.”
Make your students ambassadors. “Talk with your students about the need for more diversity in athletic training, and urge them to invite a friend to sit in on a class or visit the athletic training clinic,” says Perrin.
Small increases can add up. “If each of the 200-plus accredited programs, which typically graduate classes of about 10 students a year, had one more minority student per class, four years from now, we’d have 200 new minority athletic trainers in the field,” says Perrin. “If every curriculum director would make an effort to become engaged in this, we could very quickly make a significant impact.”
SIDEBAR
Workplace Mentors
Succeeding on the job often means being taken under the wing of someone more experienced. One of the best ways a head athletic trainer can support a minority staff member is by making sure that this takes place.
“Mentors have many roles,” says Marsha Grant-Ford, ATC, PhD, Assistant Professor at Montclair State University. “They support you, teach you coping mechanisms, help you build your resume, tell you about opportunities, vouch for you. Without our mentors, most of us wouldn’t be where we are today.”
“We’ve found that one of the greatest predictors of job satisfaction is whether a person is being mentored,” says Karen Stinson, founder and CEO of Professional Development Group, Inc., a Minneapolis-based consulting firm that addresses diversity in the workplace. “Many times, mentoring happens naturally and informally for some groups, but not for others. Minority staff members can be left out of that loop, because people tend to mentor someone who they feel is similar to them. That can really place minorities at a disadvantage, because when it comes time to tap someone for a new project or a promotion, people look for the staff members they’ve been mentoring. Minorities end up getting passed over and they no longer feel like they’re being given the chance to grow and advance.”
Making sure minority staff members have the same access to mentoring as others often means making the system more formal for everyone on staff. “Don’t say, ‘We’re going to provide you with a mentor because you’re a minority and you need special help,’” Stinson offers. “Instead, work out a system whereby everyone has a mentor, and coach them on what that role means.”
Pointing a minority staff member to a mentoring program recently launched by the NATA’s EDAC can provide another resource. The program matches minority athletic training students or athletic trainers who have been certified for less than three years with minority athletic trainers who have been certified for more than three years. People interested in finding a mentor can visit the EDAC Web site (edac.web.org) and click on their area of the country to locate mentors near them.
“I don’t think every minority athletic trainer necessarily needs to have a minority mentor,” says Grant-Ford, who serves as an EDAC mentor. “But for some people, it’s important.
“Sometimes someone will call and express frustration about issues they’re facing as a minority, and having been through that, I can give them some help,” she says. “I help them think through the situation and say, ‘Here are some suggestions you could try.’ Since there aren’t a lot of us, it’s not likely that they’re going to have a minority mentor present when they need one. This is a way they can get some guidance without having the mentor present.”