The NCAA News - News and Features

The NCAA News -- May 24, 1999

Athletic training change likely to affect NCAA membership

Issue involves student athletic trainers

BY DAVID PICKLE
STAFF WRITER

Although a new procedure for certifying athletic trainers is still five years from implementation, the time is approaching when institutions should consider how they are going to deal with the change.

Now and in the future, aspiring athletic trainers must pass a test in order to be certified. What will change in 2004 is who will be eligible to take the certification test.

"Formerly, there were two routes to certification," said Eve Becker-Doyle, executive director of the National Athletic Trainers' Association (NATA). "One was through the bona fide curriculum program, which involves accredited programs at universities across the United States. The other was through the internship route. There were pros to both ways of going about it, but it was decided we should have one route to certification, which is curriculum."

On the surface, this would appear to be a matter of interest only to the athletic training community. However, the issue has broader ramifications for many intercollegiate athletics programs.

Although the athletic training staff at almost all member institutions is headed by a certified athletic trainer, many schools have benefited from the manpower provided by prospective student athletic trainers who are accumulating the 1,500 hours required to be eligible for the certification test.

Because the internship incentive will disappear in 2004, some administrators foresee a possible shortfall in their athletic training needs. What makes the matter more urgent is that the time is at hand when a student who desires to be an athletic trainer must consider enrolling at an institution with a curriculum certified by the Commission on Accreditation of Allied Health Education Programs.

Curriculum supply and demand

James W. Watson, director of athletics at West Liberty State College and member of the Division II Management Council, is concerned about what this means for student-athlete welfare and for smaller institutions.

"My concern is that many Division II schools do not have curriculums," Watson said. "Therefore, the student athletic trainer pool at schools without curriculums will be virtually nonexistent.

"You won't have kids who want to go into athletic training coming to schools without curriculums. And the problem with that is that it leaves a void in the coverage, which is already minimal at some institutions."

Chad Starkey of Northeastern University, chair of NATA's education council, agrees that athletic training needs must be met, but he does not believe that the educational process is the means to achieving adequate coverage.

"When I hear someone say 'I need to have a program so I can have students,' that becomes a work-force issue," Starkey said. "I think ultimately the ideal case would be for those institutions to have an adequate certified athletic training staff.

"For the most part, the football team doesn't use student coaches and if you look at a basketball team, it has 15 players and three full-time coaches. That same school might have 300 or 400 athletes and only one certified athletic trainer. There has to be some onus of responsibility on the part of the institution itself in providing adequate athletics health care."

On that point, Watson agrees.

"There have not been enough dollars expended, especially at the Division II level, to hire the necessary trainers, particularly if student trainers are going to evaporate, so to speak," Watson said. "CEOs are going to have to realize that there is a student-athlete welfare issue here -- the quality and standard of care of the coverage."

Although Division I-A has the largest percentage of accredited programs (25 percent), only 19.4 percent of all Division I institutions have certified athletic training curriculums. The percentage in Division II is 7.1 percent; in Division III, it is 4.9 percent. Overall, 10.2 percent of NCAA institutions currently have certified curriculums. In all divisions and all sizes of institutions, many more colleges and universities are not accredited than are.

Starkey said it is likely that more programs will be certified by 2004 -- 70 applications currently are pending -- but the change probably will not be dramatic. So, with the internship option eliminated and all prospective athletic trainers soon to be bunched into fewer than 20 percent of the schools, what are institutions supposed to do to provide adequate athletic training coverage?

"Nobody is saying that just because you don't have an accredited athletic training program you can't get student help," Starkey said. "Certainly work study can help."

He cited the cases of Harvard University and the Massachusetts Institute of Technology, both of which have met their athletic training needs even though, as Starkey said, "students don't go to Harvard or MIT to become athletic trainers."

"They get some student affiliations from locally accredited programs," Starkey said. "They also have people who are attending Harvard or MIT, enjoy the (athletics) environment, have work study and rather than going to the library and dusting off books, they go down and lend a hand in the athletics department."

Dick Emerson, head athletic trainer at Harvard, said at one time he did attempt to use individuals from the general student body as student trainers.

"Basically, they just wanted to come down here and hang around with the doctors because they were pre-med," he said. "They were looking for that exposure, looking at X-rays and that sort of thing. They weren't interested in learning the basics of athletic training. So that doesn't work."

Instead, Harvard has acquired student athletic training assistance in cooperative arrangements with Northeastern and Boston University. The students are assigned athletic training duties as part of the curriculum at the school at which they are enrolled.

Good for all?

While such an arrangement works well for Harvard and perhaps other institutions located in urban areas, it would not appear to relate as much to a school such as West Liberty State, situated in West Liberty, West Virginia.

Should an institution such as West Liberty address this problem by adding an athletic training curriculum? Wouldn't that add athletic trainers to the staff and faculty while bolstering student training resources?

It is an alternative, one that a number of institutions appear to be considering. But it raises the question of whether it is appropriate for an institution to make curriculum decisions based on considerations that are not necessarily academic.

Further, Watson questions what might be gained. "It might help you from a student trainer standpoint," he said, "but it wouldn't help from the standpoint of having certified athletic trainers out there with your teams. If you had two people, they could each teach six hours and each be a half-time trainer for the athletics population. But two halves is still a one in terms of coverage for your teams."

Karen Toburen of Southwest Missouri State University, vice-chair of the Joint Review Committee on Athletic Training, was quoted on that matter in the May issue of NATA News.

"I've had people in the workshops we've presented stand in front of a whole group and admit that (the possible loss of student trainers) is the only reason they're looking into accreditation. They don't know what they're going to do without their student athletic trainers. That is the wrong reason to have a program.

"You need to have an academic program in athletic training that has the same status as any other major. They have faculty members, they teach classes.

"If a school is going to have its certified athletic trainers who care for the athletes also teach classes, who's going to help with the workload? Caring for athletes is already extremely time-intensive. The reality is more positions have to be added. Certified athletic trainers cannot run a curriculum and take care of all the student-athletes at the same time."

In the final analysis, there is so much difference in the number of student-athletes and available resources that it seems almost impossible to discuss the needs of West Liberty and Harvard at the same time. Harvard soon will have a full-time athletic training staff of eight for a student-athlete population of about 1,500. West Liberty has one full-time athletic trainer for all of its student-athletes.

That difference -- and the fact that it may be growing -- is Watson's concern.

"You've got Division I with lots of curriculums, lots of staff athletic trainers and kids in those curriculums to fill student athletic trainer roles, and they've got medical schools and so forth," he said. "So you've got a standard of care that's clearly different than what Division II is going to end up with. We know our care is suspect now (based on a recent survey on emergency care). So what will it be like when this kicks in?"

Starkey strongly believes that student-athletes should be provided adequate athletic training support, but he also believes that trainers should be better prepared. In his view, the new policy is the best approach.

"Having two different preparation methods to the same end, No. 1, was confusing to potential employers," he said. "And No. 2, we found that there were in many, many cases, significant differences in the quality of preparation between the two.

"An analogy that's often used is this: If you want to be a physician, you go to medical school. If you want to be a physical therapist, you go to physical therapy school. And we're saying, if you want to be an athletic trainer, you have to attend an athletic training program."

Accredited athletic training programs

The standard for who is eligible to be certified as an athletic trainer was changed in 1996 by the Board of Directors of the National Athletic Trainers' Association as part of an NATA education reform initiative. The policy change states: "The NATA should work with the NATABOC to institute a requirement, to take effect in 2004, that in order to be eligible for NATABOC certification, all candidates must possess a baccalaureate degree and have successfully completed a CAAHEP accredited entry-level athletic training education program."

The following is a list of entry-level programs currently accredited by CAAHEP (Commission on Accreditation of Allied Health Education Program):

Division I-A

University of Alabama, Tuscaloosa

Ball State University

Brigham Young University

California State University, Fresno

Central Michigan University

East Carolina University

Eastern Michigan University

University of Illinois, Champaign

Indiana University, Bloomington

Indiana State University

University of Iowa

Kansas State University

Marshall University

Miami University (Ohio)

New Mexico State University

University of North Carolina, Chapel Hill

Oregon State University

Pennsylvania State University

University of Pittsburgh

Purdue University

University of South Carolina, Columbia

University of Southern Mississippi

Temple University

Texas Christian University

University of Toledo

University of Tulsa

Washington State University

West Virginia University

Division I-AA

Appalachian State University

Boise State University

Duquesne University

Eastern Illinois University

Eastern Kentucky University

California State University, Northridge

California State University, Sacramento

University of Delaware

Hofstra University

James Madison University

University of Montana

Samford University

Southeast Missouri State University

Southwest Missouri State University

Southwest Texas State University

Southern Illinois University at Carbondale

Troy State University

University of Vermont

Division I-AAA

Boston University

Stetson University

Division II

Barry University

California University (Pennsylvania)

University of Charleston (West Virginia)

East Stroudsburg University of Pennsylvania

Grand Valley State University

High Point University

Lock Haven University of Pennsylvania

Mercyhurst College

Minnesota State University-Mankato

University of New Hampshire

University of North Dakota

North Dakota State University

University of North Florida

University of Northern Colorado

Slippery Rock University of Pennsylvania

South Dakota State University

Southern Connecticut State University

Valdosta State University

West Chester University of Pennsylvania

Division III

Anderson University (Indiana)

Bridgewater State College (Massachusetts)

Capital University

State University College at Cortland

Endicott College

Gustavus Adolphus College

Hope College

Ithaca College

Kean University

Marietta College

Messiah College

Mount Union College

Ohio Northern University

Plymouth State College

Salem State College

Springfield College

Waynesburg College

William Paterson University of New Jersey

University of Wisconsin, La Crosse

Source: NATA Web site

Need for athletic training equity discussed at Title IX conference

CHICAGO -- Possible effects resulting from a new way of certifying athletic trainers was among the issues discussed during the recent Title IX seminar.

"Gender equity in the training room: The application of Title IX" provided a look at how universities should examine their athletic training programs to avoid violating Title IX.

Availability of medical personnel, availability and qualifications of athletic trainers, and access to athletic training facilities all are included under the areas reviewed for Title IX compliance.

If an institution's athletic trainers already are stretched in terms of providing service equitably to student-athletes, a reduction in the number of people providing athletic training services could exacerbate the problem.

"Title IX tells you that you need to have certified athletic trainers at both men's and women's events," said Anita Barker, associate athletics director/assistant athletic trainer at California State University, Chico, and one of the session's presenters.

Barker said that institutions need to carefully examine how they are allocating personnel.

"You can justify putting a certified athletic trainer with football," Barker said. "The problem arises when you have only one certified athletic trainer and they go with the football team on the road, leaving student athletic trainers for women's soccer and women's volleyball.

"And, beginning in 2004, there will be athletic training education changes that will likely have an effect on the availability of those student athletic trainers."

Barker also pointed out that there are several women's sports with relatively high injury rates, such as basketball and lacrosse, and noted that it would be unwise for an institution to staff the men's teams in those sports with certified athletic trainers and the women's teams with student athletic trainers, a practice that is not uncommon.

And, as more institutions work to add women's programs to enhance gender equity, the problem of adequate staffing could increase rather than decrease.

The program's other presenter, Steven L. Cole, director of sports medicine at the College of William and Mary, pointed out that support services funding often has been overlooked as institutions add new sports.

"The trend has been to fund teams, not support services," he said.