Achieving Work-Life Balance in the National Collegiate Athletic Association Division I Setting, Part II: Perspectives From Head Athletic Trainers

Abstract

Context:

Work-life balance has been examined at the collegiate level from multiple perspectives except for the athletic trainer (AT) serving in a managerial or leadership role.

Objective:

To investigate challenges and strategies used in achieving work-life balance from the perspective of the head AT at a National Collegiate Athletic Association Division I university.

Design:

Qualitative study.

Setting:

Web-based management system.

Patients or Other Participants:

A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered.

Data Collection and Analysis:

Participants journaled their thoughts and experiences in response to a series of questions. To establish data credibility, we included multiple-analyst triangulation, stakeholder checks, and peer review. We used a general inductive approach to analyze the data.

Results:

Two higher-order themes emerged from our analysis of the data: organizational challenges and work-life balance strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The work-life balance strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration.

Conclusions:

Head ATs are susceptible to experiencing work-life imbalance just as ATs in nonsupervisory roles are. Although not avoidable, the causes are manageable. Head ATs are encouraged to prioritize their personal time, make efforts to spend time away from their demanding positions, and reduce the number of additional responsibilities that can impede time available to spend away from work.

Key Points

• Work-life imbalance is inevitable, particularly in the collegiate setting, but is manageable.

• As do athletic trainers in nonsupervisory roles, head athletic trainers can experience work-life imbalance due to role overload and a lack of autonomy over work schedules.

• Head athletic trainers are encouraged to prioritize their personal time, try to spend time away from work, and reduce additional responsibilities that prevent spending time away from work.

• Expectations of the athletes and coaches for medical care during out-of-season training can limit the athletic trainer's time away, particularly because many are responsible for more than 1 team.

Work-life balance (WLB) is a complex, overarching concept that encompasses the extent to which individuals are equally engaged or satisfied with their work and family or life roles.¹ Achievement of WLB includes the time necessary to meet each role, an emotional investment within each role, and enjoyment and fulfillment from each role.¹ When the demands of either role become overwhelming or difficult to manage, conflict can arise. Work-life imbalance is a documented concern for the medical care provider^2,3 and the athletic training professional.^4–8 Many factors have been linked to the occurrence of work-life imbalance in athletic training; most notable, however, are the time demands associated with patient care and administrative responsibilities held by the athletic trainer (AT) and the inflexibility related to work scheduling.^4,6

Athletic trainers working in the collegiate setting can experience conflicts between their workplace and domestic responsibilities,^4–6 primarily due to the unconventional work schedules associated with athletics, long work hours, travel, and the demands and expectations placed on them by coaches.⁶ Whereas the antecedents of work-life imbalance can be multifactorial,^9,10 many appear to be rooted in the organizational structure of the workplace for the collegiate AT. In addition to long, demanding work hours, an inadequate number of full-time athletic training staff also has been identified as a major culprit in work-life imbalance.^4–6,11 Beyond patient care responsibilities, ATs can be engaged in clinical instruction or supervision and administrative duties that compete for their time and energy and may lead to role strain and conflict.¹² Current empirical data present the sources of work-life imbalance from the perspective of the assistant AT, and whereas this is a common position held by ATs in the collegiate setting, information regarding factors leading to conflict for the AT in a supervisory role is limited.^4–6,11,13 In addition to providing patient care, the AT in this role must complete administrative and supervisory responsibilities, which require additional time during the workday. Given that the role of the head AT requires additional responsibilities beyond the role of the assistant AT, a different set of factors can contribute to experiences of work-life imbalance. Therefore, investigating which factors potentially cause stress and conflict from the perspective of the head AT is important.

Despite the reports, ATs working in the collegiate setting empirically and anecdotally have been able to establish WLB.⁶ Establishment of WLB requires prioritizing time away from the role as an AT, having personal hobbies and stress-reduction outlets, and establishing boundaries between personal and professional responsibilities.^6,14 Working in the collegiate setting, particularly the National Collegiate Athletic Association (NCAA) Division I setting, is stressful mostly owing to the long work hours and travel. Therefore, time away to rejuvenate and reenergize is necessary to promote continuing professional commitment for the AT.¹⁵ Often, this is accomplished by exercising, spending time with friends and family, and participating in leisure activities.^6,13 A positive workplace culture, specifically having coworkers who share a teamwork mentality and a supervisor who supports and implements WLB policies,¹³ is necessary for the AT to fulfill WLB while fulfilling a full-time role as an AT in the collegiate setting. Research on work-life conflict antecedents and strategies used to reduce their occurrence is often either from the perspective of the assistant AT alone or the perspectives of head ATs are examined collectively with other staff ATs' perspectives. Furthermore, the head AT is a critical component in creating WLB for the AT and in mentoring, which can be associated with a supervisory role and has been suggested as an important socializing agent in the role of an AT and a means to facilitate WLB.¹³

Work-life imbalance is inevitable for every working professional and can be influenced by a host of factors. Specifically, for those working in the sport culture, this can be a combination of organizational, personal, and socioeconomic factors.¹⁰ Little information regarding WLB exists from the perspective of the head AT. Therefore, the purpose of our study was to investigate the workplace dynamic that occurs at an NCAA Division I university and its effect on WLB from the perspective of the head AT. The central research questions guiding our study were (1) What factors or challenges influence the achievement of WLB for the head AT? and (2) What strategies or motivations do head ATs use to personally achieve WLB?

METHODS

The methods were substantially the same as those described in part I of this study.¹⁶ Refer to part I for a more in-depth discussion of participant recruitment; participants; and data collection, analysis, and trustworthiness.¹⁶

Participants

We used criterion-, convenience-, and snowball-sampling techniques to purposefully recruit head ATs employed in the NCAA Division I clinical setting. A total of 18 head ATs (13 men, 5 women) volunteered to participate in our study. Demographic data on these participants (ie, age, social status, experience, and current employment information) are detailed in part I.¹⁶ Participants indicated informed consent by completing the survey, and the study was approved by the University of Connecticut–Storrs Institutional Review Board.

Data-Collection Procedures

We used Web-based, asynchronous interviewing as our medium for data collection and Survey Monkey (www.SurveyMonkey.com, LLC, Palo Alto, CA) as the data storage site. Participants initially provided demographic information and then answered a series of open-ended questions on WLB and the workplace.

Data Analysis

Our analysis procedures followed the general inductive process. We focused on data obtained from the following questions: (1) What is your personal WLB philosophy? (2) What factors influence WLB for you? and (3) What potential obstacles and challenges do you come across in your current position and how do you negotiate them?

Trustworthiness

We used 3 trustworthiness-of-data strategies: multiple-analyst triangulation, stakeholder checks, and peer review. Multiple-analyst triangulation was completed by the first 2 authors (A.G., S.M.M.). Two head AT participants were selected to review the data, which established our stakeholder checks. A peer (W.A.P.) reviewed the final results and confirmed our findings.

RESULTS

Two higher-order themes emerged from our analysis of the data: organizational challenges and WLB strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The WLB strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration. Each theme and its supporting quotes are discussed in the following sections.

Organizational Challenges

Lack of Autonomy

The head ATs in our study frequently discussed organizational challenges as factors influencing their attempts at WLB. Specifically, participants noted a lack of autonomy as a factor or obstacle, which related exclusively to a lack of flexibility in their work schedules. One head AT, who has been employed at the same university for 15 years, stated:

For me, time of year is a big factor. I know that at certain times of the year, I will have less flexibility. At other times of [the] year, I will have a lot more flexibility. . . . Not always having control over my own schedule is the biggest obstacle. During the season, your schedule is really dictated by the coach's practice time and by travel. Throughout the year, it can be frustrating when you think you'll have some time to yourself, but a crisis emerges. As a head athletic trainer, you don't just get to turn off your phone.

Other participants also spoke about lack of autonomy in terms of addressing coaches and the scheduling of practices and activities for the team they primarily covered. One head AT explained the biggest factors affecting his WLB included “… being at the mercy of someone's else schedule (ie, a coach controls the practice schedule to fit his/her needs oftentimes without regard to how that affects others).” Another participant supported this factor and also added his strategy in negotiating the obstacle. He offered,

… [my biggest challenge is] with coaches scheduling and changing schedules without the courtesy [of considering] … other schedules or lives [of those involved]. I try to address these issues [by alerting my] supervisors … of potential downfalls.

Role Demands

Many head ATs discussed traversing the duties and demands that are required of them. Travel responsibilities and role overload were the predominant work-related demands that influenced the WLB of participants. Seventeen of 18 participants traveled with at least 1 sport, and travel was identified as a critical factor that influenced WLB. A father of 2 children shared the difficulties of travel by journaling, “Traveling with my team takes me away from home/family events. Rarely are my family invited to travel with me, only in bowl games.”

Role overload was discussed frequently among the participants, specifically in terms of “long work days,” “[having] too much to do,” and “being on call 24/7.” The increase in year-round training at the Division I level often was highlighted as an important nontraditional job demand that affected WLB. One participant noted, “. . . the increasing year-round hours that sport demands,” was his greatest obstacle in his current position. Another stated, “Particularly the off-season [demands] like workouts, off-season conditioning, etc,” was one of his biggest challenges in having a balanced life. Furthermore, the increase in year-round demands also conveyed increased expectations, as one head AT explained, “[there are increased] expectations that I am always available when a student-athlete needs me to be.” Moreover, the emphasis on administrative responsibilities for the head ATs added to the role demands because there was “too much administration work and not enough time for hands-on [patient care].” This role tension further added to the challenges faced by the participants.

Work-Life Balance Strategies

The second higher-order theme, WLB strategies, emerged primarily from the WLB philosophy and strategies that participants used to personally promote a balanced life.

Prioritization of Commitments

Many head ATs in our study identified the prioritization of values and commitments as an important strategy to achieve WLB. This arrangement primarily addressed putting family first. One female head AT and the only mother (of 1 child) in our study offered her approach:

I feel there are experiences in life that are too important to miss, and for those we will facilitate attendance for any member of the staff [full-time or graduate assistant]. In addition, and maybe even more important, are the everyday routine exchanges that build a sense of being … [a] sense of value that I try to maximize when I am present. I never want my daughter to feel like she comes second.

Another participant, who was a father of 3 children, stated, “[I] try to maintain a focus on the important things like family, things you can never get back. [I try to] make smart, informed choices when challenged with family-work conflicts.” Another participant, who was also a father of 3 children, offered this specific strategy: “Get home as early as possible [and] protect weekends to the greatest extent within control. [For example, Sunday mornings with] family in church is a priority [for me].”

Prioritization and subsequent fulfillment of commitments were not simple matters for several participants. They provided experiences of having an internal dialogue while trying to navigate the “absolutes that occur within both family and work schedules.” As a father of 3, one participant struggled with “the importance of events whether personal or professional. Is this event something I'll regret missing or being late for?” He further explained his approach to such dilemmas:

There are always coverage challenges within the [athletic training] profession. The biggest challenge I face is an internal challenge: ‘Why shouldn't I go to that family event? Why am I spending so much time at work?' I have to remind myself to treat myself as good as those patients that I encounter—mentally, physically, [and] emotionally.

Successfully prioritizing and satisfying commitments also required good communication with and understanding of both family members and work colleagues. A father of 2 children stated, “Family is always first, [yet] work requires a great deal of time. [Therefore, you] must have an understanding family.” Another participant explained this concept further:

Good communication with my family is important. A good understanding of my work commitments helps in providing good communication. At work we tend to feel they cannot survive without us. However, I'll ask to adjust my work time for family reasons. If I don't ask, then the answer is automatically no. A lot of times things will work out.

Strategic Boundary Setting

Participants recognized that their roles required them to be available to injured patients. To the extent that these individuals are responsible for the care provided, saying no was not always an option; however, these individuals made a point of setting boundaries related to executing their roles. Our participants journaled several different strategies used to set boundaries in the workplace, primarily with coaches and student-athletes. They often provided the phrase “saying no” or “know when to say no.” One female participant, who has held the head AT position for more than 23 years, specifically stated, “[I] set boundaries as to what constitutes an emergency. [I] ask athletes not to call after 10:00 pm unless it is an emergency.” Another head AT with children wrote, “[I] make a conscious effort to not deal with work-related phone calls when at home.” One participant simply stated that “limiting low-value work” was 1 strategy he used in his efforts to maintain a balance.

Work-Family Integration

Several participants discussed integrating their family members into the workplace. One participant, who was married and a father of 2 children and had been employed at his university for more than 17 years, stated his WLB philosophy included, “[trying] to have my children with me at work when possible.” Another head AT, who was married with 3 children and had 21 years of employment, supported this strategy, “[I] involve the family in work whenever feasible.” A female head AT participant, who was married with 1 child and had 10 years of employment, provided her specific integration strategies, “. . . [I try to integrate] family into work, [including] family travel opportunities [and having them] attend recovery practices or treatment on off days.”

The head ATs in our study shared many challenges and obstacles that affect their WLB. Yet, they also offered sound strategies to improve this balance and persist in the collegiate setting. One participant offered a suitable summation: “I believe we work in order to live, not live to work. I believe a positive work-life balance enables athletic trainers to be sustained in the college setting while also nourishing a healthy family life.”

DISCUSSION

Organizational Challenges

The purpose of our study was to investigate the workplace dynamic that occurs at the Division I university level and its effect on WLB and retention from the perspective of the head AT. As outlined in the model by Dixon and Bruening,¹⁰ organizational factors heavily influence experiences of conflict between work and life and often include work scheduling, work hours, and job demands. Athletic trainers working in the Division I collegiate setting must navigate long work hours related to patient care, travel, and administrative duties that affect the time available to attend to personal and family needs. Other sources of conflict have included role overload due to inadequate staff size, lack of control over work schedules, and coaches' expectations of ATs.^4,6,11 Our findings continue to substantiate the findings of others^4,6 that the demands of the profession create challenges in achieving WLB.

Long work hours and travel have been at the forefront of discussions regarding factors that fuel conflicts between work and home life for the AT.^4,6 The experiences of our participants were no different, as they logged inordinate hours during the work weeks and traveled with at least 1 team during the year. Supporting the results of Mazerolle et al,⁶ the expectations of the coaches were problematic for this cohort in finding WLB. Flexibility in work scheduling has been a favorable organizational WLB policy^17,18; however, for the AT, enjoying it can be difficult owing to a lack of control over practice and game scheduling.⁶ Our participants believed they had lack of autonomy over the logistics of scheduling because ultimately it was the responsibility of the coaching staff, and this mirrors the concerns outlined by Mazerolle et al.⁶ Our findings, in collaboration with those of Mazerolle et al,⁶ illustrate the need for increased communication among the coach, AT, head AT, and administration to promote improved autonomy and more manageable work schedules. Similar to the findings of Mazerolle et al,⁶ our participants were concerned with the expectations of coaches for around-the-clock medical care and accessibility, which had the potential to spill over into or interfere with time allocated for personal and family obligations. The spill-over effect has been discussed as a barrier to finding WLB and helps support the need to create separation or boundaries between work and family roles.^4,5

Professional autonomy, particularly regarding work scheduling, is necessary to find WLB in the collegiate setting because it allows the AT the means to complete nonwork obligations around the time constraints placed on patient care, practice or game coverage, and administrative duties. Whereas our findings indicated a lack of professional autonomy, Mazerolle and Goodman¹³ reported that it is possible to have in the collegiate setting and requires increased communication between supervisors and coworkers, as well as a team approach to patient care and job-sharing duties. Autonomy and social support not only can facilitate fulfillment of WLB but also are important factors in reducing organizational and professional turnover.¹⁹

Before our investigation, researchers had presented results primarily from the perspective of an AT serving in a nonleadership or nonadministrative role. Interestingly, however, the antecedents of conflict for an AT in a managerial or leadership role stemmed from very comparable sources. Although administrative duties were mentioned briefly, they were not a dominant theme. Our participants were forced to juggle the same time constraints and lack of autonomy over scheduling as ATs serving in entry-level positions. Researchers¹³ have suggested that head ATs recognize the need to provide autonomy in the workplace for their staffs, which is something from which they themselves may not be able to benefit.

Unique to our findings, however, was the role of year-round conditioning and training. The idea of an off-season for the AT, which allows for time away from the workplace and to enjoy a more reasonable workload, has been reduced owing to the demands placed on the athlete outside of the traditional in-season. Expectations of the athletes and coaches for medical care during out-of-season training can limit the ATs' time away, particularly because many are responsible for more than 1 team.⁴

Work-Life Balance Strategies

Facilitation of WLB takes prioritization of commitments; establishment of boundaries or separation between personal and professional responsibilities; and when necessary, a degree of work-family integration. These strategies continue to be supported by the literature in athletic training regarding the fulfillment of WLB,^6–8,13 yet they offer a different perspective and help to establish a holistic view of WLB in athletic training.

Prioritization of responsibilities simply means to establish a daily to-do list of the most important items, which must be completed during the day. This list, as outlined in the literature,^6,20–23 should include both work and nonwork items. Items on the list may include updating patient records, meeting an athlete for a physician's appointment, and covering practice. However, items such as paying personal bills, working out, or having lunch with a friend also should be on the list. These examples have permeated the literature for WLB. What our data add is the mentality that family comes first and that personal or family time must be protected. Our participants did not necessarily discuss prioritization as a daily item but rather described creating rituals or obligations with which work will not interfere. They valued their family or personal time and made a concerted effort to protect that time. This concept parallels the idea of work-life separation, which simply means that, while engaged in work, home or personal life is immaterial and vice versa. Prioritization also helps to restore or create a sense of control or flexibility over one's obligations and responsibilities, which is a common concern with respect to finding WLB, as indicated by our data and those of others.^4,6

Two popular, yet distinctly different, WLB strategies are separation and integration.^6,14 Both have been identified as helpful in reducing work-life imbalance in athletic training. Separation⁶ has been defined operationally as maintaining clear boundaries between work and personal roles, meaning the responsibilities in 1 role should not interfere or compete with time spent engaged in the other. Popular ways to achieve this separation, as discussed by our participants and those of other researchers,⁶ are to say no to additional responsibilities that can interfere with home life and to establish clear expectations regarding treatment times and availability during the workday. In addition, boundaries can be established to limit the amount of time spent completing work tasks while at home. Separation ultimately allows ATs the chance to fully concentrate and presumably enjoy the responsibilities in which they are engaged without the distractions or interference of the other roles. Similar to the participants studied by Mazerolle et al¹⁴ and Mazerolle and Pitney,⁸ our participants viewed this strategy as necessary to disengage from the demands of the role of the AT. Time spent away from the role of the AT is not only important for facilitating WLB but also helps to increase job satisfaction and organizational commitment,¹⁵ which are both facilitators in retention.

In contrast, integration¹⁴ works on the premise that responsibilities associated with either work or home roles can be combined or completed simultaneously. Athletic trainers working in the collegiate or secondary school setting often use this method to find WLB primarily because of the length of the work hours.^6,7 Integration of responsibilities creates a more family-friendly work environment, which was an important factor for our participants and other ATs managing married and family life.⁶ Integration also can be helpful for ATs without spousal or family obligations because they can use the downtime during a workday to work out, run errands, or simply decompress, all personal responsibilities that require time to complete.

Limitations and Future Directions

Our study had several limitations. First, our cohort of head ATs predominately was married or partnered. Experiences of work-life imbalance can occur regardless of marital or family status⁴; however, those factors leading to conflict or resolution of conflict can be starkly different based on home and personal obligations. Future investigators should include a more robust population of all aspects of the lifespan continuum (eg, single, married, married with children) to confirm and expand on our findings. Second, our population represents head ATs employed in the Division I setting; therefore, their experiences and opinions may not reflect those of other head ATs working in other collegiate settings. Although the core responsibilities of the AT are consistent, employment setting characteristics potentially can influence sources of conflict and strategies or policies used to facilitate WLB. Third, as acknowledged in part I of this study, we did not record to whom the head ATs directly reported (eg, the athletic director or the medical director).¹⁶ Fourth, we used Web-based interviewing to collect data, limiting the dynamic and dialogue that typically occurs between the interviewer and interviewee. Whereas we used data redundancy to guide recruitment and an adapted but established instrument, additional information possibly could have been ascertained. In subsequent investigations, researchers may use other qualitative means to collect data, such as focus groups or one-on-one interviews, to allow for a more natural inquiry regarding experiences of WLB.

Implications and Conclusions

Head ATs were as susceptible to experiencing work-life imbalance as ATs in nonsupervisory roles. Although inevitable, the causes are certainly manageable. Head ATs are encouraged to prioritize their personal time; make efforts to spend time away from their demanding positions; and when possible, reduce the number of additional responsibilities that can impede on time available to step away from work. Separation and integration offer the AT opportunities to create WLB but for markedly different reasons. Separation allows ATs to disengage from their roles as ATs and is a strategy that is more appropriate to use while meeting personal obligations, whereas integration is more appropriate for the AT engaged in a work role.