Elevating athletic trainers' standard of care through cultural competency education -
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Elevating athletic trainers’ standard of care through cultural competency education

The population of the United States is increasingly diverse and athletic trainers (ATs) have a professional obligation to expand their cultural competency and provide the highest standard of care for their patients. In a nutshell, that’s the argument master of athletic training (MAT) student Hana Clancy is making.

“In order to grow the athletic training profession,” Clancy noted, “the gold standard should be developing culturally competent clinicians who provide transcultural health care. The minimum standard our profession should strive for is to possess, practice and continue to grow our cultural competency skills and knowledge. The bottom line is that ATs must accept and respect people who are different than themselves.”

Hana Clancy in a garden
MAT student Hana Clancy

Clancy’s position is supported by the extensive research she has undertaken in an MAT course called Research for Practice. Rachel Hildebrand, the director of the MAT program, noted that “developing the desire to conduct investigations on given topics is emphasized throughout all aspects of our students’ curricular progression. Research for Practice enables them to initiate the process of evidence-based practice by allowing them to study a topic of their choosing.”

As part of this course, students can submit their project to the Mid-America Athletic Trainers’ Association Annual Symposium for peer review and possible selection on the program. Clancy’s work on cultural competency among ATs was accepted for presentation at the gathering in March 2020; however, as a result of COVID-19, this year’s symposium was canceled.

Focus areas for cultural competency training

For her study, Clancy chose to explore three areas of cultural competency that “should be explicitly taught in athletic training education programs (ATEPs)”:

  • Athletes who have high adverse childhood experience (ACE) scores (i.e., trauma and stress between the ages of 0 and 18)
  • Athletes who identify as LGBTQ+
  • Athletes of color

“It’s important to note,” said Clancy, “that these categories often overlap.” For instance, “people who identify as LGBTQ+ and people of color statistically will experience more ACEs due to the oppression, discrimination and stigmatization they face throughout their lifetimes. This complex relationship is further evidence in favor of the need for cultural competency education in ATEPs.”

This need is underscored by one of Clancy’s more arresting findings during her literature review: a significant gap between ATs’ self-reported high levels of cultural competence (mean = 90%) vs their Cultural Competence Assessment scores (mean = 68.5%). “In other words,” she remarked, “ATs overestimate their cultural competence.”

Opportunities to improve the standard of care

“Hana’s project is very timely and fits with a focus within the athletic training profession and the National Athletic Trainers’ Association,” noted Robin Ploeger, dean of the Oxley College of Health Sciences and an expert in the field of athletic training. “Health care providers, including ATs, treat a wide range of people. It is vital that we understand their differences and how that can affect the care we provide to them.”

Clancy’s research led her to identify the lack of cultural competence amongst ATs as a serious threat to providing optimal care to their patients. “As health care providers,” she contended, “ATs should not tolerate an environment that does not support positive physical and mental health for all patients, regardless of cultural differences. Just as the AT profession advocates for the promotion of all aspects of physical health, it must also promote all aspects of mental health. Only then, will ATs have the opportunity to enhance the standard of care.”

Part of Clancy’s project entailed providing workable solutions to enhance cultural competency among ATs. First and foremost is the immediate inclusion of relevant training in ATEPs, both for AT students and in continuing education programs for practicing ATs. This would entail social, ethical and professional skills that enable them to work with diverse patients as well as with colleagues who may be different than themselves.

Another way – “perhaps the easiest method,” she noted – is to increase the number of diverse AT students. Accomplishing this would require ATEPs to actively recruit diverse candidates to their programs. The fact that 86% of the membership of the National Athletic Trainers’ Association is white underscores Clancy’s point.

“I hope my research helps ATEP leaders think and act in a new way,” Clancy said. “We know that culturally competent ATs directly increase patient health outcomes. Now is the time to diversify our profession.”


Are you interested in a career in one of the fastest-growing professions in the United States? Then consider applying to TU’s master of athletic training program.