Equity within the AT workforce: Building a Wider Pathway
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By Cathy Ortega, EdD, ATC, OCS and Marsha Grant-Ford, PhD, ATC
Currently, the proportion of the health care workforce who identify as underrepresented in the medical profession (UIM) is disproportionately smaller when compared to that proportion within the U.S. population. This includes credential holders of the various health care disciplines, including Athletic Trainers (ATs). These disparities result in professionals that are significantly unrepresentative of the populations they serve in all professional settings, i.e., interscholastic, intercollegiate and professional sports teams, as well as hospital based, physician offices, performing arts and industrial.
Patient outcomes can be adversely affected as a result of the number of UIM clinicians. Marginalized community members experience health care disparities disproportionally in both preventable and treatable conditions. Increasing numbers of diverse individuals in the health care workforce is purported to decrease disparity variables such as the impact of implicit bias; patient satisfaction; willingness to practice in minority communities; racial concordance; greater acceptance of health care; communication; trust; and adherence to advice.1-4
Culturally specific experiences and knowledge may serve as the basis for increased trust, enhanced communication and even compliance for some minority patients. In many settings, an AT may be the sole clinician, or one of two, making this aspirational goal of racial concordance logistically impossible. Increasing the numbers of diverse ATs is one way to positively impact patient care. Increasing the cultural humility of all ATs will also be impactful in increasing positive outcomes for patients. Without unduly burdening underrepresented in athletic training (UIAT) with the responsibility for serving as racial ambassadors in educational programs,5 much can be gained in an intentional culturally based curriculum and the incidental knowledge that accompanies experiencing an educational journey in diverse educational cohorts through group projects and collaborative learning.6,7
Many health professions, to include ATs, have equity, diversity and inclusion goals aimed at increasing their numbers of diverse clinicians. The various disciplines have prioritized addressing barriers to equity and inclusion, as well as the creation of socially just and responsible clinical and educational settings as pathways into their respective professions. To date, these have not been satisfactorily achieved. The commitment to building diverse and equitable health care settings begins with recruitment, admission and retention of diverse students, as well as supporting their successful completion of the credentialling process.2,3,5,8,9
Now that we recognize that a diverse AT workforce enhances patient outcomes, what are some steps as a profession that we could take to proactively diversify the AT workforce? The following potential solutions could be considered, along with others:
- Implement ongoing programs that include a comprehensive strategic plan for recruiting and retaining UIAT students, systems for guidance and exam preparation, as well as focused mentoring to qualify for financial resources and support.
- Extend efforts within the athletic training profession, developing multi-faceted pathway programs that reach into the under-graduate, high school and middle school populations to help increase the number of potential AT students.
- Create multiple touch points such as immersive activities, branding of the AT, peer mentoring, mentoring by athletic training professionals, tracking of contacts with annual follow-up until the students are in the profession.
1. Chapman EN, Kaatz A, Carnes M. Physicians and implicit bias: How doctors may unwittingly perpetuate health care disparities. J Gen Intern Med. 2013;28(11):1504-10. http://ezproxy.montclair.edu:2048/login?url=https://www.proquest.com/scholarly-journals/physicians-implicit-bias-how-doctors-may/docview/1442193367/se-2. doi: https://doi.org/10.1007/s11606-013-2441-1.
2. Banks J, Onsomu EO, Hall S, et al. Factors that predict NCLEX-RN success at a Historically Black College and University: A four-year retrospective study. J Prof Nurs. 2022;39:177-186. doi:https://doi.org/10.1016/j.profnurs.2021.12.011.
3. Mertz EA, Wides CD, Kottek AM, Calvo JM, Gates PE. Underrepresented minority dentists: Quantifying their numbers and characterizing the communities they serve. Health Aff. 2016;35(12):2190-2199. http://ezproxy.montclair.edu:2048/login?url=https://www.proquest.com/scholarly-journals/underrepresented-minority-dentists-quantifying/docview/1848800061/se-2. doi: https://doi.org/10.1377/hlthaff.2016.1122.
4. Boyle P. Do Black Patients fare better with Black doctors? https://www.aamc.org/news/do-black-patients-fare-better-black-doctors. Accessed August 9, 2023.
5. Nguemeni Tiako MJ, Ray V, South EC. Medical schools as racialized organizations: How race-neutral structures sustain racial inequality in medical Education—a narrative review. J Gen Intern Med. 2022;37(9):2259-2266. http://ezproxy.montclair.edu:2048/login?url=https://www.proquest.com/scholarly-journals/medical-schools-as-racialized-organizations-how/docview/2691602135/se-2. doi: https://doi.org/10.1007/s11606-022-07500-w.
6. Gabard DL. Increasing minority representation in the health care professions. J Allied Health. 2007;36(3):165-75. http://ezproxy.montclair.edu:2048/login?url=www.proquest.com/scholarly-journals/increasing-minority-representation-health-care/docview/211080539/se-2.
7. Shaya FT, Gbarayor CM. The case for cultural competence in health professions education. Am J Pharm Educ. 2006;70(6):6-124. http://ezproxy.montclair.edu:2048/login? url=http:www.proquest.com/scholarly-journals/case-cultural-competence-health-professions/docview/211250074/se-2.
8. Adams WM, Belval LN. Addressing diversity, equity, and inclusion in athletic training: Shifting the focus to athletic training education. JAT. 2021;56(2):129-133. http://ezproxy.montclair.edu:2048/login?url=https://www.proquest.com/scholarly-journals/addressing-diversity-equity-inclusion-athletic/docview/2509002781/se-2. doi: https://doi.org/10.4085/1062-6050-0558-20.
9. Greene R, Karavatas S. Increasing diversity in the physical therapy profession by addressing deficiencies in the performance of African Americans on the National Physical Therapy Examination. J Best Pract Health Prof Divers. 2018;11(1):51-59. http://ezproxy.montclair.edu:2048/login?url=http://www.proquest.com/scholarly-journals/increasing-diversity-physical-therapy-profession/docview/2111541677/se-2.
About the Authors
Cathy Ortega, EdD, ATC, OCS, (IDEAS Committee co-chair) has developed and implemented pathway programs to increase diversity of students enrolled in health professions programs. Projects include the multi-faceted Student Tailored Education Pathway, delivered through a $400,00 grant funded by the Texas Higher Education Coordinating Board; Summer Sports Medicine & Health Profession Immersion Camps for high school and middle school students from Texas rural communities and underserved inner city areas. She is currently working at the University of Utah expansion program to improve access to health professions for students from the Four Corners Navajo nation region, rural communities and other underserved areas.
Marsha Grant-Ford, PhD, ATC, (IDEAS Committee member) is an associate professor and clinical education coordinator at Montclair State University where approximately half of program graduates have diverse identities and identity intersections including national origin, race, ethnicity, age, religion, disability, sexual orientation, gender expression, military service and immigration status. In addition to the clinical education program administration, she has been committed to mentoring diverse students in her program and nationally. She supports improving IDEAS initiatives among our professional stakeholders. She also serves on the NATA International Committee and is the NJ EDAC chair.