Transition to Practice Part 1: Common Issues in the Metamorphosis from Student to Practitioner

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April 23, 2019

By Jeremy D. Howard, MS, LAT, ATC

Bottom Line Up Front (B.L.U.F.): Mazerolle, Kirby, and Walker (2018) have brought to light a research-based concern of Athletic Training Students’ preparedness to perform as autonomous practitioners

Spring is an exciting time for many athletic training students (ATS), it marks the term of their graduation and transition from the learner to the practitioner. However, there is a dark-side to the metamorphosis, the concerns for transition to practice issues. But, where do these issues come from? They do not just appear out of the blue by any means? So, before diving further into this quagmire, let’s first look at the profession from a bird’s-eye-view.

Athletic training has 5 established professional domains with a total of 26 sub-domains; further, professional-level athletic training programs at both the master’s and bachelor’s level have 220 professional competencies divided into 8 content areas and 8 clinical integration proficiencies. ATS must then meet the accreditation standards and prepare to take and pass the BOC exam. All of this has to occur in around 4 to 5 semesters. That’s a lot of education and competence in limited amount of time. Transition to practice issues develop in the gap between what ATSs are required to learn and what Athletic Trainers need to develop competence in for their first professional role. This gap can then cause increases in both burnout and role strain (Mazerolle, Walker, & Thrasher, 2015).

Luckily, there is a plethora of research out there on the transition to practice issue in athletic training, and its effects on our future Athletic Trainers thanks to the incredible efforts of Mazerolle, Kirby, Walker, Thrasher, Myers and Benes to name a few. As a profession, we should collectively thank these researchers and practitioners for targeting this issue and bringing the issue to light. Their efforts have not only been key in the issues identification, but their recommended best practices and key points of discussion can help to guide the entire spectrum of our profession from key leaders and Program Directors to the clinical preceptor and the ATS themselves to better prepare the learner for their entry into our amazing field. I would recommend that any Athletic Trainer who has a touch-point in the education to review the research by these professionals. You could be the person who changes a life, directs the ATS from a future of burnout or assists in the maintenance of professional commitment of Athletic Trainers keeping them in the field.

What we can do to help our next generation of professionals? The majority of the research lends itself to support a 3-pronged approach to success. The first occurs in the professional-level program and can be facilitated by instructors, professors and Program Directors. This prong of the attack on the transition to practice is a focus on past-experience, in other words exposure of the learner to the settings of future employment (Mazerolle, Myers, Walker, & Kirby, 2018).

Often, educators in an athletic training program are aware of the long-term professional goals of their learners. As the learners progress through the professional-level program the educators can see the development of the ATS and easily identify their weaknesses. Knowing the professional interests and intents of the learners for future employment should guide the educators to place specific learners in clinical locations that would better expose the ATS to the day-to-day requirements that would be asked of the Athletic Trainer in that setting (Mazerolle, Walker, & Thrasher, 2015). Mazerolle, Kirby and Walker (2018) expanded on this recommendation suggesting that there was a good deal of beneficence in preventing issues with transition to practice if the ATS had previous experience in the setting for which they were accepting employment in upon formal credentialing as an Athletic Trainer.

However, some students may not yet have defined goals for employment and setting, especially when considering the emerging settings of the profession. Mazerolle and Benes (2014) recommended a diverse exposure to various settings to help prepare the ATS for transition to practice. That was cited as one of the key factors in perception of preparedness for the learner’s pending transition. It is worth noting here that the clinical preceptor also plays a role in this capacity, taking on an ATS at the clinical site to guide, develop, mentor and prepare them for the setting in which they are embedded. The clinical preceptor plays a vital role in the exposure of the ATS to the appropriate experiences of a clinical site, experience that will shape how the ATS practices once they are a certified healthcare professional (Walker, Thrasher, & Mazerolle, 2016). That is a very serious charge to the licensed professional operating as a clinical preceptor, they are truly in the trenches fighting the good fight to properly form the future in the profession.

The next area of emphasis in overcoming issues with transition to practice occurs at the point of first employment. This is a point of potential ‘transition shock’ for the newly Certified Athletic Trainer and employers, department heads and directors can take major steps in ensuring a successful transition by implementing initiative that support appropriate orientation to the new hire (Kirby, Walker, & Mazerolle, 2018; Mazerolle, Myers, Walker, & Kirby, 2018). The authors suggested that orientations should include clear professional expectations of practice, defined roles and responsibilities, identification of key players and departmental contacts, policy and emergency action plan (EAP) review and the establishment of mentors. This author highly recommends the development of a continuity book for positions and sports that can be referenced by new hires after orientation is complete as an additional concept for inclusion in this area. It would also be worth including the director’s views on work-life balance and positional requirements, as this has been shown to be a major point of contention in our career and linked to the issue of professional attrition from the field (Mazerolle, Myers, Walker, & Kirby, 2018). By formally exposing the newly Certified Athletic Trainer to these important operational areas many potential future issues will be mitigated.

This brings the discussion to the final recommendation made. It is hard to define one of these recommendations over another, but this final one does standout as it spans the entire career of the professional. This final concept is mentorship! While this was briefly mentioned in the orientation process, in this case the recommendation is speaking more globally and well beyond a single setting of employment. This one is placed primarily in the hands of the ATS but there is shared responsibility here with both the educators and clinical preceptors guiding the ATS through their professional-level program and learning experience.

While the ATS must identify and cultivate relationships with appropriate mentors, the educators and preceptors must explain the value of a professional mentor to the ATS. They simply do not know what they do not know. Many young ATS will be shaped by their first exposures to Athletic Trainers, be they educators or preceptors. Often the relationship created will span well beyond their graduation and work force entry. The mentor serves a vital role not only to offer advice in professional predicaments but also to simply reassure and azimuth check the newly credentialed professional to ensure they are practicing ethically and within the professional concept of the setting (Mazerolle, Kirby, & Walker, 2018).

The mentor-mentee relationship should be one where open lines of communication exist and where the mentee is receptive to the mentor’s feedback, the mentor should be able to advise the mentee candidly when mistakes are made, and the mentee should receive this feedback as constructive in nature. If the mentor and/or mentee are incapable of maintaining a relationship where these standards of communication can be supported then the relationship is not appropriately categorized as mentor-mentee and both need to seek another for that role.

Transitioning from student to practitioner seem like crossing shifty-looking bridge in a dark and stormy night, but it does not have to be! Efforts and initiatives taken by all parties including educators, preceptors, employers and the ATS themselves, can be the light in the darkness. Actions taken to diversely expose the ATS to various settings including their goal employment settings, develop and implement timely and appropriate orientations and the establishment of a solid mentor-mentee relationship that supports clear communication can make the process seamless for the ATS to become an amazing practitioner!


Kirby, J.L., Walker, S.E., & Mazerolle, S.M. (2018). Transition to practice for graduate assistant athletic trainers providing medical care in the secondary school setting. Journal of Athletic Training, 53(5), 521-528. doi: 10.4085/1062-6050-466-16.

Mazerolle, S.M., & Benes, S.S. (2014). Factors influencing senior athletic training students’ preparedness to enter the workforce. Athletic Training education Journal, 9(1), 5-11. doi: 10.4085/09015.

Mazerolle, S.M., Kirby, J., & Walker, S.E. (2018). A narrative analysis: Examining the transition to practice for the full-time secondary school athletic trainer. Journal of Athletic Training, 53(3), 303-311. doi: 10.4085/1062-6050-45-17.

Mazerolle, S.M., Myers, S.L., Walker, S.E., & Kirby, J. (2018). Maintaining professional commitment as a newly credentialed athletic trainer in the secondary school setting. Journal of Athletic Training, 53(3), 312-319. doi: 10.4085/1062-6050-72-17.

Mazerolle, S.M., Walker, S.E., & Thrasher, A.B. (2015). Exploring the transition to practice for the newly credentialed athletic trainer: A programmatic view. Journal of Athletic Training, 50(10), 1042-1053. doi: 10.4085/1062-6050-50.9.02.

Walker, S.E., Thrasher, A.B., & Mazerolle, S.M. (2016). Exploring the perceptions of newly credentialed athletic trainers as they transition to practice. Journal of Athletic Training, 51(8), 601-612. doi: 10.4085/1062-6050-51.9.12.


About the Author

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Jeremy Howard is the State Health Promotion Officer for Florida Army National Guard under the Resilience, Risk Reduction, and Suicide Prevention Program. Howard graduated with a Bachelor of Science in Athletic Training from Florida Gulf Coast University (#DunkCity) and from the University of Saint Augustine for Health Sciences’ Master of Health Science in Athletic Training programs. He is currently pursuing an Educational Doctorate in Health Sciences at the same institution. In 2002, Howard enlisted in the Florida Army National Guard and is still currently serving; he is also a veteran of Operation Enduring Freedom-Afghanistan. His professional interests include Concussion/TBI, Injury Prevention Programs and Manual Therapy.

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