Secondary School Athletic Trainers' Perceptions of How Youth Sport Specialization Impacts Workload

Background: Youth sport specialization is a growing trend in youth sports and is associated with an increased risk of injuries and burnout. However, it is unknown how sport specialization is perceived to be affecting the working environment of secondary school athletic trainers (ATs). The purpose of this paper is to describe how ATs perceive youth sport specialization impacting their workload and whether they perceive it to impact patient safety.Hypothesis: ATs will perceive that youth sport specialization impacts their workload and could impact patient safety.Study Design: A sequential, explanatory mixed methods design with 2 phases: (1) cross-sectional surveys and (2) individual interviews.Level of Evidence: Level 3.Methods: A total of 487 secondary school ATs completed the online survey (access rate, 8.4%; completion rate, 85.4%). The survey consisted of Likert questions and included sections about aspects of workload impacted by specialization, impacts on patient safety, demographics. Ten participants were selected to complete a semi-structured interview via video conference.Results: Approximately two-thirds of ATs perceive that sport specialization impacts their workload. (Somewhat, 38.6%; Quite a bit, 25.5%; A great deal, 5.5%) Attempts to reduce or modify patient activity and a patient's time for rehabilitation were the highest rated aspects of workload impacted by sport specialization. Approximately 30% ATs (29.9%) perceive that sport specialization impacts their workload to where it may influence patient safety (Somewhat, 21.6%; Quite a bit, 6.4%; A great deal, 1.9%). Three themes and subsequent subthemes were identified from the qualitative interviews: (1) current youth sport expectations, (2) conflict between school and club sports, and (3) AT job impacts.Conclusion: Secondary school ATs perceive their workload to be negatively impacted by youth sport specialization and some believe it may impact patient safety.Clinical Relevance: Youth sport specialization is impacting youth sport stakeholders, including ATs, in a variety of ways.