Pay, Pressure, and Persistence: Factors Influencing Retention for Athletic Trainers in the College/University Setting

Context Emerging evidence has suggested a distinct decrease in the number of early-career (0–6 years of experience) and career-advancing (7–12 years of experience) athletic trainers (ATs) practicing in the college/university setting (CAT). Attrition of CATs has been linked to factors including low salary, poor work-life balance, and a perception that CATs’ contributions are undervalued by employers. Objective To explore perspectives of early-career and career-advancing CATs regarding the factors influencing their decisions to remain in or leave the college/university practice setting. Design Qualitative study. Setting Individual virtual interviews. Patients or Other Participants Twenty-four CATs (16 female, 8 male; 6.33 ± 3.05 years of experience) employed across 23 colleges and universities of various competitive levels. Data Collection and Analysis Individual semistructured interviews were conducted with participants using a validated interview guide. Interview data were analyzed to identify recurring themes and categories using the consensual qualitative research framework. To ensure accuracy and credibility, data triangulation was achieved through member checking and collaboration among 7 researchers during the analysis process. Results Data analysis revealed 2 major themes: compensation and job demands. Participants expressed dissatisfaction with salaries that failed to reflect their education, experience, and workload, citing compensation as a key factor affecting long-term retention. Additionally, participants highlighted excessive workloads, understaffing, and blurred professional boundaries as barriers to maintaining adequate work-life balance and subsequently long-term retention. Competitive compensation packages, enhanced benefits, and supervisors who formally and informally reinforced professional boundaries supporting work-life balance were seen as strategies employers can use to encourage long-term retention. Conclusions The sustainability of the college/university practice setting rests in the ability of institutions to offer sustainable employment practices. By prioritizing creative, competitive compensation packages and implementing structural and cultural changes that promote work-life balance, employers can not only improve CAT retention but also encourage recruitment of ATs to the college/university setting.