Preparation, Expectations, Experience, and Environment of a College/University Athletic Training Residency: An Ethnographic Study

Athletic training residency programs are proliferating rapidly, yet only 1 accredited residency is housed outside of physician-practice or clinic settings. The focus of this article was to explore the structural and cultural factors that support a residency program in a college/university athletic training facility. Qualitative ethnographic study. Boston University Commission on Accreditation of Athletic Training Education–accredited residency program. The unit includes 16 full-time athletic trainers (2 of whom are residents, 6 of whom are residency faculty/preceptors) and 3 fellowship-trained primary care sports medicine physicians. I made observations, engaged in discussions, and conducted interviews for 34 days (159.5 hours) over 4 months. Data analysis involved examining transcriptions, field notes, and observational summaries of dialogue and behaviors, reactions, and my own interpretations. I used an inductive coding process to develop meaningful concepts, grouping them together to classify the data and identify themes and subthemes characterizing the structures of the culture. I identified 3 themes: resident preparation and expectations, residency experience, and environment. In the first theme, I identified that the residents came into the residency having some deficiencies and incongruent expectations of the program. In the second theme, I observed the residents gained depth of knowledge, skills, and abilities in their focused area of practice, and they improved self-reflective practices through their exposure to clinical specialists and the varied pedagogical approaches within the program. The environment included both benefits and challenges in having a residency. Engagement in interprofessional and collaborative practice and a culture of teaching and learning supported the residency environment. Athletic health care administrators must clearly communicate expectations when recruiting candidates, consider the training and commitment of their staff, and ensure culture of health care education within their unit before developing a residency, regardless of setting.