Context: Considering recent high-profile reports of malpractice and negligence by National Collegiate Athletic Association (NCAA) athletic trainers (ATs), it is prudent to investigate the psychological mechanisms that may influence ATs' ability to justify unethical behaviors. When treating injured student-athletes, ATs may undergo a cognitive process known as moral disengagement, which involves convincing oneself that ethical standards do not apply in a particular context.
Objective: To explore the psychological factors and traits among ATs that may predict moral disengagement pertaining to allowing athletes to play through injuries.
Design: Cross-sectional study.
Setting: Online survey.
Patients or other participants: A total of 187 Division I, II, and III ATs from 100 NCAA universities.
Main outcome measure(s): In addition to the primary outcome variable of moral disengagement, the survey captured the AT's demographic background, sport and athletic training histories, and measures of sport ethic, contesting orientations, commitment, and social identity.
Results: Cluster analysis was used to identify homogeneous subgroups of participants based on these variables. A 2-cluster solution emerged, with cluster 1 (n = 94) scoring higher in the sport-ethic and sport-contesting orientations but lower in commitment and social identity compared with cluster 2 (n = 93). An independent-samples t test revealed that moral disengagement was highest (t185 = 19.59, P < .001, d = 0.69) among ATs in cluster 1.
Conclusions: These findings advance our understanding of the psychological processes that may predict moral disengagement of ATs in allowing student-athletes to play through injury. Although additional research is needed to test whether moral disengagement influences return-to-play decisions, we provide initial evidence that ATs who conform to sport norms (eg, "no pain, no gain") and who tend to view sport competition with a "war-like" orientation are more likely to morally disengage.
Keywords: athletic medical care; collegiate sports; sport morality.