Jan 29, 2015
Big Job, Small Staff

Being a head athletic trainer with just one or two assistants presents a management challenge: How do you be a boss and a supportive co-worker at the same time?

By Laura Smith

Laura Smith is an Assistant Editor at Training & Conditioning. She can be reached at: [email protected].

Mike O’Shea, LAT, ATC, has spent his entire athletic training career working with small staffs, and after two decades, he has come up with an apt analogy. “Being the head athletic trainer for a small staff is like being a restaurant owner,” says O’Shea, Head Athletic Trainer at the University of Houston, where he has two assistants on staff. “You work long hours and you roll up your sleeves and do every part of the job, whether it’s cooking or washing the dishes. And ultimately, everyone is depending on you.”

For many head athletic trainers with small staffs, the plus is that you become a close-knit team. But it can also be very challenging. Along with the heavy workload, navigating the human relationships of a two- or three-person staff is not something you are taught in school. Knowing how to establish a rapport while maintaining professional boundaries can take extra care and special insight.

“Whether you have a large staff or a small staff, you can be effective at providing great care,” says O’Shea. “But when you’re running a small staff, you need a little extra creativity.”


When you’re operating with one or two assistants, success begins with hiring the right people for the job. Certification and experience are obviously important, but possibly even more critical are personality, character, and people skills. And these variables are often overlooked when managers make new hires, according to Mark Murphy, Founder and CEO of Leadership IQ, a management consulting firm based in Washington, D.C.

“We just completed a three-year study following 20,000 new hires, and an astounding 46 percent of them failed within 18 months,” Murphy says. “When we interviewed bosses whose hires had failed, we found that technical skills were not the reason. The four biggest downfalls were lack of coachability, lack of emotional intelligence, lack of motivation, and simply having the wrong temperament for the job.”

So what is the right temperament for working as part of a small staff? “Think of a startup company operating in a garage,” Murphy says. “You want someone who can take direction, has a positive attitude, and above all, is willing to pitch in and do whatever tasks need to be done. Someone who says ‘That’s not part of my job’ isn’t going to make it in a small staff setting.”

Sharon Wood, LAT, ATC, Head Athletic Trainer at NCAA Division III Maryville College, agrees. For many years, Wood has shared her workload with just one assistant, and has recently added a second part-time assistant. “In my setting, I hire a lot of recent grads, so I expect to do a lot of teaching when it comes to technical skills,” she says. “But they need to come in with the right work ethic—that’s something you can’t really teach. I want to hear, ‘I’m excited to do this, and I don’t mind working hard.'”

For Chris White, MS, LAT, ATC, Head Athletic Trainer at Brophy College Preparatory School in Phoenix, Ariz., who has served for 21 years with one part-time assistant, people skills are an absolute. “I have to know that my assistant can relate well to coaches and athletes,” he says. “More than technical skills, I look for their ability to get along well with others. That goes a long way with a small staff.”

Communication skills are also a factor. “We’re going to be working together closely, so I cannot have someone who is difficult to talk with or who only tells me what they think I want to hear,” White says.

Brian Robinson, MS, ATC, Head Athletic Trainer at Glenbrook South (Ill.) High School and Chair of the NATA’s Secondary School Athletic Trainers’ Committee, believes it’s important to look for applicants who possess some assets that are different from his own. “I definitely want them to share my basic approach and philosophy, which is that there is no such thing as ‘just’ a high school athlete—young athletes deserve the highest quality care available,” says Robinson, who supervises two assistants. “But I also look for them to offer different strengths than I posses.

“For example, after working in this field for nearly 30 years, sometimes I feel like I’ve gotten a bit worn down in my ability to relate to the kids and give them the caring they need,” Robinson continues. “You give so much of yourself in this field that over time, you run out of stuff to give. However, my assistants really bring that caring element to our athletic training room. In a small setting, it’s important to be honest about your own strengths and weaknesses and hire assistants who complement you.”

Assessing interpersonal adeptness in an interview can be tougher than determining technical skills, so you need to develop specific hiring strategies for your setting. The first step is slowing the process down, according to Murphy. “Most hiring decisions are made in the first five minutes of an interview,” he says. “Instead, spend time before the interview making two lists: the attributes you cannot live with and the attributes you cannot live without. Make sure a significant number of the items relate to character. Try thinking of the best and worst assistants you have ever had and list their qualities.”

In a small staff setting, says Murphy, the two lists might look something like this: “I cannot live with someone who has a negative attitude or a poor work ethic, someone who gossips, or someone who always brings me problems but not solutions. I cannot live without someone who is willing to do whatever needs to be done, gets along well with others, takes initiative, and embraces change.”

The final step is coming up with questions that reveal whether the candidate has the qualities you’ve listed. As examples, Murphy offers the following interview prompts designed to measure a candidate’s people skills, work ethic, and initiative:

  • Tell me about a time when you saw something that needed to be done and you took the initiative to begin doing it.
  • Tell me about a time when you modified your approach toward a coworker in order to improve the working relationship.
  • Tell me about a time when your boss gave you an assignment you disagreed with, and how you handled the situation.


Once you have the right people in place, a small staff can become almost like a family—and that can be a strength or a weakness. “In small departments, relationships between people are the key to making things work,” says Murphy. “You spend more time with your assistants than with your spouse. Everyone simply has to get along, and the head athletic trainer sets the tone for all the other relationships.”

The fundamental rule in establishing good relationships is to strike the right balance between being supportive and being in charge. “The pitfall is that when everyone becomes close, the manager can lose the ‘boss’ component of his or her role,” Murphy says. “He or she becomes hesitant to enforce the standards when people make mistakes or don’t fulfill their responsibilities, and that’s where the problems come in.”

“I’ve definitely seen how that can happen,” O’Shea says. “In my job I am the confidante, but I also have to be the taskmaster who cracks the whip. We’re in this together, but at the same time, I can’t be on exactly the same level as my assistants, and that can be a delicate line to walk.”

Achieving balance starts with maintaining a professional atmosphere in the athletic training room, says O’Shea, who believes adhering to simple rules can go a long way. “I do not allow any cursing,” he says. “I am adamant about it, and my staff knows I’m serious. It may seem like a small thing, but it sets a tone, adds to the respect they have for me, and lets everyone know that while it’s good to laugh and have fun, we also have professional boundaries.”

O’Shea’s approach is right on the money, according to Murphy. “Clear expectations are critical in small staffs, because they act like a third party in the relationship,” he explains. “Having a clear set of rules that everyone lives by allows the manager to hold people accountable in a way that keeps it from becoming personal. If you have a clear code of conduct that is always in the forefront, it becomes like an outside party and allows you to say, ‘This isn’t personal. It’s just the way our department operates.'”

For rules and expectations to work, they must be spelled out in clear and concise terms. “You can’t simply say, ‘We are going to be really focused on serving our athletes,'”Murphy says. “What exactly does that mean? What exactly do you want to see your assistants doing and not doing?”

A head athletic trainer who feels he or she has tipped the scales too far in the “friend”direction can still implement this strategy to get things back on track. “If you sense that you are hesitant to honestly evaluate your assistants and performance is slipping, it’s a sign that you need to put some formality back into the relationship,” Murphy says. “The best way to change course is to ask your assistants to work with you on developing a list of expectations that you will all abide by.

“Sit down with them and say, ‘I think we could all benefit from clarifying how we do things as a department. I have a list of things that I think need to be worked on, and you probably have things you’d like me to improve. Let’s all bring our lists to the table,'” he continues. “They will take ownership of the result, and you’ll have a more effective way to hold them accountable. It’s a great way to begin changing the dynamic.”

In addition to expectations, the way a head athletic trainer carries him- or herself has an impact on working relationships. “Hold yourself to a high standard and act in a professional manner, and the people around you are likely to do the same,” White says.

It’s also important to be aware of relationships between assistants so you can quickly step in to fix problems when needed. “If two of my staff people aren’t getting along, I try to straighten that out right away,” O’Shea says. “I remember a time when a coach came to me and said, ‘I can tell there is friction between your assistants, and it’s making things difficult for us.’ Since then, I have paid very close attention to those dynamics and I address problems while they’re still small.”

The same principle applies to giving criticism when an assistant’s performance is lacking. “With a small staff, formal sit-downs to give negative feedback can be painful,” Murphy says. “So try to catch things when they are really small. The sooner you offer criticism, the lighter it can be, and the less difficult it is on the relationship.”

Above all, you need to employ a leadership style that is inclusive and open-minded and promotes teamwork. “Be honest, be humble, and treat your assistants with respect,” Robinson advises. “Make sure that you pitch in and do the thankless parts of the job right alongside them. Acknowledge your mistakes and be willing to learn from your assistants, and don’t worry about trying to prove to everyone that you’re the boss.”


A fact of life for small staffs is that it can be hard to get everything done with just two or three pairs of hands. For Robinson, part of the solution is to be very organized. “Every head athletic trainer makes a calendar of coverage assignments, but here, I find that it has to be really detailed and it has to be worked out far ahead of time,” he says. “Everyone needs to know exactly what they are doing and when. The three of us go out to lunch once a month to map out the next month’s coverage, and it becomes our bible.”

For White, fewer assistants means he relies more on athletes to be responsible for their own rehab and gives them home exercise programs with very clear direction. “I use a computer program that allows me to print out exercises and schedules for athletes, and that’s been very successful,” he says.

Many athletic trainers with small staffs also give additional responsibility to coaches. That has worked well for David Green, MA, ATC, Head Athletic Trainer for 22 years at Tennessee Tech University, who has two full time assistants (and will be adding a third this year). “With the size of our staff, we can’t be everywhere, but our coaches are always going to be there,” he says. “The past two years, we’ve made sure each of them is certified in CPR and first aid and that they know how to contact us quickly if there is an injury. We rely on them to monitor their own teams in the offseason. That allows us to focus on the teams that are in-season.”

White also uses coaches as an extension of his staff, starting out each season with mandatory coaches’ training. He also believes that having very detailed emergency action plans is essential for small programs. “At our school, each coach is required to compile an emergency plan for their practice site using a template we give them,” he says. “It must detail exactly what they will do and who is responsible for what in an emergency. The plan includes instructions on how to reach myself and emergency personnel, and coaches are required to have their plan with them at all times. Emergency plans are always important, but with small staffs, they are even more critical.”

Managing the workload also means having great communication systems. Most small staffs share a physical space, but with everyone absorbed in their own responsibilities, people can end up like ships passing in the night. For Robinson, technology is part of the answer. “I designed a computer system a few years ago that allows us to track all of our injuries and treatments, and we use it for everything,” he says. “If one of us talks to a parent, the conversation is summarized in the system. Return-to-play decisions, notes from a physician, new injuries, and even non-health-related incidents with kids are all there. It takes time to input the information, but it’s a great communication tool for when we’re too busy to keep each other updated verbally.”

However, you still need to find some time for face-to-face communication. “We recently reinstituted a Monday morning staff meeting after not doing if for a while, and it definitely makes a difference,” Green says. “We go over specific athletes’ care, who got injured over the weekend, who returned to play, and who needs to see a doctor. It’s helped us to be more efficient.”

Communication is also key to avoiding the burnout that can result from a big workload and small staff. It’s up to the head athletic trainer to be aware of whether his or her staff is feeling energized and motivated or exhausted and needing a break.

“I let my staff know I’m concerned about how they’re handling the workload,” Green says. “If they need time off to take care of things in their personal lives, I try hard to accommodate that, and I try to schedule in a way that gives them as much downtime as possible.”

“It’s important to communicate about this issue often,” agrees Murphy. “Check in at least once a month with each of your folks and ask, ‘How are you holding up? What is your motivation level like?’ High volume can lead to frustration and fatigue, but by simply keeping in touch, you can guard against it.”


Despite all its challenges, being in the trenches alongside a close-knit group of dedicated professionals who are passionate about athletic training can be extremely rewarding, and perhaps the best thing a head athletic trainer with a small staff can do is focus on the benefits the setting offers. “I might not get reimbursed like athletic trainers at larger schools or clinics, but I love being where I am,” Wood says.

“There are great benefits to a small setting,” she continues. “You really get to know the kids and appreciate who they are. As a staff, you have a chance to work in ways that are a little less formal and really create friendships.”

“I’ve never been part of a big staff, and I wouldn’t have it any other way,” O’Shea says. “I love really getting to know my assistants and my athletes. I love seeing my assistants learn and grow and take on bigger challenges. It’s a family, and I’m part of it. For me, that’s as good as it gets.”

Sidebar: Encouraging Initiative

Assistant positions in small athletic training staffs are often the first career stop for recent grads. And that can be a great situation, according to Sharon Wood, LAT, ATC, Head Athletic Trainer at Maryville College. Athletic trainers in their first full-time job are energetic, passionate about the profession, and up to date on the latest information.

What they sometimes are not, however, is confident. And when their head athletic trainer has been in the profession for decades, that can lead to problems.

“One of my challenges is getting my assistants to believe in their abilities, take initiative, and not constantly defer to me on decisions,” says Wood, who has been at Maryville for nearly 20 years. “Because I have been here so long and am used to having so much responsibility, it’s also hard for me to not jump in and do things for them when I see them hesitate. But I know I need to let them do the job—we have too much on our plates for me to try to do it all.”

For Wood, the solution has been to allow her assistants to make mistakes as long as they won’t negatively affect an athlete. “They have to learn their lessons the same way I learned mine, and I have to let them do it,” she says.

Another effective strategy has been what Wood calls “debriefing.” “When an assistant has turned to me for help on something, after the athlete leaves, I talk with them about what happened,” she says. “I say, ‘You know, you had that. You were fine. You didn’t need me. You’re making great decisions, so try to do it yourself next time.’

“I also always make sure to tell them, ‘If you see me coming in and bumping you off something when you have it under control, feel free to tell me to get lost!'” she continues. “It takes time, but the delegation process has finally become a lot smoother.”


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