Purpose: Legislation was created for NCAA Divisions I, II, and III to guarantee an independent medical care administrative structure designed to give “unchallengeable autonomous authority” regarding diagnosis, management, and return to play decisions to primary athletics health care providers (physicians and athletic trainers). The purpose of this project was to 1) explore the structure of athletic health care in NCAA athletic institutions as it relates to independent medical care, and 2) describe changes in those structures that have occurred as a result of the COVID-19 pandemic. Methods: We used a cross-Sectional Study. Setting: College/University. In 2017, 162 supervising athletic trainers responded to our survey. Variables collected included health care delivery model, AHCA selection, decision making and injury reporting structure, confidence in independent medical care, COVID-19 response involvement, changes due to COVID-19. Results: The overall demographic characteristics indicated that most supervising athletic trainers were male (117/162, 72.2%), 48 ± 10 y old, and have been at the institution for a significant tenure 15 ± 11y. In 2020, responses from 174 supervising athletic trainers were recorded in the survey. The majority of respondents were male (108/174, 62.1%). Average age of the population was 45 ± 11y with 22 ± 10y of experience and 15 ± 10y of experience at their current institution The athletics health care model is most common across all NCAA Divisions (n=163 80.7%). Average confidence was rated 4.54 ± 0.67. Results indicate a significant increase in confidence from 2017 to 2020 that patient care decisions are independent of influence. The majority of supervising athletic trainers indicated that they were involved in COVID-19 response (n=190, 94.1%) Conclusions: More NCAA Institutions should transition to a medical model of health care delivery to ensure independent medical care. Athletic trainers were used in the policy creation and implementation of COVID-19 protocols for their institutions and athletics programs.

Author Bio(s)

Benjamin J.Colletti, DAT, LAT, ATC, is an Assistant Athletic Trainer at North Central College.

Matthew J. Rivera, DAT, LAT, ATC, is an Assistant Professor at Indiana State University in the College of Health and Human Services.

Lindsey E. Eberman, PhD, LAT, ATC, is a Professor at Indiana State University in the College of Health and Human Services.


The authors would like to thank the following members of our team: Sean Degerstrom, DAT, ATC, LAT (St. Cloud State University), Mark Laursen, MS, ATC (Boston University), Elizabeth Neil, PhD, ATC, LAT (Temple University). Their contributions and passion for high quality patient care were pivotal in the development of this project.




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