Agentic Denial: How Athletic Teams Sustain Divergent Structures During Concussion Events

Abstract

This study reveals how athletic health care teams, embedded within large bureaucratic organizations and complex social systems, negotiate and sustain multiple divergent structures. An iterative analysis of 69 in-depth interviews with National Collegiate Athletic Association (NCAA) Division I athletes’ certified athletic trainers (ATCs) and coaches from four high-contact sports (i.e., women’s lacrosse, men’s wrestling, men’s soccer, and men’s football) revealed that team members coconstructed and negotiated multiple conflicting structures during concussion events. The divergent macro-, meso-, and micro-level structures include (a) formal versus hidden authority structures, (b) prevention versus inevitability discourse, (c) assigned versus enacted roles, and (d) authentic versus inauthentic injury performance. The analysis also revealed how a specific speech act, termed agentic denial, enabled members to obscure their agency within concussion events. Theoretical implications and practical recommendations are discussed.