Higher Order Themes Research Articles

Undergraduate Athletic Training Students' Influences on Career Decisions After Graduation

Career opportunities for athletic training students (ATSs) have increased substantially over the past few years. However, ATSs commonly appear to be opting for a more diversified professional experience after graduation. With the diversity in available options, an understanding of career decision is imperative. To use the theoretical framework of socialization to investigate the influential factors behind the postgraduation decisions of senior ATSs. Qualitative study. Web-based management system and telephone interviews. Twenty-two ATSs (16 females, 6 males; age = 22 ± 2 years) who graduated in May 2010 from 13 different programs accredited by the Commission on Accreditation of Athletic Training Education. All interviews were transcribed verbatim, and the data were analyzed inductively. Data analysis required independent coding by 2 athletic trainers for specific themes. Credibility of the results was confirmed via peer review, methodologic triangulation, and multiple analyst triangulation. Two higher-order themes emerged from the data analysis: persistence in athletic training (AT) and decision to leave AT. Faculty and clinical instructor support, marketability, and professional growth were supporting themes describing persistence in AT. Shift of interest away from AT, lack of respect for the AT profession, compensation, time commitment, and AT as a stepping stone were themes sustaining the reasons that ATSs leave AT. The aforementioned reasons to leave often were discussed collectively, generating a collective undesirable outlook on the AT profession. Our results highlight the importance of faculty support, professional growth, and early socialization into AT. Socialization of pre-AT students could alter retention rates by providing in-depth information about the profession before students commit in their undergraduate education and by helping reduce attrition before entrance into the workforce.

Barriers to cervical screening in women who have experienced sexual abuse: an exploratory study

ObjectivesTo explore self-reported cervical screening history and barriers to attendance among women who have been sexually abused and to identify measures to improve the experience of cervical screening for these...

Performance leadership and management in elite sport: recommendations, advice and suggestions from national performance directors

The purpose of this study was to elicit recommendations, advice and suggestions that can be used to enhance performance leadership and management in elite sport. To garner such information, 13 national performance directors were interviewed regarding the recommendations, advice and suggestions they had for leaders and managers of national sports teams and the sport organisations in which they operate. Five higher-order themes emerged for leaders and managers: establishing an approach, understanding roles within the team, developing contextual awareness, enhancing personal skills and strengthening relationships. There were also five higher-order themes for sport organisations: employing the most appropriate individual, creating the optimal environment, implementing systems and structures, developing an inclusive culture and providing appropriate support. As national governments place heightened importance on international sporting success, it is anticipated that the findings of this study will enable leaders, managers and sport organisations to more effectively address issues accompanying the leadership and management of Olympic programmes.

Elite Swimming Coaches’ Perceptions of Mental Toughness

Using the mental toughness framework of Jones, Hanton and Connaughton (2007), the authors interviewed thirteen highly-experienced swimming coaches in a two-part study to determine the specific mental toughness subcomponents present in mentally tough swimmers, and to examine the factors that led swimmers to develop mental toughness. Interviews were transcribed and analyzed using methods outlined by Creswell (2007). While confirming eleven of thirteen subcomponents of mental toughness previously identified by Jones et al. (2007), the participants identified (a) “coachability” and (b) “retaining psychological control on poor training days” as previously unidentified subcomponents of mental toughness. In the second part of the study, the authors identified six higher-order themes describing how both the coach and the swimmer acted to develop mental toughness in the swimmer. Implications for researchers, swimming coaches, and sport psychology consultants are discussed.

Exploring the impact of involving fathers in the treatment of their children: A study using Interpretative Phenomenological Analysis (IPA)

Although fathers have been shown to contribute uniquely to the development of psychopathology in children, they continue to be ignored in research and clinical work. Knowledge about the impact of involving fathers in their child’s treatment – for the child, couple and the family as a whole - is still sparse. The aim of this study was to explore parents’ experiences of having fathers involved in the treatment of their child. Parents, whose children had received cognitive behavioural therapy for an anxiety disorder, were interviewed about this topic. The participating parents had all been involved in the treatment of their child. Interpretative phenomenological analysis (IPA) was used to analyze the data in this study. Three higher order themes and 11 subthemes emerged from the six interview accounts. The three higher order themes were as follows: Strengthening the family system, empowerment of parents, and impact on partner relationship. Results indicated that parents’ experiences of the involvement of fathers to be beneficial not only on the child’s treatment but also on other aspects of family life. The parents reported that the family as a whole benefitted from the treatment and that the relationship between the parents was strengthened. A model was created to conceptualize these results.

Climate change discourse in mass media: application of computer-assisted content analysis

Content analysis of mass media publications has become a major scientific method used to analyze public discourse on climate change. We propose a computer-assisted content analysis method to extract prevalent themes and analyze discourse changes over an extended period in an objective and quantifiable manner. The method includes the following: (1) sample selection; (2) preparation of the text segments for computer processing; (3) identifying themes in the texts using exploratory factor analysis; (4) combining identified themes into higher order themes using confirmatory factor analysis; (5) using factor scores to interpret themes obtained from public discourse; and (6) tracking the main themes of public discourse through time. We apply the proposed methodology to the analysis of the articles published in the New York Times on climate change during the period from 1995 to 2010. We found a gradual decline in the volume of material within the “Science” topic and an expansion of themes classified under the “Politics” topic.

Collegiate Basketball Players’ Experiences of being Coached During a Turnaround Season

The primary purpose of this study was to examine basketball players’ experiences of being coached during a turnaround season. Participants included eight collegiate men’s basketball players (ages 18–23) and one staff member representing an NCAA Division I program at a large university in the United States. All participants were involved with the basketball program during back-to-back seasons in which the team experienced a losing record (14–17) followed by a coaching change, and then a winning record (22–8) and conference championship. Semistructured interviews (lasting between 30–90 min) were conducted and transcribed verbatim. Analyses of the transcripts revealed 631 meaning units that were further grouped into lower and higher order themes. This led to the development of five major dimensions which encompassed these basketball players’ experiences of being coached during this extraordinary turnaround season including their (a) Experiences of Coach’s Personality Characteristics; (b) Experiences of Coach’s Philosophy, System, and Style of play; (c) Experiences of His Coaching Style; (d) Experiences of the Practice Environment; and (e) Experiences of How Coach Influenced Us.

‘Skating on thin ice?’ Consultant surgeon's contemporary experience of adverse surgical events

Concerns about patient safety have prompted studies of adverse surgical events (ASEs), but descriptive classification of errors and malpractice claims have overshadowed qualitative investigations into the processes that lead to expert errors and their solutions. We studied consultant surgeon's perspectives on how and why events occurred through semi-structured interviews about general and specific events. The sample contained heterogeneous cross-section of ages, gender and specialists, with >2 years consultant status and working within a 25-mile radius. Overarching findings included (1) pressures to work harder, faster and beyond capability within a blaming culture; (2) optimism bias from over-confidence and complacency; and (3) multiple pressures to ‘finish’ an operation or list, resulting in completion bias. Seven high order themes were identified on the healthcare system, adverse event types, contributing factors, emotions, cognitive processes, error detection, and strategies, solutions and barriers. The process of classifying event types guided solution selection, and the decision about whether to formally report it. How serious consequences were for patients and their temporal effects, defined an adversity continuum. Minor events arose routinely i.e. technical discrepancies, side-effects. More problematic were sub-optimal outcomes and avoidable events. Despite their expertise, consultants were vulnerable to unavoidable, uncontrollable events which were major concerns. Most serious were near-misses, errors and mistakes. However, major errors did not inevitably lead to a catastrophe and minor errors could be extremely serious. A ‘cascade’ of minor events exacerbated by negative emotions can precipitate major events, and interception methods need investigation. Consultants felt powerless and helpless to change environmental, organisational and systemic problems; new communication and action channels are desirable. Confidence building in team leadership would promote ‘flatter’ hierarchies, facilitating appropriate warnings. Although implementing the WHO Checklist averts important problems, social, environmental and organisational contributing factors are largely overlooked here and in existing models.

What motivates the motivators? An examination of sports coaches

Background: Motivation is central to successful performance. In the case of sports coaches, drive is a prerequisite to sustained successful engagement in a complex, dynamic, and turbulent work environment. What fuels these coaches’ drive to pursue this vocational activity? Coach motivation has been underrepresented in previous research which has typically focused on the crucial impact coach behavior has on athlete motivation and subsequent sport participation. However, the motivation of coaches influences their coaching practices and behaviors. Purpose: The purpose of the current study was to examine the motivation of Australian sports coaches. Participants and setting: 13 coaches (nine men, four women) from a range of sports and levels of competition (i.e. participation, development, high performance) were selected to take part. Data collection: Participants were involved in one semi-structured interview lasting 50–90 minutes that was digitally recorded and transcribed by a professional blind to the nature of the task. Data analysis: Content analysis of the interview data was conducted to identify themes. Higher order themes were based on a process of triangular consensus. Findings: Data yielded four key dimensions related to why coaches coached: (1) connection with sport; (2) coach and athlete development; (3) external influences, and (4) internal influences. Conclusion: Coaches have a range of motivations driving their continued involvement. Findings are discussed in light of self-determination theory, and specifically the importance of promoting high levels of self-determined motivation and psychological need satisfaction in this population.

Revisions to the Sport Psychology Service Delivery (SPSD) Heuristic: Explorations With Experienced Consultants

Sport psychology service delivery (SPSD) heuristic (Poczwardowski, Sherman, & Henschen, 1998) included key components of applied work. Nevertheless, the complexities of sport psychology consulting need an even broader representation. In individual, semistructured interviews, 10 experienced sport psychology consultants explored the usefulness of the original heuristic and newly added elements in their professional practice. Inductive analysis (Lincoln & Guba, 1985) resulted in a total of 2409 meaning units that were grouped into 127 lower-order themes and 32 higher-order themes that were used to clarify, expand, and revise the SPSD model as interpreted by the participants. Based on the new elements (i.e., consultant-client relationship, the consultant variables, the client variables, immersion, and the goodness of fit) and two meta-themes (i.e., interrelation and person-focused values), a newly configured heuristic is proposed (SPSD-Revised). Future researchers will benefit from different research methods and diversified conceptualizations of sport psychology service delivery to account for professional practice variables in various contexts.

Professional Preparation Regarding The Recognition And Treatment Of Exertional Heat Stroke: The Student Perspective

Context: Current evidence suggests rectal temperature(Tre) and cold-water immersion (CWI) are the most effective means to diagnose and treat exertional heat stroke (EHS), respectively. Educators, clinicians, and students should be apprised of this evidence to guide their practice. Objective: Investigate what athletic training students (ATS) are learning regarding EHS, both in the classroom and clinical settings that may one day influence their practices as athletic trainers (AT). Design: Qualitative design using in-person focus groups. Setting: National meeting in San Antonio, Texas, 2009. Patients or Other Participants: Thirteen rising senior ATS in a Commission on Accreditation of Athletic Training Education (CAATE)-accredited athletic training education program. Data Collection and Analysis: Interviews were transcribed verbatim and analyzed using open coding techniques. Peer debriefing and multiple-analyst triangulation were used to ensure trustworthiness of the data. Results: Two higher order themes emerged from the data analysis: Lack of Experience and Educators' Influence. Lack of Experience summarizes the ATS lack of exposure, both in the classroom and in the clinical setting regarding the skills associated with EHS. It was apparent that the participant's lack of understanding of EHS was a direct result of a lack of time spent with the topic. The higher order theme of Educators' Influence highlights the role that educators play in influencing and shaping ATS retention of materials, competence, and future practice beliefs regarding EHS. Conclusion: A cyclic reaction occurs with regards to EBP that directly influences ATS. Until the cycle is broken, ATs will continue to struggle implementing best practices identified from research into clinical practice.

Barriers and enablers for visually impaired students at a UK Higher Education Institution

The present study explored the factors which represent barriers and enablers to participation in Higher Education for students who are visually impaired. Semi-structured interviews were conducted with nine visually impaired students who were studying at a Higher Education Institution in the United Kingdom. Interpretative Phenomenological Analysis revealed four higher-order themes: the student’s attitude (i.e. self identity, positive aspects of being visually impaired, engagement with support), institutional provision (i.e. campus navigability, central services support, school-level support), external support (i.e. travelling to and from campus, external financial support) and others’ attitudes (i.e. parental attitudes, staff attitudes). These findings are discussed with reference to how institutions may enhance the experience of not only visually impaired, but all Higher Education students.

Critical learning themes in project management education: Implications for blended learning

This research examines the underlying reasons why students taking project management courses emphasise skills that are transferable and the utilisation of e-learning environments as critical to their learning experiences. Students' opinions are expressed through a series of focus groups. We found that the underlying reasons for students' emphasis on these two factors as crucial to learning and teaching project management could be classed under five higher-order themes. The implications of our findings are that in order to develop desired human, conceptual and technical skills, a teaching approach based on a blend of learning that resides at the intersection of the ‘transferable skills’ and ‘e-learning environments’ construct is required for the effective teaching of project management. For effectiveness, this blended form of andragogy (learning focused on adults) must be flexible enough to cater for the vast variations in the profiles of students, and their individual learning preferences.

Ethical issues encountered by medical students during international health electives

Medical students increasingly wish to participate in international health electives (IHEs). The authors undertook to understand from the students' perspective the ethical challenges encountered on IHEs in low-resource settings and how students respond to these issues. Semi-structured interviews were conducted with 12 medical students upon their return from an IHE. A purposive sampling strategy was used. Inductive data analysis using a constant comparative technique generated initial codes which were later organised into higher-order themes. Five themes relating to ethical issues were identified: (i) uncertainty about how best to help; (ii) perceptions of Western medical students as different; (iii) moving beyond one's scope of practice; (iv) navigating different cultures of medicine, and (v) unilateral capacity building. International health electives are associated with a range of ethical issues for students. Students would benefit from formal pre-departure training, which should include an evaluation of their expectations of and motivations for participating in an IHE, careful selection of the IHE from amongst the opportunities available, learning about the local context of the IHE prior to departure, and the exploration and discussion of ethical and professionalism issues. Other factors that would benefit students include having an invested onsite colleague or supervisor, maintaining an ongoing connection with the home institution, and formal debriefing on conclusion of the IHE.

Coaches' views of mental toughness and how it is built

The purpose of the present study was to explore coaches' perceptions of mental toughness attributes as well as the strategies used to build mental toughness. Participants were 10 National Collegiate Athletic Association head coaches from a variety of sports. In-depth interviews were conducted using standard qualitative methodology and content analyzed by three researchers. Based on raw data responses, lower and then higher-order themes were developed to capture the main ideas of mental toughness discussed by coaches. Regarding mental toughness attributes, psychological skills, motivation to succeed, and resilience emerged as higher-order themes, indicating some overlapping themes with previous studies exploring attributes from athletes' perspectives. Creating a tough physical practice environment, a positive mental environment, and providing mental toughness learning opportunities were themes that emerged as strategies coaches used to build mentally tough athletes. Findings are discussed in reference to previous literature on mental toughness and the psychology of excellence.

Is anybody listening? A qualitative study of nurses’ reflections on practice

To explore nurses' perceptions of the reality of practice based on data from the Nurses and Midwives e-cohort Study which examined the workforce characteristics, work-life balance and health of nurses. Recruitment and retention of the nursing workforce is of international concern as demands increase due to demographic changes, political pressure and community expectations, in a climate of economic constraint. Qualitative analysis of data from a cohort of Australian, New Zealand and UK nurses. Of the 7604 participants in the electronic cohort, 1909 provided qualitative comments of which 162 related to nursing practice; thematic analysis resulted in four high order themes. The analytical discussion is structured around 'care' as the organising construct. Four themes emerged: 'embodied care' which discusses the impact of work on the nurse's physical and emotional health; 'quantity/quality care' which addresses increasing pressures of work and ability to provide quality care; 'organisational (non)care' raising the seeming lack of support from management; and '(un)collegial/self care' where bullying and professional relationships were raised. Issues raised by participants have been discussed in the nursing literature for several years yet nurses still experience these negative aspects of nursing. It appears there is a significant gap between what is known about the practice environment, recommendations for change and change occurring: the management equivalent of the theory-practice gap, resulting in nurses intending to leave the profession. Research demonstrates that a well-qualified, stable nursing workforce improves quality of health care and health outcomes. Changing the work environment and fostering a positive workplace culture seems fundamental to supporting the retention of nurses, that this is not occurring in some areas in the current climate is a concern for the profession and those responsible for the provision of care.

One World, One Dream: A Qualitative Comparison of the Newspaper Coverage of the 2008 Olympic and Paralympic Games

This study compared and explored the textual coverage of the 2008 Beijing Olympic Games (OG) and Paralympic Games (PG) by the Canadian newspaper The Globe and Mail. The authors found 8 high-order themes and 25 low-order themes for the OG. The high-order themes were predicting game results, reporting game results, athleticism, politics, ethical issues, nationalism, the media, and the economy. For the PG, there were 4 high-order themes, and each high-order theme had 1 low-order theme. The high-order themes were reporting game results, athleticism, ethical issues, and equality between Paralympians and Olympians. Comparisons between OG and PG coverage are discussed and recommendations for future research provided.

Assessing Strategies to Manage Work and Life Balance of Athletic Trainers Working in the National Collegiate Athletic Association Division I Setting

Certified athletic trainers (ATs) working at the National Collegiate Athletic Association Division I level experience challenges balancing their professional and personal lives. However, an understanding of the strategies ATs use to promote a balance between their professional and personal lives is lacking. To identify the strategies ATs employed in the Division I setting use to establish a balance between their professional and personal lives. Qualitative investigation using inductive content analysis. Athletic trainers employed at Division I schools from 5 National Athletic Trainers' Association districts. A total of 28 (15 women, 13 men) ATs aged 35 ± 9 years volunteered for the study. Asynchronous electronic interviews with follow-up phone interviews. Data were analyzed using inductive content analysis. Peer review, member checking, and data-source triangulation were conducted to establish trustworthiness. Three higher-order themes emerged from the analysis. The initial theme, antecedents of work-family conflict, focused on the demands of the profession, flexibility of work schedules, and staffing patterns as contributing to work-life conflict for this group of ATs. The other 2 emergent higher-order themes, professional factors and personal factors, describe the components of a balanced lifestyle. The second-order theme of constructing the professional factors included both organizational policies and individual strategies, whereas the second-order theme of personal factors was separation of work and life and a supportive personal network. Long work hours, lack of control over work schedules, and unbalanced athlete-to-AT ratios can facilitate conflicts. However, as demonstrated by our results, several organizational and personal strategies can be helpful in creating a balanced lifestyle.

Psychological Qualities of Elite Adolescent Rugby Players: Parents, Coaches, and Sport Administration Staff Perceptions and Supporting Roles

The aim of the current study was to extend previous research by Holland and colleagues (2010) into the required psychological qualities of young talented rugby players by considering the perceptions and supportive role of influential others. Perceptions of players’ parents (n = 17), coaches (n = 7), and sport administration staff (SAS; n = 2) were explored through focus group discussions. Findings show that these influential others considered the same 11 higher order themes for psychological qualities previously identified as desirable by players. Their views on how they assisted in developing these player psychological qualities were classified into three higher-order themes, namely progressive development, professional environment, and performance environment. Specific behaviors contributing to each context and deemed helpful by influential others were discussed in terms of ecological systems theory (Bonfenbrenner, 1977). Recommendations for future research and applied implications for consultants are subsequently offered.

A Cross-Cultural Perspective of Parental Influence on Female Adolescents' Achievement Beliefs and Behaviors in Sport and School Domains

Little is known about parental socialization processes for youth participants from different cultural backgrounds. The purpose of this study was to examine parental influence on self-perceptions, task values, and achievement behaviors among female adolescents from two cultures using Eccles' expectancy-value theory (Eccles et al., 1983) . Twelve Anglo Canadian and nine East Indian female adolescents were interviewed about perceptions of parental influence on expectancy-value constructs for sport and academic domains. Inductive and deductive content analyses were performed to identify lower and higher order themes from interview responses. Similarities and differences in perceived parental influence emerged for girls of both cultural groups and in both domains. Our findings support links among expectancy-value constructs and highlight cultural variations in parental socialization of achievement cognitions and behaviors in multiple domains.