Team Leadership Model Compared to Transformational Approach for Head Athletic Trainers at Division II Universities

Context: The demands and expectations of athletic trainers employed at various settings, especially within the collegiate level have increased over the years. This creates additional experience and knowledge that athletic trainers must acquire. Objective: To investigate the best leadership approach for Head Athletic Trainers. Design: Sequential, explanatory study utilizing surveys to a specific population. Participants: From a purposeful sampling of 313 head athletic trainers employed in the NCAA Division II setting, 76 individuals provided usable data to use. Main Outcome Measure(s): A previously validated and reliable leadership survey using a 4-point Likert scale was administered. Results: A quarter of the participants (24.3%) experienced to display Transformational leadership in their daily duties as a Head Athletic Trainer. Differences existed by specific questions. Conclusion: Transformational leadership is most utilized. Other characteristics are lacked from team leadership that could overall benefit. Self-perception of leadership could be better.

TheAthletic Training profession is growing in popularity across the nation in multiple settings. Many colleges are also growing athletically; therefore the need for athletic trainers continues to grow as well to meet the demands. "As athletic training matures, greater leadership within the sports medicine community is needed" (Kutz, 2010). "By virtue of their responsibilities, head athletic trainers are in positions of leadership" (Laurent &Bradney, 2007). However, many Athletic Trainers do not think of themselves as leaders as they do not naturally have a need for management skills in their day-to-day lives. Therefore, with the rise of population and the growth within the Athletic Training world, Head Athletic Trainers are becoming more knowledgeable on the importance of acquiring leadership skills to run a facility most effectively. Due to this rise it will be important to differentiate between leadership and management (Table 1). Leadership influences relationships concerned with real change and management is authoritarian concerned with goods and services (Nellis, 1994). This study will attempt to answer the following question: Does the Team Leadership Model provide a more effective management style compared to a Transformational Leadership approach for a Head Athletic Trainer at a DII University? As the two leadership models can have similar outcomes, they are two distinct concepts (Table 1). The team leadership model "is designed to simplify and clarify the complex nature of team leadership and to provide an easy tool to aid leadership decisionmaking for team leaders" (Northouse, 2015).
While the transformational leadership approach focuses on "emotions, values, ethics, standards, and longterm goals" (Northouse, 2015). This study will help prospering Athletic Trainers have an idea about which leadership model they should implement into their daily workplace to be a successful manager in the athletic training field. The purpose of this study is to help novice Athletic Trainers know what it takes to be a successful leader and manager to benefit overall patient satisfaction. There are not many studies" that discuss the athletic trainers" importance in management roles. For this reason, there are many Athletic Trainers that will take on a management position, not knowing what to expect. This study will help Athletic Trainers know and understand the importance of acknowledging leadership skills and how they can utilize these skills. "Designed to simplify and clarify the complex nature of team leadership and to provide an easy tool to aid decision-making for team leaders"

Participants
The subjects for this study will include Division II collegiate Head Athletic Trainers who are in charge of the colleges"/universities" athletic training department. These subjects will be recruited from NCAA Division II institutions across all eight NCAA Division II regions: Atlantic, Central, East, Midwest, South, South Central, Southeast, and West. An email containing the survey will be sent to 313 Head Athletic Trainers of each university in all eight regions at the Division II setting. The sole criteria for inclusion are that each subject currently serves as the Head Athletic Trainer responsible for managing an athletic training department. For the purpose of this inclusion, there is only full time Head Athletic Trainers to be questioned. The obtainment of email addresses for the Head Athletic Trainers are public records listed online under the official athletic staff directory for each institution. There is a potential risk of losing anonymity. Confidentiality will be maintained by not making any links between the individuals and their responses. Utilizing Qualtrics will help insure in maintaining their confidentiality. In the event that a subject chooses not to complete the survey, there will be no way for the researcher to determine who they were. Procedures An email will be sent out to each of the 313 Head Athletic Trainers for the survey. Within this email, there will be a description of the survey and what the purpose of the study will be. At the end of the email, the link to the survey will be supplied. If the targeted participant decides to participate in the study, they will be asked to click on the link that will lead them to an informed consent form. At the conclusion of the informed consent, each subject will have the option to agree or disagree. If the subject agrees to the informed consent, they will then be taken to the survey to complete. The survey will be composed of two sections: demographics and leadership approach questions. The demographics sections will consist of 10 questions while the leadership approach questions will have 25 questions for an overall total of 35 questions. The survey will take approximately 15 minutes to complete. The survey consists of questions of how often a situation occurred, utilizing a 4-point Likert scale (1 = rarely, 2 = sometimes, 3 = often, 4 = almost always). The specific Transformational and Team Leadership questions were utilized from the survey provided by Northouse. To maintain confidentiality throughout the entire research process, each subject"s answers will be stored within the Qualtrics survey and will be protected by an electronic password protected format. The subjects" identity and answers will remain anonymous to the researchers throughout the entire process. All potential identifiers such as name, institution, email address, or other identifiers will not be collected nor disclosed to the researchers at any time. To help maintain confidentiality there will be no efforts made to link responses to specific individuals. There will be no way for the researchers to identify which subjects decided to participate in the survey to those who did not. In the event of an unintentional breach of confidentiality, the questionnaire responses from the comprised subject will be eliminated from the study and will no longer contribute to the study"s results. This study is strictly voluntary and no means of compensation will be given to those who decide to participate in the study. Participation of this study will only provide opportunity of what a Head Athletic Trainer may obtain for an appropriate leadership model.

Results
Demographics of the NCAA Division II Head Athletic Trainers in our study are presented in Table 2. The leadership approach scores from the survey are presented in Table 3.
Of the 313 subjects that were sent the survey, only 76 responded giving a 24% response rate. Transformational leadership displayed the higher overall score by the majority of the responses (80%). Demographics show the majority of the participants were male, white, between the ages 25-34, who have been Head AT for at least 0-3yrs with a Master's degree covering 15 or more teams with additional duties.
Further analysis identifies that there was a greater variation of scores for the Team Leadership approach questions versus the Transformational Leadership approach. The Team Leadership approach had a high majority score ranging from a 2-4 score (2 = sometimes; 4 = almost always). While the Transformational Leadership approach had a consistent high majority 3 score (3 = often). Self-perception scored consistent with 3 as well.  (75) Transformational leadership had a higher score rating utilizing the Likert"s scale to total the score giving an 80% score.
We noted a difference between the variation of questions and how the participants scored those questions. The Transformational Leadership approach had two questions that had a majority high score of almost always (59% and 40.3%). While the Team Leadership approach also had two questions that had a majority high score of almost always (63.9% and 47.2%) as well as two questions that had a majority low score of sometimes (51.4% and 44.4%).
Therefore, there is reason to believe that a selfperception score of 75% can be increased in relation to the low scores recorded.

Discussion
Incorporating leadership skills into the Head Athletic Trainers" roles have been associated with an increase in job satisfaction, an increase in patient satisfaction, and increase productivity by creating a positive friendly environment.
Positive leadership skills have also intrinsically affected the roles of employees by increasing motivation and accomplishing goals as an organization within a timely manner. Similarly, a positive workenvironment is produced from a positive leadership style, which then correlates to a positive patient satisfaction for their overall health. It is known that Athletic Trainers are considered as having great people skills being direct health care professionals with patients in various settings. Therefore, as Athletic Trainers it is crucial to obtain appropriate positive people skills for success. However, of all the survey questions administered, there were only two questions that a majority response scores of 2 (sometimes). Those two questions were in correspondence to people skills.

Table 4. Transformational Approach Question Scores n (%) Question
Rarely (1) Sometimes (2) Often (3) Almost Always (4) I go out of the way to make others feel good to be around me. Journal of Physical Education and Sports Management, Vol. 7(1), June 2020 Transformational leadership specific questions were sent to 313 DII Head AT's with the overall answers scored using a 4-poing Likert's scale by the 76 respondents. Team leadership specific questions pertaining to people skills and task skills are listed above thatwere sent to 313 DII Head AT's with the overall answers scored using a 4-poing Likert's scale by the 76 respondents.

Components of Leadership
Of the leadership components, specifically studied in this research between Transformational and Team Leadership, Transformational had the highest overall mean scores for Head Athletic Trainers at a Division II university. Transformational leadership focuses on "emotions, values, ethics, standards, and long-term goals" (Northouse, 2015). Table 4 displays the transformational leadership specific questions that were a part of the survey sent to 313 participants with a response rate of 24%. Team leadership"is designed to simplify and clarify the complex nature of team leadership and to provide an easy tool to aid leadership decision-making for team leaders" (Northouse, 2015). Table 5 displays the team leadership specific questions and details the difference between people and task skills using a 4-point Likert scale.
Of all the leadership questions, only four of them had a high majority score by most of the respondents. These four questions focused on task accomplishments, providing an empathic shoulder, building a great team, and encouraging team participation. Each characteristic are necessary components to have in order to be a great leader. However, there were two questions that scored fairly low overall by the majority responses. These two questions correlated with utilizing relevant information into action and counseling employees to improve performance. Both of which encourages great leadership. This goes to show that there are still areas to be worked on for Head Athletic Trainers to become better leaders in this field.

Influence on Leadership
Demographic and employment factors did not appear to influence total perceived leadership styles in Head Athletic Trainers at a Division II university. More team coverage and additional administrative duties did not cause a decrease in leadership approach. Even though the majority of the respondents were within the younger generation, leadership duties were not ignored but were also not overly utilized either. The additional administrative duties placed onto the Head Athletic Trainers seem to place a direct leadership role on them.
The number of years employed as a Head Athletic Trainer did not seem to affect leadership approach. The different organizational and personal factors such as additional administrative duties, more years experienced, and number of teams may have influenced the perceived leadership styles by the Head Athletic Trainer.
However, the Head Athletic Trainers self-perception of their leadership approach was interesting. Table 6 displays the questions asked in order to rate the Head AT"s self-perception of their leadership skills used and how they believe it affects surrounding influences. Although it had an overall majority score of 75%, which is initially good, compared to the low scores viewed in two particular questions, it is believed that the self-perception score could be and should be higher. The self-perception questions shows that current Head Athletic Trainers view their leadership approach as decent but could be better. Perceptions are crucial for confidence, trust, and growth in order to be successful. The survey then concluded with five questions pertaining to the Head AT's self-perception of their leadership skills used. The above questions were then scored using a 4-point Likert scale.

Conclusion
Our results give insight into the factors, consequences of perception, and resolution of leadership styles associated with Head Athletic Trainers. This information may be useful in developing strategies to further improve leadership into not just Head Athletic Trainers but all Athletic Trainers. Expanding athletic training educational programs to include (1) the development of people and task skills and (2) applying relevant information into action. This research study came across a few limitations. There were two Division II universities that did not receive this survey due to the website being in a different language. Another limitation was that the survey was sent out during prime "Spring Break" season, which is crucial for Athletic Trainers while this is the time for vacation or other out of office duties to be accomplished. Any future research pertaining to this study should follow allow for a longer time frame for more responses. A follow up survey may also be beneficial in order to see if the initial survey helped provoke any leadership changes.
Based on this research study, it shows that Transformational leadership provides a higher score of approach utilized within DII University Head ATs. However, while Team Leadership also provides a relative average score, a