Context: Limited literature explores professional preparation of program directors (PD) to lead an athletic training education program (ATEP). Objective: To explore challenges, effectiveness, leadership, and PD role selection. Design: Descriptive and qualitative exploratory email survey. Setting: Educational. Participants: Emails were sent to 345 PDs from a Commission on Accreditation of Athletic Training Education (CAATE) listing. Main Outcome Measure(s): Measures of central tendency were used to observe years of experience, role selection (applied versus appointed), education level, and gender. Program Director effectiveness, leadership, and challenges were grouped according to common themes. Results: Most PDs (82.5%; n = 99) reported having one to ten years of experience. Mean years of experience was 7.46 (±6.36) years. A majority, 61.7% (n = 74), reported having applied for their position. Educationally, 54.2% (n = 65) held doctoral degrees compared to 45.8% (n = 55) whose highest degree was a masters degree. Six themes emerged for PD effectiveness and challenges. Lastly, seven themes regarding leadership were described. Conclusions: Program Directors should approach their role with savvy, caring, and humanistic attitudes, developed by professional preparation. Firm in their convictions and vision, PDs also are viewed as empathetic advocates for students. Program Directors play a critical role in the advocacy of the profession within institutions of higher education through professional preparation of students. Several themes pertaining to professional preparation of PDs may positively impact the profession. Future PD's should seek educational programs that prepare them for these challenges of the position, such as professional preparation in education and higher administration or curriculum and instruction.
Objective: To present the case of a female collegiate basketball player who was diagnosed with Wegener granulomatosis of the eyes and immunoglobulin A (IgA) nephropathy. Background: A 19-year-old female collegiate basketball player presented to a rheumatologist, urologist, and nephrologist with severe eye pain and was diagnosed with Wegener granulomatosis and IgA nephropathy. At age 20, during routine follow-up testing, urine protein levels were found to be 3 times normal values (0–8 mg/dL), prompting the need for a kidney biopsy, which showed IgA nephropathy, another autoimmune disorder. Differential Diagnosis: Sinus infection, scleritis, lymphomatoid granulomatosis, Churg-Strauss syndrome, lupus erythematosus, general granulomatosis. Treatment: Initial assessment revealed signs and symptoms, particularly in the patient's eyes, consistent with a sinus infection and scleritis. Her corneas were examined by a specialist, who prescribed various medications, including prednisone, for the relief of symptoms. When the dosage of prednisone was reduced, symptoms returned. Further tests revealed the presence of anti-neutrophil cytoplasmic antibody, a protein associated with Wegener granulomatosis, which helped confirm the diagnosis. The following year, a routine urinalysis showed abnormal levels of protein in her urine. A kidney biopsy revealed that IgA nephropathy also was present. At the time of this case report, the athlete continues to be monitored by an ophthalmologist who specializes in Wegener granulomatosis, a rheumatologist, and a nephrologist. Uniqueness: This athlete presented with 2 rare autoimmune disorders at an early stage of life. The medications used to treat the disorders left the athlete fatigued on a daily basis. Additionally, she was placed on 3 immunosuppressant drugs, which increased her risk for further health complications, yet she was able to successfully compete in athletics at the collegiate level. No family history of renal disease or other autoimmune disorders was discovered, further adding to the complexity and uniqueness of this case. Conclusions: Autoimmune disorders, such as Wegener granulomatosis, can present with a variety of common signs and symptoms. As athletic trainers, we encounter a host of unusual signs and symptoms; however, in cases such as this, further investigation into the cause of the chief complaints can go a long way toward restoring or managing an athlete's health. Excellent communication among the sports medicine team helped this athlete manage her potentially life-threatening condition while allowing her to remain active in her sport.
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