Context: Many secondary school athletic trainers (ATs) complete per diem work as a way to supplement their income. Working per diem means the AT provides services to events that are not part of their main employment. Since this type of work is not connected to their main employment, the AT may lack appropriate professional liability insurance (PLI). PLI is a type of insurance that protects healthcare professionals from bearing the entire cost of defending a malpractice claim made by a former or current patient. Anecdotally, many ATs believe that the PLI provided by their main employer covers all health care services they provide, although this is not typically the case. Working without PLI is a legally risky behavior for ATs because defense against a malpractice claim could lead to financial ruin. Objective: This study examined ATs knowledge about the importance of having PLI and situations where they remain unprotected. Design: Cross-sectional. Setting: Participants completed a web-based questionnaire. Patients or Other Participants: Responses from 66 secondary school ATs were analyzed. Main Outcome Measures: The web-based survey was distributed to evaluate the level of knowledge secondary school ATs have regarding PLI. Results: The questionnaire revealed that 86.4% (n=57) of the participants did per diem work at least once per year. Of those who participated in per diem work, 29.8% (n=17) stated they did not have PLI. The questionnaire also revealed that only 46.8% (n=29) of the participants reported always having a physician who oversees them and knows they are working a per diem event. In addition, only 22.6% (n=14) of the participants reported always having a written contract that delineates their responsibilities for a per diem event. Conclusion: Many ATs self-reported athletic training practices that are in violation of the Board of Certification (BOC) Standards of Professional Practice and in violation of state practice acts by working without physician oversight and without PLI during per diem and volunteer events. In addition, many ATs are practicing with suboptimal business standards by working per diem and volunteer events without a contract that delineates responsibilities or pay. ATs must understand the situations where they are in violation of the BOC Standards of Professional Practice, their state acts, and situations where they are putting themselves at risk. ATs should ensure they have privately purchased adequate PLI any time they provide care outside their main employment job description, such as when they work per diem or volunteer as an AT. If an AT provides athletic training services without PLI they are ultimately exposing their personal assets and financial stability if a malpractice claim is made against them.

Thesis Completion




Thesis Chair/Advisor

Schellhase, Kristen


Bachelor of Science (B.S.)


College of Health Professions and Sciences


Kinesiology and Physical Therapy

Degree Program

Athletic Training



Access Status

Open Access

Release Date