Teaching Diversity Awareness

Carol Biddington, California University of Pennsylvania, PA

Biddington, Ed.D., is an Assistant Professor in the Department of Health Science and Sport Studies  in the College of Education and Human Services


This paper examines how athletic training graduate students’ cultural perspective affects their professional practice and how athletes interpret their language, comments, and behavioral patterns.  The students (N=72) received diversity awareness training, observed their work place, and completed an assignment.  Sixty percent of the students believed they could handle the complex issues of diversity relations.  Most of the students (58%) were not sure that their language, comments, and behavior were correctly interpreted.  Teaching diversity awareness allows students to discover self-awareness, values and beliefs, and behaviors.    



It is important that colleges of education include assignments for students to discuss cultural diversity issues.  All students, not just education majors, should have preparation programs which include knowledge, skills, and attitudes needed to interact effectively with individuals from diverse racial, ethnic, and social class groups (Banks, 2004).  Minority students who have experienced discrimination often have a difficult time accepting and valuing their own cultural heritage.  Students can accomplish cultural development by using Banks’ Stages of Cultural Development Typology.  During stage 1, individuals may demonstrate cultural self-rejection and low self-esteem by reflecting on negative stereotypes and beliefs about their cultural group.  The belief that their ethnic group is better than others characterizes Stage 2.  In Stage 3, individuals develop positive attitudes toward their cultural group.  Individuals in Stage 4 function effectively in their own cultural community as well as in another cultural community.  Individuals in Stage 5 have positive attitudes toward other racial, cultural, and ethnic groups.  Individuals in the final Stage 6 have the knowledge, skills, and attitudes for functioning effectively within their own cultural communities, within other cultures within their nation-state, in the civic culture of their nation and in the global community.   

Athletic training students are faced with diversity issues on a regular basis.  They spend long hours providing prevention, care, treatment and rehabilitation of injuries to a diverse population of athletes.  Therefore, students should receive formal training on multicultural education and diversity awareness to be better prepared to handle interpersonal and professional responsibilities.    

Athletic training is now recognized as an allied health profession (National Athletic Trainers’ Association, 2007).  Athletic training educators need to be aware of the overall scope of the educational mission.  Educators should not only teach the aspects of athletic training necessary for passing the certification exam, but also prepare students to understand issues of race, discrimination, identity, and diversity.  Athletic training educators need to provide sensitivity training and sociocultural awareness according to the 2007 NATA Athletic Training Educational Competencies.  Salili and Hoosain (2001) state that including multiculturalism in athletic training teaches students to accept, understand and appreciate culture, race, social class, religion, and gender differences and instills in them during their formative years a sense of responsibility and commitment to work toward the democratic ideals of justice, equality, and democracy. 

Geisler (2003) recommended that two questions: “How might your personal cultural perspective affect your practice as an athletic training professional?” and “How might athletes from different cultural backgrounds interpret your language, comments, and behavioral patterns?” be included in didactic and clinical learning experiences for athletic training students.  The purpose of this paper was to examine how athletic training students answered the two questions.



From 2003 to 2006, graduate athletic training students (N=74) enrolled in a Pedagogy class from the Athletic Training Education Program at California University of Pennsylvania were asked to observe their work setting for two weeks to identify issues in diversity and respond to the two previously stated questions.  At the start of the two weeks, material (Davis, 2001) was presented to help students increase their awareness of matters that are particularly sensitive for women and students of color.  Students also participated in diversity activities, discussed teaching strategies to address diversity, and wrote a paper on diversity issues they experienced during their undergraduate education.  One activity required students to reflect on understanding their own cultural perspective.  They must first understand themselves before they can respond to how their culture affects their behavior and how athletes may interpret their behaviors.  Some teaching strategies for diversity were recognizing biases or stereotypes, refraining from remarks that make assumptions, using correct terminology for ethnic and cultural groups, and treating each student with respect.

Students were told to let their athletes know that racist, sexist, homophobic, and other types of discriminatory remarks were not acceptable.  For example, if a student made a discriminatory remark, the athletic training student was to promptly speak up and state “That is inappropriate language and not welcome here.”  Students and/or athletes need to know that disparaging comments would not be tolerated.  The graduate students worked 30 hours a week as an athletic trainer in either a high school or college setting.  They held an authoritative role and were responsible for the environment in their athletic training rooms.  After two weeks of observation, students submitted their responses to the two questions.  Data were analyzed qualitatively; whereby the results were analyzed for trends and/or themes (Patten, 2007).   


Three themes emerged from the question: “How might your personal cultural perspective affect your practice as an athletic training professional?”  Sixty percent of the graduate students commented that their personal cultural perspective would have a positive affect on their practice as an athletic trainer.  They believed they were prepared to handle issues of racial, class, sexual, ethnic, and religious diversity.  Nineteen percent stated their practice as an athletic trainer may be affected because they may not understand an athlete’s culture.  Sixteen percent commented they may treat athletes in different ways due to prejudging individuals and/or a lack of diversity experience.  They may, without knowing, neglect their feelings.  Five percent did not answer the question.

The following quotes were some of the responses to the first question:  “How might your personal cultural perspective affect your practice as an athletic training professional?”

  • In my culture it is believed that you should work through your own problems and be tough through pain.  I find that I may not be sympathetic to athletes that are more sensitive to pain.  Therefore, this attribute affects my ability to treat the athlete’s injury in a negative way.
  • At times as humans, we are drawn to those we feel most comfortable with and may tend to provide care for those individuals first.  We must make sure that we provide equal care to all athletes in need.  Care should be given first to those whose health needs are most critical.
  • It makes a big difference knowing your athlete and their social status.  I’m not saying to be nosey but just get the feel through observation.  It makes a big difference with how the athlete deals with serious injuries and their attitude towards rehabilitation.  You want to be able to talk to the athlete and understand their concerns and questions.  If the athlete trusts you and finds you as a role model then you have a better chance of getting successful results as far as rehabilitation is concerned.  It helps you make big decisions for the athlete and helps you interact with the person.  It’s all about the athlete feeling comfortable about being themselves with you.  Understanding different cultures can only further your professional background as an athletic trainer.

Two themes resulted from the question: “How might athletes from different cultural backgrounds interpret your language, comments, and behavioral patterns?”  Most of the graduate students (58%) reported that athletes may interpret their language, comments, and behavior in a negative manner.  They stated that their actions and comments could be misinterpreted and they could not be certain they were understood.  Thirty six percent believed that athletes did not have problems interpreting their language, comments, and behaviors.  The question was not answered by 6% of the students. 

The following quotes were some of the responses to the second question:  “How might athletes from different cultural backgrounds interpret your language, comments, and behavioral patterns?”       

  • Athletic trainers need to be extremely aware of what is being said in the athletic training room, on the playing field, and any other time athletes may be around.  Language that could offend another individual should not be used.  First, an athlete should feel comfortable around the athletic training staff.  If improper language is being used that individual may feel tentative around you.  This may also affect how the athlete trusts you as well.  Another reason that improper language should not be used is due to the fact that an athlete may not come to you when an injury occurs if he or she believes they will not receive the proper treatment due to their different background or lack of trust in you.
  • We must give instructions clearly and ask them for their feedback to ensure that they understand what we are trying to communicate.  Sometimes different words are used for different items, thereby causing a barrier of communication. 
  • During a college cross-country invitational, I was called over to care for a runner from Kenya.  He had intense pain in his lower back, and when I lifted up his shirt to look at his lower back, I saw a scar on the left side.  I asked him where he had gotten it, thinking in my head it was some type of surgery or previous injury, and he said, “hunting”.  To that reply I was confused and was not sure if I had heard him correctly so I asked him again.  His reply was the same, “hunting”.  At this point I could tell that he was starting to get a bit frustrated from the pain and from me not comprehending his previous injury, so I decided to inject a little bit of humor into the situation.  I asked him, “Were you hunting or were people hunting you?”  This being the most innocent of statements or I thought it was, he laughed.  I gave the athlete ice and a few instructions to follow.  The athlete was very polite when leaving and I got him to smile one last time.  I discussed the situation with another athletic trainer.  She told me how much fighting was over in Kenya at the time and he could have been “hunted”.  I felt terrible at the mistake I had made, but luckily for me, the athlete allowed me to indirectly learn something new about his culture without taking offense to my innocent comment.
  • Athletes from cultures placing a great amount of importance on showing respect may be somewhat insulted by the lack of respect in the behavior of some Americans.  Additionally, those from cultures in which women have little power or voice may not take kindly to the influence American women have on everything from day-to-day life to the economy.  For example, an athlete from this type of country may not be pleased with a female athletic trainer making the decision of who is ready to play and who is not.  Also, I tend to be rather laid back with a joking attitude.  Athletes from other cultures, especially when English is not their first language, may not understand and take comments personally or in a way other than how they are meant.
  • In the south home remedies are quite often used to treat illnesses and injuries.  I have found that mothers will often perform these remedies on their children while receiving treatment from us.  If you tell the mothers not to use the remedies they become irate and tell their children not to come back to us for treatment.  If you do not embrace their culture or understand their culture you are more likely not to have them adhere to your treatments.

Differences in race, gender, social class, and sexual orientation are associated with power.  Prejudices may be reflected based on the norms of dominant groups.  Incidences of racial fear, discrimination, and avoidance still occur.  The following situations were reported:

  • Being an African-American female I am often a minority as an athletic trainer.  As a woman, at times it can be difficult to work with sexist male coaches especially in football.
  • The junior high football team was scheduled to play an away game.  The coach said that there was a good possibility that the game would be cancelled due to the fact that several of the parents didn’t want their children playing in the game because their opponents were primarily African American athletes.


The topic of cultural diversity is complicated and some faculty and students are uncomfortable when discussing diversity issues.  A graduate student was told by his female soccer athletes that they thought he did not like them and he was always mad because of his facial expressions and body language.  He said he was very serious about his professionalism and he did not feel comfortable with the girls’ soccer team because they were always asking him personal questions.  At first he would ignore them because he was not sure how to respond.  After some time he started to talk with them, but shifted the conversations to more acceptable topics.

There were times when individuals stated they were not being acknowledged.  Several female athletic trainers stated it was difficult to work with high school football coaches, especially if previous athletic trainers were male.  One female athletic trainer said the coaches would ask her male co-worker about the injuries.  The males dominated the discussion regarding care of the athletes. 

A student believed that overall people tend to relate better with individuals having similar characteristics (i.e., gender, ethnicity, etc.).  It is important that athletic trainers do not show favoritism of one gender/race/religion over another.  They need to provide the same amount of individual attention with each athlete for treatments.  Athletes can sense little trends, like taping or taking care of one certain group of people before another.  These behaviors cause individuals to feel alienated.

Graduate students believed that athletes may interpret their language, comments, and behavior in a negative manner because many of them came from a different geographical area (i.e. Japan, Texas, California, Northeast, and South).  The Japanese students commented it may take athletes longer to feel comfortable with them because of the language barrier.  One Japanese student stated that when he first came to the United States, he was not used to expressing his opinion; therefore, athletes could not understand him.  His communication improved over time.    

Students commented that there were situations where they did speak up promptly to athletes who made offensive or insensitive remarks.  At one high school the athletic trainer heard students make racial comments when referring to athletes on the other teams.  He corrected them and let them know that those types of comments would not be tolerated in his presence.  He received feedback later that day that a student that heard him correct the athlete had told another student “hey, we don’t talk like that around here.”  Some of the athletes laughed as if to say “yea right,” but others responded seriously and agreed that too much of that goes on.  Sometimes it only takes one person to make a stand and others realize how offensive they may sound. 

The graduate athletic training students may not have responded to offensive language if they had not received a lecture informing them to not allow that type of behavior in their work environment.  A small comment that is heard one day may mill around in the persons thoughts and affect them to a higher degree later. 

No student commented on a homophobic situation.   Homophobia is not an issue people in sports want to address.  Student-athletes are hesitant to talk about homophobia for fear of having individuals believe they are associated with homosexuality (Hayes, 2001).  Sport remains an area where homophobic attitudes and behaviors are developed (Plummer, 2006).  There is still a ubiquitous stigma surrounding issues of lesbianism in women’s sport (Knight & Giuliani, 2003).  Female athletes continue to be confronted with the “the image problem” (i.e., that all female athletes are lesbians).  There is a belief in society that participating in sports will encourage homosexuality or even convert female athletes into lesbians.  The media often portray female athletes in traditionally feminine ways outside of their sport to overcompensate for their masculine behavior in their sport.   The media attempts to assure their fans that female athletes are heterosexual through coverage and photographs that portrays these women in a heterosexual manner.  Female athletes’ relationships with men and with their families are emphasized in pictures, articles, and television coverage.  Female athletes portrayed as heterosexual become more privileged and accepted than their athletic peers who do not adhere to these standards (Krane, 2001).


Diversity awareness and multicultural education need to be addressed somewhere in all curricula.  The main goal for teaching diversity awareness is to help students develop decision-making and social action skills so that they learn to view events and situations from a variety of perspectives.  If educators are going to take an active role in diversity awareness and multicultural education they need to engage in conversations regarding race, oppression, discrimination, and what is involved in participating in society.  Educators who want to promote social change and a better life for individuals must use meaningful education and start by questioning the understanding of the self.  This process improves self-awareness and helps individuals to identify their personal history, race, ethnicity, and culture.  After reflection of the self, educators are ready to use class activities that promote student dialogue, exploration, and sharing among classmates.  Exercises that allow students to elaborate on their cultural background will provide a grounded sense of interest and meaning.  For athletic training, diversity issues relative to practice of athletic training services can then be utilized in the curriculum when appropriate.

Athletic trainers in the work environment who are unaware of issues associated with various ethnic groups, cultures, and religions could experience challenging and difficult moments.  On the other hand, if athletic trainers received diversity awareness training and/or multicultural experiences during their formal education years, the diversity challenges could be positive for all stakeholders.  The results for the assignment described in this paper identified that students reflected on their multicultural values, enhanced their awareness for diversity issues, and became cognizant of the need for professionalism with their language, comments, and behaviors in the athletic training environment.  A combination of lecture, activities, observation, and reflective discussion helped the students to be socially conscious and critically aware of their role in society.  Understanding other cultures is extremely important for how athletic trainers provide prevention, care, treatment, and rehabilitation for athletes.          


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