











































MANUSCRIPT TYPE


EDITORIAL 

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                      Volume 4 – Issue 1 – February 2021 
 

Minoritized Females in Athletic Training: Educator and Clinician 
Perspective on Exploring Barriers to Healthcare Delivery 
Toni M. Torres-McGehee, PhD, SCAT, ATC*; Nancy A. Uriegas, MS, SCAT, ATC*; Kenya Moore, MS, SCAT, 
ATC† 
*University of South Carolina, SC, †Columbia College, SC  
 

 
Key Phrases 
Diversity, inclusion, equity, health disparities, patient-
centered care 
 
Correspondence 
Dr. Toni M. Torres-McGehee, University of South Carolina, 
Blatt PE Center-EXSC, Columbia, SC 29208. 
E-mail: torresmc@mailbox.sc.edu   
Twitter: @torres_mcgehee 
 
Full Citation 
Torres-McGehee TM, Uriegas NA, Moore K. Minoritized 
females in athletic training: Educator and clinician 
perspective on exploring barriers to healthcare delivery. 
Clin Pract Athl Train. 2021;4(1): 1-7. 
https://doi.org/10.31622/2021/0004.1.1.     
 
Submitted: January 23, 2021 Accepted: February 11, 
2021 

 
EDITORIAL 

In the last 5 years, there have been lessons 

learned about our country. A lesson of history, in 
general, is that disunity poses a threat to 
healthcare; our general health is a product of the 
connections that we share as individuals and 
healthcare providers. The COVID-19 pandemic 
has elevated the importance of these connections. 
This means we all need to work towards a 
collective vision of health and peace at all 
levels. This vision must be built on values of equity, 
mutual respect, openness, trust, and tolerance. To 
be successful, we must focus on creating 
communities that are welcoming to everyone, 
including those with perspectives that differ from 
our own. This requires us, as individuals and as a 
community, to rise above and set a clear example 
to our faculty, students, patients, and others of 
how a strong inclusive society operates, both 
professionally and personally, thus, enhancing our 
healthcare systems and patient-centered care for  

 

athletic training. Specifically, perspectives from 
minoritized females as healthcare providers and 
educators are critical in understanding the 
challenges as well as the positive endeavors that 
make us successful in our roles.  

CULTIVATING CULTURAL PROFICIENCY 
THROUGH EDUCATION: STORIES FROM A 
MINORITIZED EDUCATOR   

As a female Mexican-American faculty member 
at a large public institution, I acknowledge that 
there are many challenges we face as minoritized 
female faculty members at a predominantly 
White institution. However, there are also positive 
experiences starting with the environment of your 
institution. A positive environment values diversity, 
equity, inclusion, and social justice and there is a 
support system in place for minoritized faculty, 
staff, and students. The location where your 
athletic training program is housed may impact 
the education and research opportunities for 
faculty and students. From personal experience, 
being housed in an accredited School of Public 
Health allows for minoritized faculty and our 
athletic training programs to prepare 
professional practitioners and scholars to best 
serve our communities and impact disease 
prevention through healthcare, public health 
education, and intervention. It also provides a 
platform for faculty and students to collaborate in 
interprofessional practice, education, and 
research with public health professionals and 
healthcare providers. These collaborations 
improve the lives of individuals, families, 
communities, and diverse populations through a 
variety of educational and research endeavors 
(e.g., health inequalities, children’s physical 

mailto:torresmc@mailbox.sc.edu
https://doi.org/10.31622/2021/0004.1.1


Minoritized Females in Athletic Training: Educator and Clinician Perspective on Exploring Barriers to Healthcare Delivery 

 

 
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Copyright © Indiana State University   Clinical Practice in Athletic Training 
ISSN Online 2577-8188    Volume 4 – Issue 1 – February 2021 
 

activity, community health workers, Latino 
immigration studies, disability research, global 
health, speech and hearing, nutrition, exercise, 
rural and minority health).  

It is our mission to work closely with the 
communities that we serve to provide the best 
patient-centered care to our underserved 
populations. Through our work (i.e., teaching, 
research, and service) and patient care we have 
an opportunity to advocate for making an impact 
on changing socioeconomic marginalization, 
disparities in healthcare, and racial injustice. We 
do this by educating our students on the diversity, 
equity, inclusion, and the concepts of cultural 
competence and cultural humility. These are all 
critical components of patient-centered care. 
Diversity in medical education signifies 
inclusiveness, mutual respect, and multiple 
perspectives and serves as a mechanism for 
change resulting in health equity.1 In this context, 
diversity includes all aspects of human differences 
such as race, ethnicity, religion, national origin, 
age, marital status, disabilities, sexual orientation, 
gender, gender identity and expression, and 
socioeconomic status. Inclusion can be achieved by 
fostering an understanding of culture and climate 
of your organization or within patient care 
settings.   

Culture competence highlights the demand for 
health care system and providers to be aware of 
and responsive to patient’s cultural perspectives 
and backgrounds;2 and requires healthcare 
providers to appreciate and respect the patient’s 
individual viewpoints.  Cultural competency also 
encourages awareness of health disparities and 
discrimination, which is a skill that can be taught, 
trained, and achieved and is often described as 
essential for working effectively with diverse 
patients to improve access to healthcare, increase 
health literacy, improve health care quality, and 
promote health equity.3-5 Cultural humility is often 
confused with cultural competence; these terms 
are defined independent of each other but can be 

used at the same time. For example, cultural 
humility involves entering a relationship with 
another person with intentions of honoring their 
beliefs, customs, and values.2 This is an on-going 
process of self-reflection and self-critique, 
combined with the willingness to learn from others 
and addressing power imbalances and avoidance 
of stereotyping. When we merge these two 
concepts, this allows for a more meaningful 
connection with each patient as a unique 
individual, with diverse perspectives, culture, and 
lifestyles. This concept was coined cultural 
competemility,3 which is a synergistic process 
between cultural humility and cultural competence 
in which cultural humility permeates each of the 
five components of cultural competence: cultural 
awareness, cultural knowledge, cultural skill, 
cultural desire, and cultural encounters.3  Faculty, 
students, and practitioners must be cognizant of 
these concepts and how they all intersect with 
patient-centered care, student-centered learning, 
and research collaborations.  

Our healthcare system is professionally driven 
toward patient-centered care, which incorporates 
an individual’s perspective and more involvement 
in his/her/their care results in better health 
outcomes and satisfaction.6 However, it is 
important to note there are certain populations 
such as low-income individuals, uninsured persons, 
immigrants, racial and ethnic minorities, veterans, 
the disabled, and the elderly who are typically 
underserved by the health system. Thus, in turn, 
facing greater barriers to patient-centered care. 
To best tackle these challenges, it is critical to 
collaborate outside your organization and 
develop community partners. A goal of our 
program is to expose our faculty, post-
professional athletic trainers, and professional 
athletic training students to a variety of patient 
populations and settings (i.e., Historically Black 
Colleges and Universities, private colleges, public 
colleges/universities, private and public high 
schools, rural private and public high schools, and 
inner-city schools).   



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Copyright © Indiana State University   Clinical Practice in Athletic Training 
ISSN Online 2577-8188    Volume 4 – Issue 1 – February 2021 
 

To be successful in these environments, it is critical 
to prepare young professionals prior to their 
clinical placements and provide on-going 
mentoring while they are providing patient care. 
Often young professionals are not aware of the 
social determinants of health in the population that 
they work with.  Therefore, preparation begins 
with onboarding activities to include but are not 
limited to reviewing issues of diversity, equity, 
inclusion, social justice, how to become culturally 
proficient; ways to combat racism, and identify 
social determinants of health, healthcare, and 
health disparities within the community the serve. 
It is recommended, administrators integrate an 
activity during onboarding related to the 
clinician/student conducting thorough assessment 
on the community/city they serve (Table 1). With 
most of our students being from out-of-state, this 
not only allows them to familiarize themselves with 
the community/city, but also allows them to 
identify social determinants of health, potential 
resources, community collaborations and identify 
other healthcare practitioners to engage in 
interprofessional practice. This may also be 
conducted in a field trip manner.7  Developing 
relationships with community partners allows for 
the integration of best practices with patient care 
and opens opportunities for research between 
clinicians, faculty, and marginalized communities. 
Building trust and mutual respect with these 
communities, allows for ethical recruitment of 
marginalized or vulnerable groups. In turn, this 
allows successful research in the identification of 
patient health care needs for each population and 
organization.  

- Toni M. Torres-McGehee, PhD, SCAT, ATC 

 

PATIENT CARE PERSPECTIVES IN THE 
CLINICAL SETTING  

As a black woman in health care, I have been on 
the receiving end of the negative preconceived 
notions, discrimination, and microaggressions that  

Table 1: Exploring the Community you Serve  
1. Identify community/city population and 

distribution of race/ethnicity 
2. Identify community/city cost of living  
3. Identify community/city average household 

income 
4. Familiarize yourself with surrounding 

neighborhoods, parks, and shopping areas 
5. Familiarize yourself with public 

transportation  
6. Identify types of community/city health 

services (e.g., financial support, 
communication resources such as speech 
and language services, behavioral 
resources, sensory and motor services, 
social and recreational services, family 
support services, school services, research 
opportunities, etc.) 

7. Identify health care facilities (e.g., 
hospitals, clinics, urgent care, veteran 
services, dentists, optometrist, physical 
therapy, occupational therapy, disability 
services, specialty clinics, social work, 
counselors, etc.)  

8. Identify current community/city social 
determinants of health data (e.g., social 
and community, 
neighborhoods/environment, 
demographics, educational attainment, 
economics, insurance coverage, health 
status – disabilities, heart disease, chronic 
disease, etc.) 

9. Identify the location of public library 
10. Identify communities of faith (religious 

facilities)  
11. Identify locations of private and public 

schools 
12. Identify cultural events in the 

community/city 
 

are projected onto minoritized populations. As 
humans we all wrongly assume things about those 
we do not know or understand. However, for too 
long the distorted images of people of color and 
minoritized persons that stem from racism and 
stereotypes, have been supported not only by 
individuals but also by institutions like our 
government, educational system, healthcare, and 
workplace. Within these institutions, we find that 



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Copyright © Indiana State University   Clinical Practice in Athletic Training 
ISSN Online 2577-8188    Volume 4 – Issue 1 – February 2021 
 

policies and laws, were by design, created to 
exclude. Systemic oppression creates barriers that 
are often covert, and inherently carry negative 
messages to minoritized persons about our 
“place” in society and what is or is not accessible 
to us. I recall stories from my parents about their 
experiences as children. Enduring everything from 
racial slurs to the struggles of segregation and 
integration. Because I was surrounded by a loving 
community and such a rich culture, my eyes were 
often blind to some of those racial tensions. But as 
a high school student my heart filled with many 
emotions as I marched for the first time to protest 
the murder of Trayvon Martin, a murder that that 
took place near my home in a neighborhood I had 
been several times to visit with family friends.  

Fast forwarding to 2020, and our country's issues 
with police brutality towards people of color are 
still high. It is a very sad reality that some believe 
lives like mine are expendable or do not matter 
enough. These physical, emotional, and 
psychological traumas add to the subliminal 
messages that ring through society about race. I 
have experienced times of being racially profiled 
in stores, and as a college student even been 
asked where I learned to speak and if there were 
others like me where I come from. Being 
categorized as “exceptional for a Black student,” 
was concerning as to suggest students of color are 
not bright, articulate students. The stigma of 
having to “work twice as hard” just to be on a 
level playing field seemed all too true. Usually 
being one of few students of color in my academic 
spaces illuminated the impression that I had to 
carry my culture alone. It highlighted this 
misconception, that what I do or how I perform will 
positively or negatively affect the way that others 
like myself would be perceived and accepted in 
those spaces. And while one's presence may aid in 
opening the door for those to come, minoritized 
persons certainly have the weight of feeling the 
pressure to succeed. For success was not only for 
one’s self, but for others as well. 

As a clinician today, I recognize how those 
feelings and encounters I faced have led me to be 
more mindful in the way I practice and interact 
with my patients. I began working at a low 
socioeconomic school in South Carolina, where 
most of the student-athletes were Black. Although 
I felt I could relate to the students I did not want 
to assume that I knew them. I did not want to take 
for granted that I knew their story, what their 
home life was like, nor what their passions were, 
or what they valued in life. I was intentional about 
being visible in the school, getting to know not only 
the athletes and coaches, but also people like the 
custodians, nurses, bookkeeper, receptionist, 
parents, and campus police. Establishing those 
relationships allowed me to better understand the 
overall culture, and advocate for the student 
athlete’s health. I often verbalized my treatment 
plans and involved both the student, 
parent/guardian, team physician and coaches 
into the plan of care. I explained why I did 
something and made room for them to ask 
questions regarding their own health and 
progress. I consistently led with openness and 
transparency, as I wanted each student to feel like 
they were involved in what was happening to 
them. If I could, I would accompany students when 
seeing our collaborating physician to help them 
feel at ease because for many of them doctors 
represented people who were just there to 
capitalize on their pain and provide services they 
could not afford. I tried to take my time to 
dismantle the social disparities in health care 
experienced by my population. And while it was 
not my role to solve every issue in my time there, 
my efforts helped set the standard for what those 
student athletes now expected from health care 
professionals and improved the care that was 
available to them.  

Regardless of the setting, becoming more aware 
of the patient population aids in establishing 
appropriate relationships with those we serve. This 
ultimately helps guide the process of decision-
making that considers and respects their beliefs, 



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Copyright © Indiana State University   Clinical Practice in Athletic Training 
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values, language, and traditions. It has caused me 
to even evaluate what I tolerate as acceptable 
behavior and speech in the athletic training 
facilities. As one who is both ethnically diverse and 
a healthcare provider in athletic training, I 
recognize the influence I have in igniting change 
where I am. I have experienced firsthand the 
benefits and power of representation, mentorship, 
and leadership from minoritized athletic trainers 
as well as the benefits of diversity regarding 
collaboration and innovation. When we think 
about research and how it leads the way in 
creating the standards of how we care for our 
patients, overlooking the importance of diversity, 
even here, can be detrimental. Most research in 
the realm of athletic training does not currently 
reflect such inclusion, having shown to provide 
gaps in applicability. As clinicians we talk about 
evidence-based practice and integrating 
available research, merging that with clinical 
knowledge. This should include efforts in both 
addressing a lack of diversity amongst research 
participants involved, as well as research that 
gains the perspectives of diverse certified and 
athletic training students.  

It may be easier said than done to operate in a 
way where we are proficient in interacting with 
those across an array of backgrounds. So, how do 
we transition from just merely having a “one size 
fits all” mentality in our care to one that is a lot 
more progressive and considerate of our patient’s 
needs, background, health concerns, health 
beliefs, and values? Historically, there have been 
many systemic barriers that exist for minoritized 
persons pertaining to health care, along with other 
racial disparities that perpetuate discrimination 
and stereotypes. We must learn to come from a 
place of empathy and compassion with a desire 
to understand our patients. Additionally, there 
must be acknowledgment of any biases that 
hinder us from effectively treating others or that 
cause us to treat one group different from 
another. These steps are key to change from the 
inside out. It will take a willingness to be 

uncomfortable, as there is always difficulty with 
having to realize biases thoughts and feelings that 
sit within the subconscious mind. 

- Kenya Moore MS, SCAT, ATC 

 

BLENDING CULTURES WITHIN PATIENT-
CARE SETTINGS  

Through my academic and professional career, I 
have been an athletic training student, an 
undergraduate teaching assistant, a secondary 
school athletic trainer, a performing arts athletic 
trainer, a military athletic trainer, a doctoral 
research and teaching assistant and in each 
setting – a minoritized person. Twenty years ago, 
if you were to ask my parents what they expected 
of their children regarding education, they would 
both state, and I translate: “to accomplish more 
than I did.” I am the daughter of two Mexican 
born and raced individuals, one whom completed 
4th grade and the other not much further, 6th 
grade. The resources were so limited that they 
had one classroom and one teacher to teach 
students regardless of their grade level or age; 
and where 6th grade was the highest level of 
education you could attain. Living there, never did 
high school cross their minds, and let us not even 
mention college, because odds are, they had no 
idea what that was or how to even get there. If 
asked that same question ten years ago and 
knowing what a college education meant, that 
was the new expectation; an expectation soon to 
be met by all five children of a meagerly 
educated Mexican couple. In 2015, I became a 
1st generation college graduate; that same year 
my oldest sister and brother received their 
master’s degree. It did not stop there; today I am 
a second year PhD student and scholar in the 
making.  

Following my education and clinical rotations at 
an institution with many resources available at 
hand, I began my journey as a clinician in the same 



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community I came from a predominately Spanish 
speaking and low-income city on the Mexican 
border. Health literacy is extremely low and often 
I found myself translating orthopedic or concussion 
associated terminology to patients and parents, 
which is quite difficult for anyone who went 
through an English-only curriculum, even when 
Spanish is your first language, and you speak it 
daily. Information always had to be simplified, 
and though difficult, I was comfortable; I was 
around those that looked like me, talked like me, 
and shared the same culture and values as me. 
The students could reflect on me and I could reflect 
on them. I was once in their shoes and the 
concerned parents reminded me of my own 
mother driving me to urgent care to get an X-ray 
because that is what you do when your ankle looks 
like a balloon, right? It was here I learned the 
importance of patient education, whether that was 
in English or in Spanish. I learned to have open 
discussions about their injuries, their goals, their 
accessibility to care and medical insurance, and 
what the best plan of care and treatment would 
be for them. It was here I learned to be patient 
centered, around the same community I grew up 
in, around the same struggles I, as a patient, 
faced. 

I transitioned to practice across the country in a 
small rural high school in St. Matthews, South 
Carolina, where the state’s Hispanic or Latino 
population is less than 6%. I was an outsider; my 
patients constantly asked if I played soccer 
growing up, because “that is the only sport the 
Hispanic kids play here.” As much of an outsider 
as I was, there were some things that remained the 
same—my work was in the best interest of my 
patients and their well-being. I was now in a 
predominately Black school, coaches were 
predominately White males, and the community 
was close knit; I was no longer in my comfort zone. 
Head coaches constantly questioned and 
undermined me, parents always asked where I 
was from; people around me said I spoke “funny.” 
One of my biggest challenges was being told I 

was not a doctor and my medical opinion did not 
count compared to that of a nurse practitioner who 
signed a clearance note. Once again, education 
was my most powerful tool. I do not think coaches 
ever expected a female athletic trainer to hold 
her ground, as I did; and to make it known that 
my number one priority was the health of the 
patients.  

All the patients had different upbringings from 
mine, but in some ways so similar. I submerged 
myself into the community there too, I made it 
known that my job was not 2-7pm and that where 
I came from did not mean I did not understand 
what they were going through. The greatest 
appreciation came from parents; I gained their 
trust simply through education and patient-
centered care. We learned about each other in 
the process; we respected our diverse 
backgrounds and adapted to what their needs 
were. When the resources were not available, I 
went out of my way collaborating with our 
collaborating physician and orthopedic network 
to provide as much as we could for them. What 
goes unnoticed in these settings is the power of 
research, constant self-assessment, and patient-
reported outcome measures. To bring change and 
more resources, others must see the value of our 
work.  Lastly, a few things we always kept in mind: 
an open-door always meant you were welcomed 
in, respect was reciprocated and practiced daily, 
and patient care and goals were the priority. I 
learned that the patient-clinician rapport can only 
evolve with continuous communication, trust is 
earned, and happiness in the workplace is not 
dependent on the resources available but network 
you build in the community.   

- Nancy A. Uriegas MS, SCAT, ATC 

SUMMARY 

Our experiences are diverse and unique in their 
own way. However, all three of us have faced 
similar challenges as minoritized female clinicians 
and educators. We have also seen the challenges 



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Copyright © Indiana State University   Clinical Practice in Athletic Training 
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faced by our diverse patients and students. We 
as an athletic training profession, should promote 
and practice diversity, equity, inclusion, and social 
justice across our settings. We must come together, 
rise above, and lead by example and this begins 
with providing opportunities of education, 
research, and patient-centered care equally 
across our communities. Let us all take a step back, 
evaluate where we are, who we serve, and how 
we can improve in the best interest of those 
around us.  

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https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2002_oct_cultural_competence_in_health_care__emerging_frameworks_and_practical_approaches_betancourt_culturalcompetence_576_pdf.pdf
https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2002_oct_cultural_competence_in_health_care__emerging_frameworks_and_practical_approaches_betancourt_culturalcompetence_576_pdf.pdf
https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2002_oct_cultural_competence_in_health_care__emerging_frameworks_and_practical_approaches_betancourt_culturalcompetence_576_pdf.pdf
https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2002_oct_cultural_competence_in_health_care__emerging_frameworks_and_practical_approaches_betancourt_culturalcompetence_576_pdf.pdf
https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2002_oct_cultural_competence_in_health_care__emerging_frameworks_and_practical_approaches_betancourt_culturalcompetence_576_pdf.pdf
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