The Athletic Trainer's Role in Baseline Testing: Scope of Practice, Best Practices, and Common Mistakes

Athletic trainers are the front-line professionals for most baseline concussion testing programs in school and collegiate settings. Understanding their scope of practice — what they can and should do, and where they should involve other professionals — is essential for effective program management.

BOC domains and concussion care

According to the Board of Certification (BOC), athletic training practice encompasses five domains directly relevant to concussion care. Domain 1 (Risk Reduction) includes pre-participation examinations and risk factor identification. Domain 2 (Assessment and Diagnosis) covers concussion recognition and initial evaluation. Domain 3 (Critical Incident Management) addresses on-field management and emergency action plan activation. Domain 4 (Therapeutic Intervention) covers treatment and rehabilitation. Domain 5 (Healthcare Administration) encompasses policy development and protocol management.

What athletic trainers can administer

The NATA position statement on concussion management (Broglio et al., 2014, published in the Journal of Athletic Training) specifically states that athletic trainers should be involved in baseline testing and recommends a multimodal approach evaluating symptoms, cognition, motor control, and ocular motor function. Athletic trainers can administer ImPACT, SCAT6, BESS/mBESS, King-Devick, and other standardized assessment tools as part of their professional scope.

Administration vs. interpretation

However, a critical distinction exists between administering a test and interpreting it for clinical decision-making. While athletic trainers can and should administer baseline assessments, the interpretation of post-injury results — particularly when making return-to-play clearance decisions — should involve a physician or neuropsychologist in accordance with state practice acts and institutional protocols. ImPACT recommends that post-injury interpretation be conducted by a Credentialed ImPACT Consultant (CIC) or equivalent trained professional.

Common mistakes

Common mistakes in athletic trainer-managed baseline programs include: testing in too-large groups with inadequate supervision, failing to review validity indicators before storing results, not re-testing invalid baselines, inconsistent administration across multiple trainers, and inadequate documentation of testing conditions (environment, medication status, recent exercise).

The coverage gap

Currently, according to data from the NATA and ImPACT Applications, approximately 50% of U.S. high schools have athletic training coverage — leaving half of student-athletes without access to professional baseline testing administration.

At Headquarters, we support athletic trainers with training, tools, quality assurance, and clinical consultation. We believe athletic trainers are essential partners in concussion safety, and we’re committed to helping them build the strongest possible baseline programs.

Frequently asked questions