Sports Medicine (2022) 52:1879–1917

https://doi.org/10.1007/s40279-022-01664-5

SYSTEMATIC REVIEW

The Impacts of Sports Schools on Holistic Athlete Development:

A Mixed Methods Systematic Review
Ffion Thompson1,2,4 · Fieke Rongen1 · Ian Cowburn1 · Kevin Till1,3

Accepted: 15 February 2022 / Published online: 9 March 2022

© The Author(s) 2022

Abstract
Background To understand the multiple and wide-ranging impacts of intensified youth sport, the need for a holistic approach
to athlete development has recently been advocated. Sports schools are an increasingly popular operationalisation of intensi-
fied youth sport, aiming to offer an optimal environment for holistic development by combining sport and education. Yet,
no study has systematically explored the impacts associated with sports schools.
Objectives The aims of this mixed method systematic review were to (1) determine the characteristics and features of sports
schools; (2) identify the methods used to evaluate sports school impacts, and (3) evaluate the positive and negative holistic
athlete development impacts associated with sports school programme involvement.
Methods Adhering to PRISMA guidelines, eight electronic databases were searched until the final return in February 2021.
Forty-six articles satisfied the inclusion criteria, were analysed thematically, and synthesised using a narrative approach. The
methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool.
Results Findings indicated (1) sports school student-athletes receive considerable support in terms of academic and athletic
services, more intensified training and competition schedules with high-level training partners, but regularly miss school;
(2) multiple methods have been used to evaluate student-athlete impacts, making comparison across studies and develop-
ing consensus on the impacts of sports schools difficult; and (3) there are a multitude of immediate, short- and long-term
positive and negative impacts associated with the academic/vocational, athletic/physical, psychosocial and psychological
development of sports school student-athletes.
Conclusions This study is the first to systematically review the research literature to understand the impacts associated with
sports schools in terms of holistic athlete development. Practitioners should be aware that they can promote (positive) and
negate (negative) health impacts through the design of an appropriate learning environment that simultaneously balances
multiple training, academic, psychosocial and psychological factors that can be challenging for youth athletes. We recom-
mend that practitioners aim to design and implement monitoring and evaluation tools that assess the holistic development of
student-athletes within their sports schools to ensure they are promoting all-round and healthy youth athlete development.

1 Introduction

The present-day outlook of Olympic and professional sport

is now arguably more competitive than ever. One conse-
quence is the increased intensity and professionalisation
* Ffion Thompson of youth sport programmes supporting athletes towards
[email protected] the Olympic and professional level [1, 2]. This increased
1 professionalisation of youth sport programmes introduces a
Carnegie School of Sport, Leeds Beckett University, Leeds,
UK number of characteristics, such as early specialisation [3],
2 increased volume and intensity of training [4], prioritisation
Queen Ethelburga’s College, Thorpe Underwood, York, UK
3
of sports over other aspects of life [5], and distinct cultures
Leeds Rhinos Rugby League Club, Leeds, UK
of eliteness [6], raising potential issues with the healthi-
4
Carnegie School of Sport, Leeds Beckett University, Room ness of intensified youth sports programmes. Indeed, recent
G07, Cavendish Hall, Headingley Campus, Leeds LS6 3QS,
position and consensus statements [1, 7] have warned about
UK

Vol.:(0123456789)
1880 F. Thompson et al.

interactions between all levels of an athlete's development

Key Points (e.g., academic/vocational, athletic/physical, psychosocial
and psychological). This means that transitions occurring in
Sports school student-athletes receive more support in one domain (e.g., athletic development) are concurrent and
academic and athletic services than non-sports school interact with transitions occurring in another domain of an
athletes. athlete’s life (e.g., academic studies). Therefore, although
There are a multitude of immediate, short- and long-term practitioners may instinctively focus on assessing and moni-
positive and negative impacts associated with being a toring measures of physical performance, for the holistic
sports school student-athlete that stakeholders should be development of youth athletes, it is imperative that consid-
aware of when designing, implementing, and evaluating erations are also given to the academic/vocational, psycho-
sports school programmes. social and psychological domains [14].
By advocating a holistic approach, youth sport pro-
Practitioners should aim to design and implement moni- grammes are not only nurturing successful athletes but
toring and evaluation tools that assess the holistic devel- also developing competencies and skills that allow them to
opment of student-athletes within their sports schools to cope with challenges they face both in sport and other life
ensure they are promoting healthy youth athlete develop- domains. More specifically, to ensure this healthy all-round
ment. development and minimise the potential negative impacts
The large range of data collection methods used to of intensified youth sport programmes highlighted above,
evaluate the impacts of sports school programmes makes a dual-career approach to athlete development has been
comparison across studies difficult but offers multiple encouraged. This proposes that youth athletes must success-
avenues for future research. fully develop their athletic career alongside pursuing educa-
tion and/or vocation, and other domains (e.g., social life [10,
13, 14]). Indeed, the combination of sport and education or
vocational endeavours has been shown to have benefits such
the risk of several negative impacts associated with inten- as improving coping with adversity, protecting against poor
sified youth sport programme involvement. Rongen et al. mental health or burnout, and maintaining perspective for
[8] emphasised that there are also potential positives but athletes [15–18]. However, the way dual-career development
that ensuring healthiness may require a balancing act. For environments (i.e., environments that support dual-career
the purpose of this paper, impact is not confined to outputs athletes [19]) are shaped and the support provided is highly
(athletic performance), but also incorporates the holistic variable [17, 20, 21].
development of youth athletes. As such, potential impacts One example of a dual-career development environ-
include academic/vocational (e.g., academic high achievers ment that aims to cater for the holistic development of
vs. educational sacrifice), athletic/physical (e.g., enhanced youth athletes is a sports school. A sports school is defined
physiological capacity vs. injury), psychosocial (e.g., time as a school, whether state-funded or private, that concen-
away from family vs. enhanced social skills, such as com- trates resources on developing sporting talent either within
munication), and psychological (e.g., increased confidence the curriculum and/or through extra-curricular activities
vs. burnout) areas. Given their popularity, the likelihood that [22–24]. Sports schools aim to safeguard the dual-career of
most youth athletes do not ultimately succeed in their sport, school-aged athletes. In most countries, sports schools were
and the multiple and wide-ranging positive and negative founded in the early 1990s; however, sports boarding schools
impacts associated with intensified youth sport programmes, existed in the Soviet Union since 1962 [25]. While in some
understanding the holistic development impacts for youth countries sports schools are part of a national sport system
athletes in these programmes is crucial [8, 9] to ensure the and in other countries they are not, all schools cater for elite
promotion of healthy development. student-athletes in systematic ways [26]. Attendance at these
In light of the multiple and wide-ranging potential sports schools is voluntary and specific to the individual,
impacts of intensified youth sport programmes, the need school and sport context. In some contexts, the schools are
for a holistic approach to an athlete's development has state funded, in others students can be fee paying or receive
recently been advocated [10–13]. In response to these calls, a scholarship. Sports schools provide a structural coupling of
researchers have increasingly followed Wylleman’s [14] competitive sports and education, accomplished by organis-
Holistic Athletic Career model where for healthy, all-round ing more time for training alongside sufficient time devoted
development, youth sport programmes should embrace the to education [22]. For example, timetables can be adjusted
multidimensional nature of youth athlete development. by school officials to enable early training, allow exemp-
As conceptualised by the Holistic Athletic Career model tions from lessons for training and competition, and provide
[14], throughout their sporting careers there are constant compensatory lessons [22, 24, 27, 28]. With the effective
Impacts of Sports Schools on Holistic Athlete Development 1881

combination of competitive sports, education, and accom- to PRISMA guidelines, a systematic search of eight elec-
modation, sports schools could guarantee conditions that tronic databases (The Cochrane Library, ERIC, PsycINFO,
favour future top sporting performances while safeguard- PsycArticles, PsycTESTS, SAGE Journals Online, Scopus
ing opportunities for primary and secondary education [22] and Academic Search Complete) was conducted to identify
alongside allowing for more ‘free time’ through optimised original research articles from the earliest available records
time-schedules. Furthermore, many sports schools have spe- up to and including January 2021 (when the formal search
cialist staff (e.g., physiotherapists, strength and condition- was finalised). Boolean search phrases were used to include
ing coaches) [24] that may further support the holistic and search terms relevant to student-athletes (population; “Stu-
healthy development of youth athletes. dent-athlete”, “School student”, “Adolescent”, “Youth”,
Despite sports schools offering an optimum environ- “Young”, “Junior”, “Elite”, and “Talented”) and the educa-
ment where positives could be maximised and negatives tional systems/types of sports school intervention; (“Sport
minimised, to date no study has attempted to systematically School”, “Elite School of Sport”, “Topsport Talent School”,
review the research literature to understand the impacts and “Dual Career”). Relevant keywords for each search term
associated with sports schools in terms of holistic athlete were determined through pilot searching (screening titles/
development. Understanding the impacts associated with abstracts/keywords/full texts of previously known articles).
sports school involvement is important to inform the design, Keywords were combined within terms using the 'OR' opera-
implementation, monitoring and evaluation of sports school tor, and the final search phrase was constructed by combin-
programmes. Furthermore, there are many ways in which ing the two search terms using the ‘AND’ operator. Addi-
sports school systems can be implemented. Consequently, tional records were taken from the bibliographies of eligible
we need to understand the characteristics and features of studies and previous reviews. Attempts were made to contact
such sports schools and how these relate to holistic athlete two authors of the selected articles to request any missing
development impacts. Finally, there are multiple data col- relevant information. One author replied to confirm that par-
lection methods/instruments to assess impacts and it would ticipants were from a sports school sample.
be beneficial to gain an understanding of the commonly
used methods to guide future research. Therefore, the aims 2.2 Study Selection
of this systematic review were to (1) determine the char-
acteristics and features of sports school programmes; (2) Duplicate records were identified and removed before the
identify the methods used to evaluate sports school impacts; remaining records were screened against predefined inclu-
and (3) evaluate the common positive and negative holistic sion–exclusion criteria (Table 1). Studies were screened
athlete development impacts associated with sports school independently by two researchers (FT, FR). The screening
programme involvement. of the journal articles was completed over two phases. Stud-
ies were initially excluded based on the content of the titles
and abstracts, followed by a full-text review. In the event of
2 Methods disagreement over the reviewer's decision, reviewers met to
come to an agreed decision on the paper.
2.1 Design and Search Strategy
2.3 Search Returns
A systematic review was conducted according to the Pre-
ferred Reporting Items for Systematic Reviews and Meta- The final search phase was completed on 1 February
Analyses Protocol (PRISMA-P) guidelines [29]. Adhering 2021, and returned 2,488 studies following the removal of

Table 1  Inclusion/exclusion criteria (title/abstract screening and full screening)

Criteria Inclusion Exclusion

1 Original peer reviewed research article Reviews, surveys, opinion pieces, books, periodicals and editorial
2 Published in the English Language Non-English publications
3 Published before 1/02/2021 (when the formal search was finalized)
4 Population—Explicitly related to current or former primary or Primary or secondary non-sport school athletes
secondary sport school student-athletes
5 Either contains entirely sport school athletes or a separable discrete University cohort and athletes with a physical or mental disability
sports school athlete sample (e.g., comparing sport school ath-
letes to non-sport school athletes)
6 Include data relevant and compatible with the study aims Data not relevant or compatible with the study aims
1882 F. Thompson et al.

duplicates. After abstract screening against the inclusion/ 2.4 Data Extraction

exclusion criteria, 2,319 papers were excluded, leaving a
total of 169 studies. After each paper's full text was assessed One author (FT) extracted the data using a specifically
against the inclusion/exclusion criteria, 123 papers were designed standardised Microsoft Excel spreadsheet. Gen-
excluded due to not explicitly relating to primary or sec- eral information (i.e., author, year, country, and setting),
ondary age sports schools (n = 63), data irrelevant or not study aim(s), study design, study population, data collec-
aligned to study aims (n = 28), full text was not available tion method and instrument, and the key findings presented
(n = 11), lack of empirical data (n = 10), published in non- in accordance with this systematic review’s aims were
English (n = 2), university cohort (n = 4) and non-original extracted.
peer-reviewed research articles (n = 5). Therefore, a total of
46 papers met the inclusion criteria. The process of study 2.5 Quality Assessment
identification, screening, and selection is presented in Fig. 1.
All included studies were critically appraised by two
researchers for risk of bias. The methodological quality of
studies included was assessed using the Mixed Methods

Fig. 1  Flow of selection process

of eligible studies
Identification

Records removed before screening:

Records identified from:
Duplicate records removed
Databases (n = 2,674)
(n = 190)
Other sources (n = 4)

Records screened Records excluded

(n = 2,488) (n = 2,319)

Reports sought for retrieval Reports not retrieved

(n = 169) (n = 0)
Screening

Reports excluded (n = 123)

Reports assessed for eligibility
• Did not explicitly relate to
(n = 169) primary or secondary age sport
schools (n = 63)
• Did not include data that were
relevant and compatible with the
aims of the study (n = 28)
• University cohort (n = 4)
• Did not gather original empirical
evidence (n = 10)
• Full text not available (n = 11)
• Not published in English
Studies included in review
Included

language (n = 2)
(n = 46) • Non-original peer reviewed
research articles (n = 5)
Impacts of Sports Schools on Holistic Athlete Development 1883

Appraisal Tool (MMAT) [30]. A third reviewer was con- 3 Results

sulted when disagreements occurred. The MMAT can evalu-
ate the primary studies' methodology of quantitative, quali- 3.1 Overview of Study Methodology
tative, and mixed methods studies; therefore, it was deemed
the most appropriate tool due to the variety of primary stud- The 46 studies were conducted in Australia (n = 1), Bel-
ies represented in the search return. The MMAT's validity gium (n = 2), Bulgaria (n = 1), China (n = 1), Czech Repub-
and reliability have been documented previously as moderate lic (n = 1), Denmark (n = 4), Finland (n = 12), Germany
to perfect regarding MMAT criteria and substantial concern- (n = 6), Malaysia (n = 1), the Netherlands (n = 1), New Zea-
ing the overall quality score of appraised studies [31, 32]. land (n = 2), Norway (n = 8), Singapore (n = 1), Slovenia
The tool poses two questions for screening purposes and five (n = 1), Spain (n = 2), Sweden (n = 8) and the UK (n = 1).
questions about the methodological quality that differ for Sample size could only be determined based on the infor-
qualitative and quantitative study designs. There are three mation provided in 45 studies, resulting in a total popula-
possible answers to each question ("yes," "no," or "can't tion of 11,036 sports school student-athletes, made up of
tell"). For the five questions about methodological quality, 3,034 females, 3,746 males and 4,256 participants whose
every "yes" is converted to a score of 1 for a total summed sex was not declared. Overall, 11 studies evaluated the char-
score ranging from 0 to 5 [30]. acteristics and features of sports schools and 44 evaluated
impacts across the four holistic athlete development themes
2.6 Data Synthesis (i.e., academic/vocational, n = 12; athletic/physical, n = 27;
psychosocial, n = 9; psychological, n = 21). Of the 44 studies
The final 46 papers were read multiple times by the first that evaluated impacts across holistic athlete development,
author to capture the focus of the investigation, the method, only 11 studies measured across two of the holistic impact
findings and implications of each study [33]. Following themes, seven studies measured across three themes, and no
this, a thematic analysis was completed to identify consist- study measured across all four themes. The research designs
ent themes within the data [34]. Inductive analysis was used used across the 46 studies included six quantitative descrip-
to determine the characteristics and features of sports school tive, 25 quantitative non-randomised, 11 qualitative, and
programmes. Deductive analysis was used to evaluate sports four mixed methods studies. A large number of data collec-
school impacts [33, 35] based on the Holistic Athletic Career tion methods/instruments were used within the literature to
model [14]. Deductive analysis focused on the four main evaluate the holistic athlete development impacts, including
themes of Wylleman’s [14] model: academic/vocational, interviews (n = 15), non-specified questionnaires (n = 12),
athletic/physical, psychosocial and psychological impacts. standardised questionnaires (n = 19), data from documents/
Inductive analysis was then completed for the subthemes materials (n = 6), field notes/observation (n = 6), clinical
under each of the main four themes. In career development analysis (n = 1), physical and physiological assessments/
research, the Holistic Athletic Career model [14] has been analysis (n = 3), cross-case analysis (n = 1), researcher dis-
recognised as one of the most comprehensive frameworks cussions (n = 1) and visual representations (n = 2). Table 2
(see, e.g., [36]), describing an athlete’s career across mul- presents the details of the 46 studies, including study design,
tiple developmental dimensions (i.e., academic/vocational, study population and characteristics (i.e., sex, age, sport,
athletic/physical, psychosocial and psychological). This type of school), the data collection method and instrument,
model has been extensively used in research studies within and the key findings presented in accordance with the the-
sport to guide data collection about the athlete as a whole matic analysis.
person (e.g., [37]). As such, this is why the current study
used the Holistic Athletic Career model as a template for 3.2 Study Quality
its thematic analysis. In this study, psychosocial impacts
referred to impacts caused by the environment on the stu- The scores for the assessment of study quality according to
dent-athlete’s social aspects. Psychological impacts referred MMAT [29] are presented in Table 3 with a description of
to impacts related to the mental and emotional state of the the study quality criteria presented in Table 4. The study
student-athletes. There was a mix of quantitative and quali- quality ranged from two to five out of the five items assessed
tative data across the studies; therefore, to find a "middle with a mean score of 4.39 (SD = 0.95), with study quality for
ground" [32], a narrative approach to synthesis was adopted quantitative descriptive 4.00 (SD = 1.26), quantitative non-
to integrate, interpret and communicate the relevant finding randomised 4.36 (SD = 0.99), qualitative 4.73 (SD = 0.65)
[38, 39]. and mixed methods 4.25 (SD = 0.96), respectively. No study
was excluded based on methodological quality.
Table 2  Summary of study characteristics and findings for studies exploring the impacts of sport schools on holistic athlete development
1884

Authors and year Participant information Method Results and key findings Thematic code

Andersson and Barker-Ruchti., 2018 7 female soccer players (at least 22 years Semi-structured interviews and bio- Players struggled to manage the increas- 1, 2, 3a, 3b and 3d
[40] old), who had been playing for the graphical mapping ing school and soccer demands and felt
Swedish premier league for at least that they were physically ill-prepared.
3 years, attended a soccer high school The increasing school and soccer
and had been selected for the Swedish demands intensified their focus for
senior national soccer team soccer, but also resulted in a number of
injuries. Upon leaving school, the play-
ers had not developed equally in soccer
and education, but rather, prioritized
soccer over education and thus did not
continue their education
Aunola et al. 2018 [46] 391 first year student-athletes (51% Self-report questionnaire, exploring: task The participants' GPA was, on aver- 2, 3a and 3d
females and 49% males, mean values for school work, task values for age, 8.85 (SD = 0.62) at Time 1;
age = 16, SD = 0.17) from six differ- sport, educational aspirations, athletic 8.24 (SD = 0.88) at Time 2; and 8.05
ent upper secondary sport schools career aspirations, type of sport, level (SD = 0.92) at Time 3. The dual-moti-
in Finland. A total of 50% of them of sport competition and grade point vated pattern (characterized by high
represented individual sports and 50% average (GPA) value placed on both school and sport)
team sports. Twenty percent of the was most typical. However, the per-
athletes participated in Winter Olym- centage of athletes demonstrating this
pic sports (e.g., alpine skiing, cross pattern decreased over time, and the
country skiing, ice hockey), 52% in percentage showing a low academi-
Summer Olympic sports (e.g., athlet- cally motivated pattern increased
ics, football, swimming), and 28% in
non-Olympic sports (e.g., orienteering,
floorball, Finnish baseball)
Baron-Thiene and Alfermann, 2015 [50] 125 (73 males, 52 females, mean age Demographic and sport-related data. A In the study, 29.6% of the student- 2 and 3b
16.2, SD = 0.65) students from five standardised questionnaire, the Sport athletes who participated at Time 1
sport schools in Saxony. 69 (55%) Orientation Questionnaire (Elbe et al. had terminated their sport careers
participated in individual sports such 2009; German version) and the Voli- prematurely—a year later at Time 2,
as track and field, swimming, and div- tional Components in Sport Question- but were still pursuing their academic
ing in the summer and cross-country naire (Wenhold, Elbe, and Beckmann., education. Dropouts scored sig-
skiing, biathlon, and ice skating in 2009) nificantly higher compared to-non-
the winter. The remaining 56 (45%) dropouts on the physical complaints’
student-athletes participated in team subscales
sports such as basketball, handball,
soccer, and volleyball
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

Boyadjieva and Steinhausen, 1996 [51] Three nonclinical samples were The Eating Attitude Test (EAT) (Garner, 22 (10.4%) participants scored above the 2 and 3b
studied:(a) special secondary school 1979) and the Eating Disorders Inven- cut-off score of 30 on the EAT. Special
students (n = 91, mean age = 15.2, tory (EDI) (Garner, 1991) school students dominated with 14
SD = 1.3); (b) standard second- (15.4%) of the students, followed by 6
ary school students ( n = 70, mean (8.6%) standard secondary school stu-
age = 14.7, SD = 0.9); and sport school dents and only 2 (3.9%) sport school
students ( n = 51, mean age = 16.2, students. In general, a similar picture
SD = 1.3). The clinical sample com- emerged for the EDI
prised the entire cohort of consecutive
admissions of 22 anorectic patients(20
females and 2 males, mean age = 15,
SD = 2.0)
Brand et al. 2013 [68] 866 elite student-athletes from a variety Multidimensional Mood Questionnaire For female athletes, a number of symp- 2 and 3d
of sports (e.g. artistic gymnastics, box- (Steyer et al. 1997) and an expanded toms (panic, posttraumatic stress, and
ing, canoe/kayak, cycling, handball, 18-item version of the Composite specific phobia) were significantly
Impacts of Sports Schools on Holistic Athlete Development

judo, modern pentathlon, rowing, International Diagnostic Screener less prevalent than in non-athletes.
shooting, soccer, swimming, track and (CID-S; Wittchen et al. 1999) However, somatization was signifi-
field athletics, triathlon, volleyball, cantly more frequent. For males, the
weight- lifting and wrestling), aged differences between samples were less
12–15 years, enrolled in high-perfor- pronounced. Deselected student-ath-
mance sport programming in German letes exhibited lower mood scores (i.e.,
Elite Schools of Sport, 80 student- less positive chronic mood) compared
athletes from the same schools who to elite student-athletes as well as to
have just been deselected from elite non-athletes
sport promotion, and 432 age- and
sex-matched non-sport students from
regular schools. Distributions of male
and female students did not differ
between the three study groups
Brettschneider., 1999 [47] 711 male and female student-athletes Data on timetables and training The majority of young athletes had few 2, 3a and 3c
from elite sport schools, aged between schedules. A modified version of the problems with school; the group has
12 and 17 years, who were competitors Self- Description Questionnaire (SDQ high academic achievement, which
in various sports and 977 appropriately II) (Marsh, 1988, 1990) and narrative gives it a stable basis for develop-
matched control group from regular interviews ing self-confidence and self-esteem.
schools. Overall, 822 males and 866 Regarding the general self, adolescent
females athletes score significantly more posi-
tively than non-athletes, reflected in
higher self-ratings in the social domain
1885
Table 2  (continued)
1886

Authors and year Participant information Method Results and key findings Thematic code

Brown., 2014 [20] 20 elite athletes (age 14–18 years) and Semi-structured interviews, field notes Classifying students as high achievers, 2, 3b and 3c
five teachers/coaches from two elite during class visits and documents elite, motivated, strong, competitive
athlete programmes (EAPs), a state collected and as ‘the really good people’ and
school with a sport academy option distributing them into EAPs perpetu-
(School A) and a private correspond- ated an elitist discourse in both School
ence school designed specifically for A and School B that positioned elite
elite athletes (School B) athletes as having status, popularity
and recognition, but it also created a
source of frustration for those receiv-
ing little recognition within the EAP.
Furthermore, the elite athletes and
sponsors promoted the EAPs and in
turn the EAPs and sponsors promoted
the achievements and successes of
the elite athletes as their skills and
knowledge were highly valued in
comparison to other students within
the school. However, the EAPs offered
limited post-school options of obtain-
ing an athletic scholarship to study at a
university and/or to become a profes-
sional athlete
Brown., 2016 [27] 20 elite athletes (age 14–18 years) and Field notes and photos during school The EAPs emphasised corporate values 1, 2, 3a, 3b and 3c
five teachers/coaches from two EAPs, visits, information from school web- of loyalty, self-sacrifice and work ethic
a state school with a sport academy sites and interviews with the teachers/ and perpetuated the dichotomies of
option (School A) and a private corre- coaches (individually) and elite ath- theory/practice, thinking/doing and
spondence school designed specifically letes using semi-structured interviews mind/body discourses that assisted in
for elite athletes (School B) and two focus group interviews the marginalised academic status of the
EAP. Most of the elite athletes strug-
gled to reconcile their athletic identity
with their teenage identity as they
sacrificed time with friends, pleasures
such as frozen colas and other pursuits
to be role models for younger athletes
and others in their community
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

Chua., 2015 [65] 13 participants – dance students ( n = 4), Data were documents, letters, inter- Peers were important sources of emo- 2 and 3c
teachers ( n = 6), parents ( n = 2), views, and observation field notes tional and informational support. The
and one sibling. Students aged 16 to collected over 2 years Finnish students spend a great deal of
22 years were enrolled in their national time together in class, rehearsals, and
dance institutions— the Finnish leisure throughout the school term,
National Opera Ballet School and the pursuing a common career goal that
Singapore Dance Theatre probably spurred them to support one
another. Conversely, missing from
the data was the influence of friends
in the Singaporean students’ talent
development. Vicarious experience
or observing a peer succeed at a task
strengthened self-efficacy in ballet
De Bosscher et al. 2016 [41] 408 athletes within an Elite Sport Data from Bloso (Flemish sports The data showed no clear evidence of 1, 2, 3a and 3b
School (ESS) (188 males, 220 agency), lengthy surveys and 10 semi- more effective outputs (performance),
Impacts of Sports Schools on Holistic Athlete Development

females, < 18 years = 10.5%, structured interviews or more positive evaluation of through-
18–23 years = 66.5%, puts (processes) by athletes who
24–28 years = 23%) and 341 from attended an ESS. Athletes who did not
athletes outside ESS (50% male, attend an ESS received less support
50% female, < 18 years = 8.4%, services, but those who did receive
18–23 years = 51.3%, such services were generally more
24–28 years = 40.3%). 253 athletes satisfied. They were equally satisfied
from team sports and 496 individual about their coaches’ expertise. 95%
sport athletes of all students within an ESS attained
their diploma in secondary education.
No significant differences between
elite athletes within and outside ESS
on continuation to higher education
after secondary school
Elbe et al. 2005 [69] 327 students attending a school for Volitional Components Questionnaire Young elite athletes in comparison with 2 and 3d
young elite athletes (157 males and (Kuhl and Fuhrmann, 1998) students of a regular school show
170 females) of whom 74 lived in higher values in self-optimisation and
the on-campus boarding school. The stayed at this higher level during the
age groups are divided according to course of the study. A comparison
classes, with 12- to 13-year-olds in concerning the living situation shows
grades seven to eight (n = 98), 14- to a more positive development in self-
15-year-olds in grades nine to 10 optimisation for those athletes living
(n = 138), 16- to 17-year-olds in grades on campus
11 and 12 (n = 61) and the 18-year-olds
in grade 13 (n = 30)
1887
Table 2  (continued)
1888

Authors and year Participant information Method Results and key findings Thematic code

Emrich et al. 2009 [22] 196 German participants (32 consist- A standardized survey There was no difference in athletic per- 2, 3a, 3b and 3d
ently in ESS, 39 partly in ESS, 125 formances (medals won) between ESS
from never in ESS) participants of pupils and others in the 2004 Summer
the 2004 Summer Olympic Games Olympics, while in the 2006 Winter
as well as the 2006 Winter Olympic Olympics, there was a significant
Games. No age difference between the difference (substantially higher share
individual categories of medals amount ESS pupils than for
pupils who did not attend an ESS).
Furthermore, there were no differences
in school performances between the
groups. Missed examinations owing to
competitions and missed lessons due
to competitions were scenarios often
experienced by sport school student-
athletes. Pupils at ESS often go on to
pursue careers in the federal police and
the armed forces, while many more
non-ESS pupils work toward earning a
university degree
Eriksson et al. 2017 [52] 244 skiers at the Swedish National Postal questionnaires The proportion of participants with self- 2 and 3b
Elite Sport Schools for cross-country reported physician-diagnosed asthma
skiing, biathlon, and ski-orienteering was higher among skiers than in the
(127 males and 117 females, mean age reference group. The median age at
16.8, SD = 1.2) and 238 adolescents asthma onset was higher among skiers
(109 males and 127 females, mean than in the reference group. Female
age = 17.6, SD = 1.1) reference group, sex, family history of asthma, nasal
matched for sport school municipali- allergy, and being a skier were risk
ties factors associated with self-reported
physician-diagnosed asthma
Gisslèn et al. 2005 [53] 57 students at the Swedish National Cen- The patellar tendons were evaluated A clinical diagnosis of jumper’s knee, 2 and 3b
tre for high school volleyball (29 males clinically and by grey scale ultrasonog- together with structural tendon changes
and 28 females, mean age = 17.4) and raphy and power Doppler sonography and neovascularisation visualised with
55 (27 males and 38 females, mean sonography, was seen among Swedish
age = 17.4) non-regularly sports active elite junior volleyball players but not
controls in matched not regularly sports active
controls
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

Henriksen et al. 2011 [42] Athletes who attend Wang School of Data from interviews, participant All coaches are former elite athletes 1, 2, 3b, 3c and 3d
Elite Sports kayak program (age observation and document analysis, raised within the system. One main
16–19 years) and elite athletes, as described more fully in Henriksen feature is the relationship between
coaches, managers and parents from (2010) prospects and a community of more
the environment elite athletes, which was at the heart
of the environment. The elite athletes
were really visible as role models, and
arguably training with the elite level
athletes may prepare the prospects for
the next phase in their athletic career
and so ease their transition. A second
such feature relates to the athletes’
experience of living in an integrated
and coordinated environment. The
kayakers experienced an integrated set
Impacts of Sports Schools on Holistic Athlete Development

of “pulls”, which they attributed to a

good coordination and communica-
tion among different components in
the environment. Final feature is the
way in which the environment allowed
space for the athletes to have other
personal identities than their athletic
one (e.g., a student, a friend, a mentor
of younger athletes) and encouraged
them to develop qualities and skills
applicable not only in sport but also in
other spheres of life
Ingrell et al. 2019 [70] 78 student-athletes (30 female and 48 Swedish version of Athlete Burnout Increases in all three (reduced sense of 2 and 3d
males, mean age at T1 = 12.7 years, Questionnaire (Raedeke and Smith, accomplishment, emotional and physi-
SD = 0.44), attending a sport compul- 2011, 2009) and Swedish and ver- cal exhaustion, and sports devaluation)
sory school. The sports represented sion of the Task and Ego Orientation burnout variables, therefore burnout
by the participants in this cohort were in Sport Questionnaire (Duda and scores increased over the three-year
soccer, ice hockey, figure skating, Nicholls, 1992) period. Furthermore, task orientation
floorball, swimming, diving, basket- had a negative within-person effect on
ball, badminton, and tennis burnout perceptions with regard to a
reduced sense of accomplishment and
sport devaluation among student-
athletes
1889
Table 2  (continued)
1890

Authors and year Participant information Method Results and key findings Thematic code

Into et al. 2020 [71] 414 student-athletes (age 17–18 years, School Burnout Inventory (Salmela-Aro, 4 groups of experienced coaching 2 and 3d
49% female, 51% male), from seven Kiuru, et al. 2009), Sport Burnout climates were identified: extremely
sports high schools participated in this Inventory—Dual Career (Sorkkila disempowering (7%), disempowering
study. In the sample, 47.3% and 52.4% et al. 20,172,017) and the Empower- (27%), empowering (24%), and inter-
of the adolescents participated in indi- ing and Disempowering Motivational mediate (42%). Overall, student-ath-
vidual and team sports, respectively Climate Questionnaire (Appleton et al. letes in the extremely disempowering
2016) and disempowering coaching climate
groups reported higher levels of sport
and school burnout than student-ath-
letes in the other 2 groups
Knowles et al. 2017 [23] 233 students (74% male and 26% female, Online survey that captured information Sport school students spent less time 2, 3b and 3d
mean age = 14.3, SD = 1.6); 187 stu- about time use, sport involvement and in sedentary leisure and similar time
dent-athletes and 46 non-sport school health and wellbeing studying to non-sport school students
students from one large metropolitan and had better general health and
school in Australia. Student-athletes social and emotional wellbeing than
participated in the sport for which non-sport school students. Student-ath-
they were selected into the school; lete burnout scores for reduced sense
basketball (24%), netball (8%), football of accomplishment, emotional and
(AFL, 31%) or soccer (35%) physical exhaustion and devaluation of
sport all indicated relatively low levels
of burnout
Kristiansen and Houlihan., 2015 [24] 35 respondents from nine stakeholder Data were collected through a series of The quality of coaches working at the 1
groups, including athletes (n = 7, from interviews. The interview guide was Norwegian College of Elite Sport
summer and winter sports), coaches tailored to the different participants (NTG) is considered to be a significant
(n = 7), teachers (n = 4), elite entourage and their stakeholder position marketing advantage. The resources
members (n = 3), parents (n = 8), sport available at NTG enable athletes to
school managers (n = 5), Olympiatop- be given extra tutoring ‘to help after
pen centre (n = 4) and federations longer period of absence,’ add extra
(n = 4) hours (of tuition)' to keep up with
school and if students are away at
training camps or at competitions as
well as having access to the services
of nutritionists, nurses, physiothera-
pists and other support personnel
to deal with issues related to their
athletic career. Having these resources
‘in-house’, is an advantage that was
mentioned by both the athletes and
parents
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

Kristiansen., 2018 [28] 26 Norwegian athletes who qualified for Mixed methods survey and the author Pursuing a dual career is often a chal- 1, 2 and 3d
the European Youth Olympic Festival observed three pre-camps hosted by lenging balancing act for the young
(11 females and 15 males, mean Olympiatoppen. Observations were student-athletes. Additional results
age = 16.65 years, SD = 0.91). Athletes also made during the competition identified the importance of sup-
competed in cross-country skiing, portive parents, schools that adapt the
biathlon, alpine skiing, ski jumping, workload for the student-athletes, and
figure skating and Nordic skiing, a federation that recognizes the impor-
respectively. Overall, 19 of the athletes tant role of parents and schools
attended a private sport school, 10
athletes a sports programme at public
schools and 4 were still in lower sec-
ondary school
Lichtenstein et al. 2018 [54] Three high-risk samples (n = 471): 257 A survey which included the youth ver- The prevalence rate of exercise addiction 2 and 3b
sport school students (mean age = 15.8, sion of the Exercise Addiction Inven- was 4.0% in sport school athletes,
SD = 1.25), 127 fitness centre tory (Griffiths et al. 2005), the SCOFF 8.7% in fitness attendees, and 21% in
Impacts of Sports Schools on Holistic Athlete Development

attendees (mean age = 17.6 years, Questionnaire for eating disorders, patients with eating disorders. Exercise
SD = 1.41), and 87 patients with eating sociodemographic items, and questions addiction was associated with feelings
disorder diagnoses (mean age = 15.8, concerning disturbed attitudes toward of guilt when not exercising, ignoring
SD = 2.33) exercise and eating pain and injury, and higher levels of
body dissatisfaction
Martinsen and Sundgot-Borgen., 2013 306 elite athletes attending Elite This was a two-phase study, including a In part I, more controls than athletes 2 and 3b
[55] Sport High Schools in Norway self-report questionnaire (part I) fol- were classified as ‘‘at risk’’ for eat-
(204 males and 102 females, mean lowed by clinical interviews (part II) ing disorders (ED). In part II, the
age = 16.5 years, SD = 0.3) and 244 prevalence of ED among the total
controls from two randomly selected population of athletes and controls
regular high schools in Norway was estimated to be 7.0% versus 2.3%,
(79 males and 100 females, mean with a difference of 4.7%, with the ED
age = 16.9, SD = 0.3), representing 50 prevalence being higher for female
different sports/disciplines than male athletes and female and male
controls. No difference in the preva-
lence of ED was detected between the
females in weight-sensitive and less
weight-sensitive sport groups
1891
Table 2  (continued)
1892

Authors and year Participant information Method Results and key findings Thematic code

Martinsen et al. 2010 [56] First-year students (15–16 years old) Questionnaire and Eating Disorders A higher percentage of controls than 2 and 3b
of 16 different Norwegian Elite Sport Inventory –2 (Garner, 1991) athletes reported dieting and use of
High Schools (n = 682), two randomly pathogenic weight-control methods.
selected ordinary high schools from The most frequent reason for dieting
a county representative of the general among girl and boy controls and girl
Norwegian population (n = 423) and athletes was to improve appearance,
a birth date in 1992 (i.e., age of 15 or whereas boy athletes most often
16 at the time of data collection). The reported enhanced performance as a
athletes represented 50 different sports reason for dieting. One-third of the
athlete boys and 13% of the athlete
girls were dieting as directed by their
coach or teacher, and this was higher
than among boy and girl controls
respectively
Moazami-Goodarzi et al. 2020 [72] Student-athletes from six Finnish upper Sports achievement 4-point Likert scale, Three groups were identified: dual 2 and 3d
secondary sport schools (N = 391, grade point average, the Athletic identity (77%), changing identity (5%),
mean age at T1 = 16, SD = 0.17; 51% Identity Measurement Scale (Brewer and athletic identity (18%). The higher
females and 49% males). 50% played et al. 1993) and modified Athletic the academic achievement was at Time
individual sports (e.g., swimming or Identity Measurement Scale (Brewer 1, the more likely the athletes were to
athletics) and 50% team sports (e.g., et al. 1993) show a dual identity than an athletic
ice hockey or football) identity profile. Similarly, athletes with
dual identity showed higher subse-
quent academic achievement at Time
4 than those with an athletic identity
profile. Finally, athletes with dual
identity were more likely and athletes
with athletic identity less likely to
withdraw from sport activities during
upper secondary school than would be
expected by chance
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

Morris et al. 2020 [19] Interview participants (N = 31) were Documentary analysis, interviews with They are situated in upper and lower 1
purposefully selected because they knowledgeable stakeholders, cross- general and vocational secondary
held an understanding of one or more case analysis, and researcher discus- education (ISCED level 2–5). Data
dual career development environ- sions highlight that the majority of programs
ments (DCDE). The expert discussion support athletes through development
participants included practitioners and mastery phases of their athletic
(N = 4) and researchers (N = 13) who development. Sport schools can either
had significant experience within the be a) education-led or vocation-led
area of dual careers, in some cases system (i.e., the athlete is based in
over 20 years’ experience an education/vocation environment
which offers support for sport and
performance, or (b) a combined dual
career development environment
(i.e., an organization or institution
that works in tandem with both sport
Impacts of Sports Schools on Holistic Athlete Development

and education/vocational providers to

deliver an all-round support pack-
age to the individual undertaking the
dual career). The support provisions
between institutions in the same
country are not standardized because
each is able to decide the provision
of support, they give to each athlete
for themselves – they can, however,
include similar features (e.g., sports
facilities, academic support and sport
science provision)
Moseid et al. 2019a [57] 259 elite athletes (16-year-olds, 68% Web‐based questionnaire and the Oslo In this specialized Sport Academy 2 and 3b
male and 32% female) from three spe- Sports Trauma Research Centre High School program, 39% of the
cialised Sport Academy High Schools (Clarsen et all., 2014) questionnaire on athletes reported early specialization
in Norway. Thirty different sport health problems (at 12 years or younger). However,
disciplines (both summer and winter early specialization did not increase
sports from both individual and team the risk of injury or illness during the
sports) were represented and grouped 26 weeks, nor did being a single‐sport
into three major categories (endurance athlete the previous two years increase
[n = 69], technical [n = 62], and team this risk. The best performing athletes
sports [n = 128]) at the time of enrolment were not at
greater risk of becoming injured or ill
during the 26 weeks
1893
Table 2  (continued)
1894

Authors and year Participant information Method Results and key findings Thematic code

Moseid et al. 2019b [58] 166 Sport Academy High School youth The Oslo Sports Trauma Research During the 26‐week period, the athletes 2 and 3b
elite athletes (age 15–16 years, 72% Center Questionnaire (Clarsen et all., reported 156 overuse injuries, 146
males and 28% female) from a variety 2014) on Health Problems and Iron- acute injuries, and 294 illnesses. Each
of team, technical, and endurance man Jr physical fitness test battery athlete reported an average of 3.6
sports newly enrolled into specialized health problems. Overall, the least fit
sport academy high schools quartile of athletes did not report more
health problems compared with the
rest of the cohort
Mudrak and Zabrodska., 2014 [43] Nine young gifted children (five female Semi-structured interviews Both sport school athletes described 1, 2, 3a and 3d
and four males, aged between 17 and gradually losing a sense of agency
23 years). Three of the participants in their future development. They
(1 female, 2 male) attended sport described situations in which their
schools and achieved, in childhood, an excellent early results led to increasing
extraordinary level in sport, specifi- expectations and pressure to success-
cally gymnastics and taekwondo fully compete with other children.
They both experienced a significant
decrease in their originally very high
motivation and increase feelings of
psychological and physical burnout
and quit competitive sport altogether.
Because of their intensive engagement
in sport practice, they had had only
limited experience with “ordinary” life
outside competitive sport. After with-
drawing from competitive sport, they
experienced only a very limited sense
of agency in relation to other possible
professional careers and had difficul-
ties in finding a new direction in life
Perez-Rivases et al. 2020 [48] 72 Spanish female student-athletes Spanish versions of the Dual Career Participants perceived the need to 2, 3a and 3b
(mean age = 17.33 years; SD = 0.73), Competency Questionnaire for Ath- better develop all their dual career
who were grant holders in talent devel- letes (De Brandt et al. 2018) and Dual (DC) competencies (e.g., “ability to
opment centres or high-performance Career Competency Questionnaire for resolve conflicts”; “ability to use your
centres and studying upper secondary Athletes with scenario extension (De time efficiently”). Results show that
school. Participants took part in both Brandt, 2017) trying to combine social life with DC
individual (47.2%) and team (52.8%) (92.4%), missing significant days of
sports study (86.6%), and having a challeng-
ing study year (79.4%) were the three
scenarios most experienced by female
student-athletes. Similarly, suffering
from an injury was reported as experi-
enced by 46 (69.7%) of the participants
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

Rasyid et al. 2020 [73] 854 young athletes from two Malaysian Modified version of the School Burnout Athletes were more inclined toward Task 2 and 3d
Sport Schools (age 13–18 years old) Inventory (Salmela-Aro and Naatanen, orientation. Male were more task and
2005), School Burnout Inventory ego orientated than females. Younger
(Salmela-Aro and Naatanen, 2005), athletes are more task-oriented as
Success Expectations Scale (Nurmi, compared to senior athletes. Individual
Salmela-Aro, and Haavisto, 1995), sport athletes were found to be more
modified version of the parental Ego oriented than team sport athletes
belief’s questionnaire
Romar., 2012 [44] 49 students (15 females and 34 males, Questionnaire about academic success The results showed that 80% of the 1, 2, 3a and 3b
mean age = 17 years) from three skiing and athletic performance students extended their high school
boarding schools, two cross-country studies from three to four years. Fifty-
and one alpine school four percent of alpine skiers and 15%
of cross-country skiers indicated that
their best athletic success was in inter-
national competitions. Finnish alpine
Impacts of Sports Schools on Holistic Athlete Development

and cross-country athletes missed on

average 88 and 22 of 190 days per
academic year. Almost all students
perceived that skiing school helped by
combining sport and school. However,
only 40% of the alpine skiers and 62%
of the cross-country skiers were satis-
fied with their present athletic success.
Seventy-three percent of the alpine ski-
ers felt that sport participation affected
negatively their success in school. Suc-
cess in sport, good training possibili-
ties, skilled coaches and caring friends
were reason for enjoying life in skiing
boarding schools
Ronkainen et al. 2020 [59] 17 international level Finnish student- Visual representations of their “dream They identified three types of dream 2 and 3c
athletes pursuing sport and edu- days” and low-structured interviews days: a day on holiday, focused on
cation in upper secondary sport where participants were invited to tell relaxation, having a good time with
schools (7 males and 10 females, a story about the best possible day friends, and recreational activities;
age 16–17 years). Eleven athletes sometime in the future a day of peak athletic performance
participated in individual sports (judo, describing winning a major competi-
tennis, athletics, swimming, artistic tion; and a regular day involving
gymnastics, alpine skiing, ski orien- school or work, athletic training and
teering, and cross-country skiing) and time with family. They concluded that
six athletes participated in team sports the short future timespan and a low
(football, ice hockey, basketball, and number of sporting dream days might
artistic group gymnastics) indicate overload and lack of time for
reflection
1895
Table 2  (continued)
1896

Authors and year Participant information Method Results and key findings Thematic code

Ronkainen and Ryba., 2018 [66] 10 female Finnish youth athletes In depth interviews Summarised an account of three ath- 2, 3b, 3c, and 3d
participating in the national talent letes. One athlete was on track with her
development programme and studying life plan, had graduated with excel-
in upper-secondary sport schools (age lent grades and received an athletic
at baseline: 15–16 years) scholarship to the USA and sustained
a dual-career throughout upper second-
ary school and into higher educa-
tion. Two of the athletes equipped
themselves with 'skills' to manage
and organise time. One of the athletes
indicated that she needs to achieve
perfection every day in order to feel
good about herself finding it difficult
to be satisfied with normal perfor-
mance. This led to excessive training
regimes and subsequent injury. The
final athletes felt that she did not have
time, that sport was stealing time from
her schoolwork and from being with
friends. She experienced symptoms of
burnout, both in sport and school
Rosendahl et al. 2009 [60] 576 young athletes of Elite Sports Eating Attitude Test (Garner et al. 1982; Athletes did not show a higher frequency 2 and 3b
Schools in Germany (210 females and German version). Body image and of disordered eating than non-athletes.
366 males, mean age = 15.7 years, body ideal were measured with male Gender and dietary experience, but not
SD = 1.25) and a reference group and female silhouettes representing group (athletes vs non-athletes), were
consisting of 291 non-athletes from different weight categories. The body significant predictors of disordered
regular high schools (169 females and mass index (BMI) was calculated as eating. It can be concluded that dietary
122 males, mean age = 15.9 years, weight in kilograms divided by the experience and female gender proved
SD = 0.90). The athletes competed in square of the height in meters (kg/ m2) to be important risk factors of disor-
26 different sports representing techni- dered eating. Participation in sports
cal, endurance, esthetic, weight class, seems to be protective for developing
ball game, power and antigravitation serious eating problems, especially in
sports girls
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

Ryba et al. 2017 [36] 18 (10 females and 8 males) elite junior Two individual conversational inter- Thirteen of 18 adolescent athletes drew 2, 3a and 3b
athletes, aged 15–16 years at baseline, views primarily on the performance narrative
identified through the Finnish Sport plot to construct their life story and
Academies under the auspices of five of 18 athletes could not project
National Olympic Committee into the future beyond their athletic
selves. Constructing their identities
using the narrative resources of the
performance plot, young athletes’ sto-
ries revolved around winning or being
the best, training hard, competing and
achieving in the senior ranks. While
at the time of this research, all 18
participants were integrating sport and
education in their daily living, most
of the adolescents considered school
Impacts of Sports Schools on Holistic Athlete Development

activities to be the inevitable part of

youth, which consumed all their “free”
time after sport, and five of them had
difficulties to imagine themselves to be
anything but professional athletes in
the future
Sandström et al. 2012 [61] 57 female athletes at a senior high Questionnaires and levels of haemo- The main result of the study is the find- 2 and 3b
school for top-level athletes (mean globin, serum iron, total iron-binding ing that iron deficiency (ID) and iron
age = 16.8 years, SD = 0.9). The capacity, transferrin saturation, and deficiency anaemia (IDA) are common
control group consisted of 92 (mean serum ferritin among young adolescent female ath-
age = 17.1 years, SD = 0.9) non-athlete letes and that there was no difference
students. The athletes practiced differ- between female athletes and nonath-
ent sports, both individual and team letes. Athletes reported a significantly
higher consumption of milk a day, ate
more often and were smokers to a less
extent compared with nonathletes
1897
Table 2  (continued)
1898

Authors and year Participant information Method Results and key findings Thematic code

Skrubbeltrang et al. 2020 [45] All Sports Class students in 7th–9th Survey of the student population in 2013 Three-quarters of the Sports Class stu- 1, 2, 3b and 3d
grades (age 13–16 years, n = 1170, and a follow-up sample in 2015 dents agreed that the classes provided
733 males and 437 females) in schools better opportunities. 44% of boys
in 15 Team Denmark-supported compared to 33% of girls indicated
municipalities. More than half the that the morning practices helped them
athletes played football and handball. improve “to a great extent.” 51% stated
After this, swimming, ice hockey, at times they couldn't be bothered to
badminton and basketball follow in invest the time and energy necessary
relative popularity to reach the elite. 49% said they had
pushed themselves so much that it
affected their enjoyment in their sport
and 51% pushed themselves so much
that they sustained injuries
Skrubbeltrang et al. 2016 [67] 74 sport students (29 females and 45 Participant observation of student/par- In the sports classes, they found that 2 and 3c
males), grade 8 (age 14–15 years) and ents/teacher/club meetings, as well as there is a code of conduct, whereby the
12 (age 18–19 years) with some of the classroom observations. In addition, sports students as a learning subject
students in grade 9 (age 15–16 years), 74 interviews with sport students (48 must commit to working hard to
as well as parents, teachers and train- individual and 7 interviews in pairs) develop themselves as athletic talents
ers from four schools located in four and trainers, teachers and some of the – and they should also have the same
regions of Denmark parents. Finally, a collaborative team attitude towards their schoolwork. Stu-
ethnography dent-athletes have less time for peers
outside of sport and must continually
negotiate the terms of their member-
ship of this group, for example, that
they attend activities less frequently.
They argue that sport schools oblige
students to follow a narrow develop-
mental track with an ambitious goal of
performing in both sport and school,
and that this is threatened when a
sports student prioritises either sport
or school while he/she is still enrolled
in the class
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

Sorkkila et al. 2017 [18] 391 student-athletes (51% females and Modified version of the School Burnout Four burnout profiles were identified: 2 and 3d
49% males, mean age = 16, SD = 0.17) Inventory (Salmela-Aro and Naatanen, well-functioning (60%), mild sport
from six different upper secondary 2005), School Burnout Inventory burnout (28%), school burnout (9.6%),
sport schools in Finland, and 448 (Salmela-Aro and Naatanen, 2005), and severe sport burnout (2.7%). Ath-
parents (58% mothers). Out of the par- Success Expectations Scale (Nurmi, letes' and parents' expectations of suc-
ticipating student-athletes, 197 (50%) Salmela-Aro, and Haavisto, 1995), cess seemed to protect against burnout
played individual sports (e.g., athletics modified version of the parental in the same domain, but this protection
or judo) and 194 (50%) played team belief’s questionnaires (Nurmi et al. did not extend to the other domain.
sports (e.g., football or ice hockey) 1995) Moreover, high success expectations
in one domain seemed to increase the
risk for burnout in another domain
Sorkkila et al. 2018 [74] 391 Finnish student-athletes (51% School Burnout Inventory (Salmela- Burnout dimensions in a particular 2 and 3d
females and 49% males) from six Aro, Kiuru, et al. 2009) and modified domain were substantially stable
upper secondary sport schools, Perception of Success Questionnaire within the same domain during the
age 15–16 years (mean age = 16, (Roberts et al. 1998) first year of upper secondary school
Impacts of Sports Schools on Holistic Athlete Development

SD = 0.17). Fifty percent of the partici- and that school-related exhaustion

pants practiced individual sports and at the beginning of upper second-
50% team sports ary school predicted sport-related
exhaustion at the end of the school
year. Mastery goals in sport and
school were negatively associated with
cynicism and feelings of inadequacy
within the same domain. Furthermore,
performance goals in school were posi-
tively associated with school-related
cynicism
Sorkkila et al. 2019 [75] 391 first year student‐athletes (51% Sport Burnout Inventory—Dual Career Three burnout profiles were identified: 2 and 3d
females and 49% males, mean Form (Sorkkila et al. 2017), School (a) The Average profile (60%) (b)
age = 16, SD = 0.17) from six differ- Burnout Inventory (Salmela-Aro, The Increased burnout profile (32%),
ent upper secondary sport schools Kiuru, et al. 2009) and Brief Resil- and (c) the Non‐risk profile (8%).
in Finland. A total of 50% of them ience Scale (Fletcher and Sakar, 2013) Increased burnout group symptoms
represented individual sports and 50% were less resilient and more likely to
team sports dropout from sport than those in the
other two groups. Furthermore, those
in the Non‐risk profile were more
resilient than athletes in the other two
groups
1899
Table 2  (continued)
1900

Authors and year Participant information Method Results and key findings Thematic code

Stambulova et al. 2015 [37] 16-year-old male and female student- The Dual Career Survey (Engstrom and Student-athletes' adaptation at RIGs was 1, 2, 3a, 3c and 3d
athletes, representative of 27 different Stambulova, 2011a), The Athletic related to coordinating different layers
individual (e.g., track-and-field, tennis, Identity Measurement Scale (Brewer, of their development (athletic, psycho-
cycling, golf) and team (e.g., basket- Van Raalte, and Linder, 1993), and logical, psychosocial, and educational)
ball, handball, hockey) sports and 33 The Student Identity Measurement in order to search for, and (possibly)
national elite sport schools across Swe- Scale (Engstrom and Stambulova, obtain an optimal balance between
den (n = 261 in the first and n = 250 in 2011b) and in-depth interviews sport, studies and private life. The par-
the second measurement) ticipants of the study perceived all the
three big spheres of their life examined
in the study (sport, studies and private
life) as important and demanding, both
at the beginning and at the end of their
first educational year at RIG, and used
resources and coping efforts to deal
with them
Stenling et al. 2015 [62] A total of 247 elite skiers (109 females, Questionnaires assessing perceived Initial level of need satisfaction at Time 2 and 3b
138 males) athletes from 18 sport autonomy support from the coach, 1 negatively predicted change in per-
high schools in Sweden. The athletes’ need satisfaction, motivation, and ceived autonomy support, motivation,
age ranged from 16 to 20 years (mean psychological well-being and well-being, and initial level of
age = 17.8 years; SD = 0.9) motivation at Time 1 positively pre-
dicted change in perceived autonomy
support and change in well-being.
Correlations between intraindividual
changes were all positively correlated
and the athletes reported high and
stable levels of perceived autonomy
support, need satisfaction, self-deter-
mination index, and well-being over
the course of the competitive season
Stornæs et al. 2019 [63] 832 adolescents (13–14 years old, 53% Two perfectionism scales: the child-ado- A higher relative proportion of ordinary 2, 3b and 3d
females and 47% males): 166 students lescent perfectionism scale (Flett et al. school girls (39.3%) compared to elite
(82 females and 84 males) from elite 2000) and the frost multidimensional school girls (25.6%), and ordinary
sports- /performance-oriented lower perfectionism scale (Frost et al. 1990) school boys (36.4%) compared to elite
secondary schools, and 666 students school boys (19%), were observed
from ordinary schools (361 females within profile 1 and profile 2 (low
and 305 males) self-oriented perfectionism with high
perfectionistic concerns). Profile 1
and 2 were associated with the high-
est levels on anxiety, depression and
excessive weight and shape concerns,
and the lowest ratings for resilience
and global self-worth
F. Thompson et al.
Table 2  (continued)
Authors and year Participant information Method Results and key findings Thematic code

van Rens et al. 2012 [49] 242 (former) athletes who were labelled Online questionnaire based on: whether Attending a TTS did not influence the 2, 3a, 3b and 3d
by their sport federations as talented they attended a TTS, sport perfor- current and highest attained sport per-
athletes during the years 2004–2008 mance level, school performance level, formance levels of talented athletes (at
(46% male and 54% female, mean commitment to sport during second- both junior and senior level). Neither
age = 21 years, SD = 2.8). 70% did not ary school, and satisfaction with the were talents who had attended a TTS
attend a Topsport Talent School (TTS). combination of school and sport more satisfied about the combina-
Tennis players and gymnasts were tion of school and sport, nor were
overrepresented at TTS, speed-skaters they more motivated for their sport.
were overrepresented at mainstream Furthermore, results indicated that
secondary schools. The sports speed- talents who had attended TTS were
skating (34%) and judo (18%) were less motivated to do well in school;
most often represented in the sample attained lower educational levels in
both their secondary school and fur-
ther education and were less likely to
pursue higher education
Impacts of Sports Schools on Holistic Athlete Development

Zhao et al. 2020 [64] Male student-athletes (N = 21, mean age Physiological measurements (vital Over the 2-year investigation Hb and 2 and 3b
12.14 ± 0.62 years) from the Shanghai capacity (VC), haemoglobin (Hb) con- VC linearly increase between the ages
Elite Sport school. Categorized into centration, heart rate at rest), anthropo- of 12 and 14 years, not only reflecting
two groups: swimming group (10 ath- metric parameters (body height, body their sports-specific response to train-
letes), and the racket sports group (11 weight, chest girth), and motor tests ing, but also the impact of testosterone
players: 7 table tennis and 4 badminton (back strength (BS), complex reaction production during the onset of puberty.
players) speed) The resting HR remained on the same
level. In the racket sports group, the
dynamic BS increased over the two
years by 44.0%. In the swimmers'
group, the dynamic BS increased until
a certain levelling of developed during
the last half year
Thematic code: (1) characteristics and features of sport school programmes; (2) methods used to evaluate sport school impacts and outcomes; (3a) academic/vocational impacts and outcomes
associated with sport school programs; (3b) athletic/physical impacts and outcomes associated with sport school programs; (3c) psychosocial impacts and outcomes associated with sport school
programs; and (3d) psychological impacts and outcomes associated with sport school programs
1901
1902 F. Thompson et al.

Table 3  Methodological quality scale assessment

Study Country Design Methodologi- Total quality
cal quality assessment
criteria score
1 2 3 4 5

Andersson and Barker-Ruchti 2018 [40] Sweden Mixed methods 1 1 1 1 1 5

Aunola et al. 2018 [46] Finland Quantitative non-randomised 1 1 1 1 1 5
Baron-Thiene and Alfermann, 2015 [50] Germany Quantitative non-randomised 1 1 1 1 1 5
Boyadjieva and Steinhausen, 1996 [51] Bulgaria Quantitative non-randomised 1 0 1 0 1 3
Brand et al. 2013 [68] Germany Quantitative non-randomised 1 1 1 1 1 5
Brettschneider 1999 [47] Germany Mixed methods 1 1 0 0 1 3
Brown 2014 [20] New Zealand Qualitative 1 1 1 1 1 5
Brown 2016 [27] New Zealand Qualitative 1 1 1 1 1 5
Chua 2015 [65] Finland and Singapore Qualitative 1 0 1 1 1 4
De Bosscher et al. 2016 [41] Belgium Quantitative non-randomised 1 1 0 1 0 3
Elbe et al. 2005 [69] Germany Quantitative non-randomised 1 1 1 1 1 5
Emrich et al. 2009 [22] Germany Quantitative non-randomised 1 0 0 0 1 2
Eriksson et al. 2017 [52] Sweden Quantitative non-randomised 1 1 1 1 1 5
Gisslèn et al. 2005 [53] Sweden Quantitative non-randomised 1 1 1 1 1 5
Henriksen et al. 2011 [42] Denmark Qualitative 1 1 1 1 1 5
Ingrell et al. 2019 [70] Sweden Quantitative non-randomised 1 1 0 0 1 3
Into et al. 2020 [71] Finland Quantitative non-randomised 1 1 1 1 1 5
Knowles et al. 2017 [23] Australia Quantitative non-randomised 1 1 1 1 1 5
Kristiansen and Houlihan 2015 [24] Norway Qualitative 1 1 1 1 1 5
Kristiansen 2018 [28] Norway Mixed methods 0 1 1 1 1 4
Lichtenstein et al. 2018 [54] Denmark Quantitative non-randomised 1 1 0 0 1 3
Martinsen and Sundgot-Borgen 2013 [55] Norway Quantitative non-randomised 1 1 1 1 1 5
Martinsen et al. 2010 [56] Norway Quantitative non-randomised 1 1 1 1 1 5
Moazami-Goodarzi et al. 2020 [72] Finland Quantitative non-randomised 1 1 0 1 0 3
Morris et al. 2020 [19] Multi-Nation (Belgium, Denmark, Fin- Qualitative 1 1 0 0 1 3
land, Slovenia, Spain, Sweden, UK)
Moseid et al. 2019a [57] Norway Quantitative non-randomised 1 1 1 1 1 5
Moseid et al. 2019b [58] Norway Quantitative non-randomised 1 1 1 1 1 5
Mudrak and Zabrodska 2014 [43] Czech Republic Qualitative 1 1 1 1 1 5
Perez-Rivases et al. 2020 [48] Spain Quantitative non-randomised 1 1 1 1 1 5
Rasyid et al. 2020 [73] Malaysia Quantitative descriptive 1 1 1 1 1 5
Romar 2012 [44] Finland Quantitative descriptive 0 1 0 1 0 2
Ronkainen et al. 2020 [59] Finland Qualitative 1 1 1 1 1 5
Ronkainen and Ryba 2018 [66] Finland Qualitative 1 1 1 1 1 5
Rosendahl et al. 2009 [60] Germany Quantitative descriptive 1 1 1 1 1 5
Ryba et al. 2017 [36] Finland Qualitative 1 1 1 1 1 5
Sandström et al. 2012 [ 61] Sweden Quantitative non-randomised 1 1 1 1 1 5
Skrubbeltrang et al. 2020 [45] Denmark Quantitative descriptive 1 1 0 1 0 3
Skrubbeltrang et al. 2016 [67] Denmark Qualitative 1 1 1 1 1 5
Sorkkila et al. 2017 [18] Finland Quantitative descriptive 1 1 1 1 1 5
Sorkkila et al. 2018 [74] Finland Quantitative non-randomised 1 1 1 1 1 5
Sorkkila et al. 2019 [75] Sweden Quantitative non-randomised 1 1 1 1 1 5
Stambulova et al. 2015 [37] Sweden Mixed methods 1 1 1 1 1 5
Stenling et al. 2015 [62] Sweden Quantitative descriptive 1 1 1 0 1 4
Stornæs et al. 2019 [63] Norway Quantitative non-randomised 1 1 1 1 1 5
van Rens et al. 2012 [49] Netherlands Quantitative non-randomised 1 0 1 1 0 3
Zhao et al. 2020 [64] China Quantitative non-randomised 1 1 1 0 1 4
Impacts of Sports Schools on Holistic Athlete Development 1903

3.3 Characteristics and Features of Sports Schools

the outcome and intervention (or exposure)?

Are measurements appropriate regarding both

During the study period, is the intervention

Are the confounders accounted for in the
Are the participants representative of the

administered (or exposure occurred) as

Eleven studies [19, 24, 27, 28, 37, 40–45] explored sports
schools' characteristics and features, and are summarised

Are there complete outcome data?

in Table 2. Sports schools are situated in upper and lower
general and vocational secondary education (International
Quantitative non-randomised

Standard Classification of Education level 2–5 [19]). Data

design and analysis?

highlighted that the majority of programmes supported ath-
target population?

letes through development (i.e., athletes narrow their focus

to one or two sports) and mastery (i.e., athlete becomes an

intended?
expert in their sport) phases of their athletic development
[19]. Sports schools can either be an education-led or a
vocation-led system (i.e., the athlete is based in an educa-
tion/vocation environment that offers support for sport and
performance), or a combined dual-career development envi-
Is the sampling strategy relevant to address

Is the sample representative of the target

ronment (i.e., an organisation or institution that works in

Is the statistical analysis appropriate to
Is the risk of nonresponse bias low?

tandem with both sport and education/vocational providers

Are the measurements appropriate?

to deliver an all-round support package to the individual

answer the research question?

undertaking the dual-career [19]). However, the support

provision between institutions in the same country is not
Quantitative descriptive

the research question?

standardised because each is able to decide what support

they provide, but they can include similar features (e.g.,
sports facilities, academic support, sport science provision)
population?

[19]. The thematic analysis identified four themes: academic

support services, athletic support services, intense routines
and training partners.
sources, collection, analysis and interpreta-
adequate to address the research question?

Is there coherence between qualitative data

Are the qualitative data collection methods

3.3.1 Academic Support Services

Is the interpretation of results sufficiently
Are the findings adequately derived from
Is the qualitative approach appropriate to

Academic support services within sports schools included

answer the research question?

extra tutoring to help after periods of absence [24, 42], adap-

tation of school and training schedules [24, 42], lighter load
by one academic subject [27, 28, 42], extra tuition hours for
substantiated by data?

athletes away at training camps or competitions [24, 42], an

extra year of study [27, 28, 42], academic structure (e.g.,
timetabled lessons or study periods [27, 28, 42]), and career
Qualitative

the data?

advice [41]. In contrast, one study showed that only 25% of

tion?

non-sports school student-athletes received additional study

support [41].
between quantitative and qualitative results

adhere to the quality criteria of each tradi-

Are the different components of the study

qualitative and quantitative components

3.3.2 Athletic Support Services

Do the different components of the study
a mixed methods design to address the
Is there an adequate rationale for using
Table 4  Descriptor of study quality criteria

effectively integrated to answer the

Are divergences and inconsistencies

Are the outputs of the integration of

Athletic support services within sports schools included bet-

tion of the methods involved?

ter training facilities [41], high-quality coaches (e.g., former

elite athletes head-hunted for international coaching roles
adequately interpreted?

adequately addressed?

[24, 42]), sports training as part of the daily school pro-

research question?

research question?

grammes [42] and additional provision and access to ser-

vices (e.g., nutritionists, nurses, physiotherapists, and other
Mixed methods

support personnel to deal with issues related to their athletic

career [24]). However, in one study, non-sports school ath-
letes rated the services, the relationship with the coach, the
coach's presence during competitions, and support services
1

5
1904 F. Thompson et al.

upon leaving school more positively than sports school stu- significant days of study [49], missed examinations owing
dent-athletes [41]. to competitions [22], and missed lessons due to competi-
tions [22] were scenarios often reported by sports school
3.3.3 Intense Routines student-athletes. Although alpine student-athletes perceived
that sports school helped combine sport and school [44] and
The majority of sports school student-athletes’ routines were football student-athletes appreciated the school routine [40],
significantly more intense than their previous routines and Dutch student-athletes who had attended a sports school
schedules [37, 40, 44], with higher demands in school (e.g., were no more satisfied with the combination of school and
20–25 h work per week [37, 44]), more time in practice sport than athletes who had attended a mainstream school
(e.g., average ten times or 20 h of intensive practice a week) [49]. Additionally, higher demands in school than before
and competitions [40, 44], perceived excessive training loads was one of the least satisfied factors by Swedish athletes
[43, 45], and strict training programmes of high intensity [37] and most Finnish student-athletes considered school
[37, 40, 43, 44] highlighted. activities to be an inevitable part of youth, which consumed
all their “free” time after sport [36].
3.3.4 Training Partners
3.4.1.2 School Academic Success Six studies explored the
Findings indicated that many sports schools have quality effect of sports schools on school academic success through
training partners as indicated by sports school student-ath- standardised questionnaires [22, 41, 44, 46, 49], interviews
letes’ “having someone to aspire to” [42], being surrounded [41, 47], and classroom observations [40, 41, 47]. In the
by skilled people they can learn from and seek new knowl- majority of studies, sports schools did not impact upon the
edge [24], and having role models for the younger student- attainment of diplomas [41], grade point average [46], sec-
athletes [27, 42]. ondary school qualifications [22], high school graduation
[22], and high academic achievement [47]. However, Dutch
3.4 Impacts student-athletes who attended a sports school attained lower
educational levels in their secondary school education than
Forty-four studies (all except [19, 24]) evaluated the impacts student-athletes who attended a mainstream secondary
associated with sports school programmes. The data collec- school [49] and 73% of Finnish alpine skiers felt that sport
tion methods and instruments used to evaluate impacts are participation negatively affected their success in school [44].
presented below to gain a better understanding of the typical
methods used to assess individual impacts. The data collec- 3.4.1.3 Future Higher Education Success Five studies
tion method/instrument and the key findings of these stud- explored the impact of sports schools on future higher edu-
ies are also summarised in Table 2. Following the Holistic cation success through non-specified questionnaires [22,
Athletic Career model [14], the thematic analysis included 41, 49], interviews [27, 40, 41], field notes and observa-
in four main themes: academic/vocational impacts, athletic/ tions [27]. Sports school student-athletes often developed
physical impacts, psychosocial impacts, and psychological competencies (such as commitment and time management)
impacts with sub-themes presented within each main theme. that could lead to a university athletic scholarship and future
career [27]. The results regarding higher education continu-
3.4.1 Academic/Vocational ation were mixed, with De Bosscher et al. [41] revealing
no significant difference in continuation to higher education
Twelve studies [22, 27, 36, 37, 40, 41, 43, 44, 46–49] between student-athletes within and outside sports schools,
explored academic and vocational impacts. The thematic yet in other studies, sports school student-athletes were less
analysis included four sub-themes: school experiences, likely to start higher education [40, 49]. Swedish sports
school academic success, higher education success, and school student-athletes who did continue to higher educa-
career success. tion had lower higher education attainment [49] compared
with mainstream school students.
3.4.1.1 School Experiences Seven studies explored the
effect of sports schools on school experiences through inter- 3.4.1.4 Career Success Two studies explored sports schools'
views [36, 40], standardised questionnaires [22, 37, 48] and effect on career success through a standardised question-
non-specified questionnaires [44, 49]. Missing school was naire [22] and an interview [43]. German sports school
a common issue experienced by numerous sports schools’ student-athletes had greater likelihood of joining the Army
student-athletes [22, 40, 44, 49]. Finnish alpine and cross- or national police force than non-sports school pupils [22].
country athletes missed on average 88 and 22 of 190 days Czech Republic sports school student-athletes had only a
per academic year [44], respectively. Furthermore, missing limited experience with “ordinary” life outside competitive
Impacts of Sports Schools on Holistic Athlete Development 1905

sport and therefore, reported only a minimal sense of agency among Swedish elite junior volleyball players who had
about other possible professional careers and had difficulties attended a sports school compared to controls [53]. Sports
in finding a new direction in life [43]. school student-athletes felt physically ill-prepared for the
intensity of sports school programmes [40] and pushed
3.4.2 Athletic/Physical themselves so much that they sustained injuries [45, 59].
Further, sports school drop-outs complained significantly
Twenty-seven studies [20, 22, 23, 27, 36, 40–42, 44, 45, more often about physical symptoms than non-dropouts
48–64] explored athletic and physical impacts. The thematic [50]. In terms of illness incidences, sports school student-
analysis shaped four sub-themes: physical and physiological athletes reported an average of 3.6 health problems per per-
development, performance success, health and wellbeing, son during a 26-week period [58], a higher proportion of
and drop-out. self-reported physician-diagnosed asthma than controls [52],
and a high incidence of iron deficiency and iron-deficiency
3.4.2.1 Physical and Physiological Development One study anaemia [61].
[64] using physical and physiological assessments/analy- On the other hand, sports school student-athletes often
sis explored the impact of a sports school on physical and demonstrated stable levels of general health and well-being
physiological development of swimming and racket sports [23, 62], lower levels of depression and anxiety, and exces-
athletes. Over the 2-year investigation, haemoglobin and sive weight and shape concerns [63], spent more time in
vital capacity linearly increased, reflecting a sports-specific sport and less time in sedentary activities (screen-based
response to training, but also the effect of testosterone pro- behaviours) [23, 36] and smoked to a lesser extent than the
duction during the onset of puberty [64]. The resting heart reference group [61]. Furthermore, the results suggested that
rate (HR) remained on the same level and dynamic back disordered eating is less of a problem among sports school
strength increased over the two years until it plateaued dur- student-athletes than in the community. Significantly more
ing the last half-year in the swimming group [64]. non-athletes reported dieting [56, 60], being underweight
[60], eating behaviour disorder [60], being "at-risk" for
3.4.2.2 Performance Success Six studies explored the eating disorders [55] and use of pathogenic weight-control
impact of sports schools on performance success through methods [56] compared to sports school student-athletes.
non-specified questionnaires [41, 44, 49], standardised ques-
tionnaires [22], interviews [20, 41, 42], participant observa- 3.4.2.4 Drop Outs Two studies explored sports schools'
tion [20, 42] and document analysis [20, 42]. The major- effect on drop out through a standardised questionnaire [22]
ity of sports schools have not led to marked differences or and demographic and sport-related data [50]. Both studies
increases in the number of student-athletes performing at showed a high number of drop-outs from sports schools,
the world level as indicated by no significant differences in with 629 pupils from 27 sports schools dropping out before
the performance levels and highest level reached between attaining a school qualification [22], and 29.6% of sports
student-athletes within and outside sports schools [41, 44]. school student-athletes terminating their sports careers pre-
Only 40% of the alpine skiers and 62% of the cross-country maturely but still pursuing their academic education [50].
skiers were satisfied with their present athletic success [44].
However, one study found that sports school student-ath- 3.4.3 Psychosocial
letes demonstrated higher top place finishes [41] and more
medal success [41] compared to mainstream school student- Nine studies [20, 27, 37, 42, 47, 59, 65–67] explored psy-
athletes. On the other hand, another study [22] found no sig- chosocial impacts. The thematic analysis included four sub-
nificant differences between medals won by sports school themes: social skills, higher social status, family and friends,
and non-sports school student-athletes. and life skills.

3.4.2.3 Health and Wellbeing Twenty-one studies explored 3.4.3.1 Social Skills Two studies explored the effect of
the impact of sports schools on health and well-being, sports schools on social skills through a standardised ques-
through interviews [27, 36, 40, 55, 59], clinical analysis tionnaire [47], interviews [42, 47], and observations [42].
[53], laboratory tests [61], non-specified questionnaires [23, Data revealed that social skills (skills used to interact and
45, 50, 53, 58, 61–63], standardised questionnaires [26, 48, communicate with others) was one of main areas wherein
51, 54, 56–58, 60], and male and female silhouettes [60]. sports school student-athletes showed individual devel-
Sports school student-athletes indicated a high incidence opment [42]. Furthermore, sports school student-athletes
of injury [48, 58] and illness [58]. Clinical diagnosis of tended to rate themselves significantly higher in the social
jumper’s knee together with structural changes and neovas- domain than non-athletes [47].
cularisation in the tendon were found to be more common
1906 F. Thompson et al.

3.4.3.2 Higher Social Status Two studies explored sports 3.4.4.1 Perceived Pressure and Anxiety Seven studies eval-
schools' effect on social status, through interviews, field uated the impact of sports schools on perceived pressure and
notes/observations, and document data [20, 27]. In the two anxiety measured through standardised questionnaires [22,
studies, the coaches classified the majority of sports school 37, 63, 68], interviews [37, 40, 43], and a mixed methods
student-athletes as successful in sports, work ethic and dis- survey [28]. Findings suggested that sports school student-
cipline, and as “role models” [20, 27]. Classifying students athletes experienced a (perceived) inability to meet the ath-
as high achievers, elite, motivated, strong, competitive, and letic and performance requirements [22, 43], pressure to
as “the really good people” and distributing them into sports “perform well” [37] and a constant pressure and expectation
schools was seen to perpetuate an elitist discourse that posi- to achieve from others, such as parents and teachers [43].
tioned elite athletes as having status, popularity, and recog- Balancing sport and school was often seen as (organisation-
nition [20, 27]. However, this also caused tension amongst ally) stressful by young sports school student-athletes [28,
those within the programmes who received little recognition 40]. However, female sports school student-athletes showed
[27]. significantly fewer panic symptoms, post-traumatic stress,
and specific phobia than female non-athletes [68]. Further-
3.4.3.3 Family and Friends Four studies explored sports more, a higher proportion of ordinary school students than
schools' impacts on family and friends, through interviews sports school students reported low self-oriented perfec-
[42, 65–67], and documents, letters, and observation [65]. tionism with high perfectionistic concerns associated with
Time away from family and friends outside of sport seems higher anxiety levels [63].
to be a typical consequence for student-athletes in sports
schools. Results showed that many sports school student- 3.4.4.2 Motivation Four studies evaluated the impact of
athletes had less time for peers outside of sport [42, 66, 67] sports schools on motivation through non-specified ques-
and continually negotiated the terms of their membership of tionnaires [37, 45, 49] and interviews [42]. The dual-moti-
that group, for example, attending activities less frequently vated pattern (characterised by high value placed on both
[67]. However, several sports school student-athletes spent school and sport) was most typical among Finnish sports
a great deal of time together in class, training, competitions, school student-athletes [46]. However, the percentage of
living and leisure, and pursuing a common career goal that student-athletes demonstrating this pattern decreased over
tended to result in friendships/relationships arising along time at the sports school, and the percentage showing a low
the way [42, 65]. Competitions were highlighted as impor- academically motivated pattern increased [46]. Swedish stu-
tant social events, where athletes from different clubs and dent-athletes who had attended sports schools were signifi-
nations met, socialised, and made many friends [42]. cantly less motivated to do well at school than their coun-
terparts at mainstream secondary schools [49] and 51% of
3.4.3.4 Life Skills Three studies explored sports schools' Finnish student-athletes stated that they could not be both-
impact on life skills through in-depth interviews [37, 42, 59] ered to invest the time and energy necessary to reach the
and participant observation [42]. The results suggested that elite performance level in their sport [45]. In contrast, Hen-
sports schools encouraged student-athletes to develop quali- riksen et al. [42]’s study highlighted a strong work ethic/
ties and skills applicable not only in sport but also in other motivation as one of the main areas wherein sports school
spheres of life, such as independence. Sports school student- student-athletes showed individual development.
athletes often organized their living (e.g., to calculate their
budget), took care of themselves (e.g., washing, cleaning, 3.4.4.3 Identity and Orientation Two studies evaluated
cooking [37]), developed skills to manage and organise time sports schools’ impact on identity and orientation through a
[59] and established social skills, autonomy, responsibility, standardised questionnaire [72, 73]. The most common pro-
and a strong work ethic, which are helpful to them in both file (typical for 77% of student-athletes) was a dual identity,
sport and life. [42]. that is, student-athletes who reported strong identification
with both athlete and student roles [73]. Furthermore, sports
3.4.4 Psychological school student-athletes were more inclined towards task ori-
entation [73].
Twenty-one studies [18, 22, 23, 28, 37, 40, 42, 43, 45, 46,
49, 59, 63, 68–75] in total explored psychological impacts. 3.4.4.4 Self‑Optimisation One study using a standard-
The thematic analysis shaped five sub-themes: perceived ised questionnaire [69] evaluated sports schools' impact on
pressure and anxiety, motivation, identity and orientation, self-optimisation. Sports school student-athletes compared
self-optimisation and burnout. to students of a regular school showed higher values in
Impacts of Sports Schools on Holistic Athlete Development 1907

self-optimisation and stayed at this higher level during the associated with sports school programme involvement. In
three-year study [69]. A comparison concerning the living total, 46 studies were identified that included 11 studies
situation showed a more positive development in self-opti- determining the characteristics and features of sports school
misation for those athletes living on campus [69]. programmes, and 44 studies that evaluated the impacts on
holistic athlete development associated with sports school
3.4.4.5 Burnout Eight studies evaluated the impact of programme involvement. In summary, the systematic review
sports schools on burnout via interviews [43, 59], non-spec- identified the majority of research designs were quantitative
ified questionnaires [23] and standardised questionnaires non-randomised and were conducted within Northern Euro-
[18, 70, 71, 74, 75]. At the beginning of the upper secondary pean countries (e.g., Denmark, Norway, Sweden, Finland).
sports school, most student-athletes experienced very low Overall, the systematic review identified (1) sports school
levels of burnout [18, 23]. However, these student-athletes athletes receive considerably more support in academic and
may be prone to develop more severe burnout symptoms athletic services, more time in training and competitions,
across the later school years, indicated by an increase in have higher-level training partners and miss more days of
sport and school burnout scores of the sports school stu- school than athletes outside sports school programmes; (2)
dents over time [70, 75]. Sorkkila et al. [74] found that sport a large range of data collection methods and instruments
and school burnout dimensions remained relatively stable were used within the literature to evaluate a wide variety of
during the first year of upper secondary school. impacts; whilst insightful from an individual study perspec-
tive, this means that impacts were often only investigated
within a single or small sample of studies, thus making gen-
4 Discussion eralisable conclusions regarding impact difficult; (3) there
are a multitude of immediate, short- and long-term positive
This mixed methods systematic review is the first to (1) and negative impacts (see Fig. 2) associated with being a
determine the characteristics and features of sports school sports school student-athlete that stakeholders (e.g., teach-
programmes; (2) identify the methods used to evaluate ers, coaches, schools, parents, students) should be aware of
sports school holistic athlete development impacts; and when designing, implementing, and evaluating sports school
(3) evaluate the impacts on holistic athlete development programmes.

Fig. 2  Summary of the positive and negative holistic impacts associated with sport schools
1908 F. Thompson et al.

4.1 Literature Methodology measures which have limitations (e.g., response bias, hon-
esty, introspective ability, misinterpretation of questions and
This study specifically aimed to understand study meth- sampling bias). Most experts in research suggest that self-
odology and data-collection methods in order to enable an report data should not be used alone, as it tends to be biased
evaluation of the quality of the current literature, which is [e.g., 77]. Research is best done when combining self-report
pivotal in establishing the strength of the existing evidence data with other information (e.g., individual’s behaviour or
as well as guiding future research. Overall, for all research physiological data). Therefore, future sports school research
designs the average quality assessment was above 4. This should adopt a “multi-method” research design to provide a
suggests that on average methodological quality was high more comprehensive picture of the holistic impacts of sports
with sufficient methodological detail provided (e.g., blind- school programmes.
ing, enrolment rates, drop-out rates, control for confounding
variables) and strong philosophical or theoretical underpin- 4.2 Characteristics and Features of Sports Schools
nings. However, the standard deviations are quite large for
such a small quality assessment range (i.e., 0–5), reflecting In terms of the characteristics and features of sports schools,
the variation in study quality across the studies. Address- our findings highlighted that many sports schools offered
ing quality in mixed methods designs can be more difficult student-athletes considerable academic and athletic support
than in monomethod studies, due to the greater complex- (e.g., high-quality coaches, physiotherapy, lighter load by
ity of the former [76]. From the 46 studies included in the one subject and adaptation of school and training schedules)
systematic review, 11 studies evaluated characteristics and [24, 28, 41, 42]. Whilst non-sports schools may offer time off
features of sports schools and 44 evaluated impacts across to practice and might adapt the school day, they usually are
holistic athlete development (i.e., academic/vocational, not able to offer the same range of support services as sports
n = 12, athletic/physical, n = 27, psychosocial, n = 9, and schools [78] due to available resources (e.g., finances). Fur-
psychological, n = 21). This demonstrates a reasonably bal- thermore, sports schools may also have an advantage over
anced examination of holistic athlete development in the club-based development as they are better able to manage
literature, although the academic/vocational and psychoso- the competing calls on the student-athletes’ time [24] due to
cial domains have been explored less frequently compared to resource economic efficiency (e.g., limited travel time, eve-
the athletic/physical and psychological domains. In addition, rything on site, extra support services, and a more flexible
most studies were uni- or bi-dimensional. For example, only system). However, those outside sports schools who received
11 studies examined two holistic impact themes, only seven extra services often rated such services better [41]. There-
studies examined three themes and no studies examined all fore, although sports schools appear to provide considerably
four areas of holistic athlete development [14]. This often more support services than non-sports schools, the services
has to do with researchers working within specific research available may not be as high quality, which may be an area
areas (i.e., physical vs. psychological). Therefore, future for development within sports school programmes.
research needs a more interdisciplinary approach, which Along with additional athletic and academic support
has been rare. services, sports school programmes often offer high quality
When analysing across the four main themes of holistic training partners, role models [24, 27, 42], and more intense
athlete development, multiple subthemes were identified, training and competition routines [37, 40, 43]. For the wel-
demonstrating further breadth of evaluation. Equally, when fare and well-being of student-athletes at sports schools,
considering the methods used to assess impacts, these were training and competition workload should be appropriately
highly variable with most utilising interviews (n = 15) and monitored and assessed. Without careful planning and moni-
questionnaires (i.e., standardised, n = 19; non-specified, toring, student-athletes are at an increased risk of excessive
n = 12) alongside multiple other methods (e.g., observa- training loads, insufficient rest and recovery [79–83], injury
tion, field notes, clinical analysis). It is a strength of this [84–87], and burnout [88, 89]. While overtraining and non-
mixed methods systematic review that it is able to combine functional overreaching are not exclusively a consequence
multiple methodologies in understanding the impacts of of training overload, it is likely that sports schools that fail
sports schools. However, as the existing research is highly to provide sufficient recovery time for adaptation and natural
variable in terms of impact area and the method used, this growth will increase the chances of negative health impacts
makes comparisons across studies to develop consensus on in youth athletes [79].
the impacts of sports schools difficult but does offer multi- Although many characteristics and features of sports
ple avenues for future research. Furthermore, in the current schools are highlighted above, there are common themes that
evidence base, there is a lack of research evaluating a single have been identified in talent identification and development
enterprise or context (programme evaluation projects) of a systems (TIDS) that have not been reviewed in the current
sports school. Finally, most research-designs use self-report sports school literature. We are aware that training within
Impacts of Sports Schools on Holistic Athlete Development 1909

sports schools can be intense and competitive, but little is academic success. Therefore, whilst sports school athletes
known about what the training at sports schools involves. may miss periods of school work, strategies are in place to
For example, according to Ko et al.’s review [90], there are overcome such negative impacts.
many trainable factors contributing to sport success (i.e., Whilst the evidence supports the fact that sports school
physiological variables, psychological attributes, physical athletes were not negatively impacted in the short term, there
performance, sport skills). Most training programmes, how- may be more longer-term negative implications. The findings
ever, focus only on physical skills, although psychological on higher education continuation were mixed [40, 41, 49],
variables have been identified as critical determinants of with some sports school student-athletes achieving lower
sporting development and for the maintenance of excel- higher education attainment [49] compared to mainstream
lence [91]. Future research should explore in more detail the school student-athletes. Therefore, although student-athletes
context of training within sports schools to assess whether tended to display a dual identity while at sports schools [72],
they offer well-rounded, holistic development programmes. the fact that more athletes outside sports schools attained
In addition, with the knowledge that training programmes higher education grades may indicate that sports school
at sports schools may be intense and competitive, little is student-athletes choose to prioritise their sport over their
known about the recovery strategies used within these sports studies to a greater extent once they leave the sports school
school settings/contexts. Martindale and Mortimer’s [92] and their sporting careers progresses. An overemphasis
review suggested that effective emotional/physical recov- on sport may pose issues in terms of career opportunities
ery needs to be emphasised in youth sport programmes in for elite athletes once their athletic careers end. Therefore,
order to prevent injury and avoid other negative psychologi- although evidence suggests that sports schools provide ade-
cal consequences (e.g., stress and burnout). Various strate- quate support for student-athletes to pursue both education
gies with regard to training load, nutrition, cooling down, and sport [72], little is known about the consequences of
stretching, social support, and lifestyle education (e.g., time combining elite sport and subsequent career success. Some
management and planning) can be included in a multidimen- studies have shown that top athletes obtain higher ranking
sional training programme in order for the athletes to achieve jobs than non-athletes [97, 98]; however, further research is
the balance between life and training [92, 93]. Therefore, as needed to establish the specific impact of attending a sports
injury has been highlighted as a common issue within sports school on student-athletes’ future development outside their
schools, future research could evaluate the training and athletic careers [98].
recovery strategies/methods of sports school programmes Alongside academic development, the aim of a sports
to maximise holistic athlete development. school is to develop athletic and sporting performance.
Whilst one study demonstrated physiological and physi-
4.3 Impacts cal development across sports school training programmes
[64], research suggested sports schools have not resulted in
Given the increased popularity of sports schools, the fact an increased number of student-athletes performing at the
that only a few athletes ever obtain a professional status, world level [41, 49]. Together with findings on top place
and the multiple positive and negative impacts associated finishes and medal success results being mixed [22, 41, 49]
with intensified youth sport programmes, understanding this raises concerns about the effectiveness and importance
the impact of sports schools on holistic athlete develop- of specialist support and training within sports schools. In
ment is important to inform their design, implementation, this respect, the fact sports schools have not led to marked
monitoring and evaluation. The combination of sport and differences in the number of student-athletes performing at
academics is a key aspect of sports schools. However, cur- the world level should not automatically lead to the conclu-
rent findings suggest contradictory impacts across sports sion that sports schools are not suitable for facilitating the
school programmes across different countries and sports. combination of elite sport and education. There are multiple
Missing school was a common impact experienced by sports confounding factors influencing sporting success, such as
schools’ student-athletes [22, 40, 44, 48]. However, although genetic qualities of young talents and their close environ-
student-athletes missed schoolwork, four (out of six) stud- ment at the micro-level (e.g., parents and friends [37, 99,
ies [22, 41, 46, 47] showed that attending a sports school 100]), organisational and policy factors at the meso-level
did not impact upon school academic success. These find- (e.g., sport clubs, international competitions and scien-
ings are congruent with past research, which has indicated tific research and innovation [100–102]), and factors at the
that elite athletes achieve in both sport and school [94–96]. macro-level (e.g., media, sponsorship, politics, school sys-
Such findings within sports schools may reflect the impor- tem, geographic factors and performance culture [37, 99,
tance of additional support offered by sports schools (e.g., 100]). Ultimately, sports schools can only ever be somewhat
extra tutoring, adaptation of school and training schedules, successful due to limited spaces at the top of the pyramid.
lighter load by one subject, extra year of study) in protecting However, if the majority of other impacts are positive and
1910 F. Thompson et al.

athletes (at the same rate as in other TIDS) make it to the time management [37, 42, 59]), while being more inclined
top, they are probably successful. As such we may also need towards task orientation [73], which is associated with
some comparative numbers (through future research) from positive self-image, satisfaction and high performance in
non-sports school contexts to appreciate what ‘normal’ per- sports [114, 115]. As such, it may be suggested that the best
formance success would be. It is also important to consider foundation for noticeable, permanent development within,
the bigger picture (holistic advantages) of sports schools through and after sports schools would be a focus on devel-
(i.e., not just focusing on sport performance). As a whole, oping and supporting personal motivation, task-orientation,
attending a sports school might be the only possibility for and volitional and psycho-behavioural skills, while reduc-
young student-athletes to combine school and elite sports. ing physical complaints for every individual at any stage of
Therefore, even though sports schools may not guarantee participation [113].
better sporting performances and academic success, with- Being identified as talented can change the nature of peer
out sports schools, student-athletes may not be able to pur- relationships [3]. Although many sports schools positioned
sue their sporting ambitions at all, or they might have been student-athletes as having positive status, popularity and
even less successful in school/sport or might have become recognition [20, 27], this also caused tension amongst some
school/sport drop-outs. Overall, due to the sports school set student-athletes within the programmes [27]. Furthermore,
up, there is hope for added value (i.e., instead of allowing although sports schools may have provided many opportuni-
youngsters to pursue elite sports away from school and not ties to retain and develop friendships within sport, time away
make it, and sacrifice their schooling, here they may at least from family and friends outside of sport was a typical con-
safeguard their schooling and have a more pleasurable/bal- sequence for student-athletes [42, 45, 66]. Researchers have
anced experience along the way). highlighted the risk of social isolation and feelings of aliena-
It is impossible to eradicate all injuries from youth tion that result from spending substantial amounts of time
sport programmes; however, injury prevention schemes away from family and inevitably having fewer opportuni-
that develop appropriate training can significantly reduce ties to make and retain friendships outside sport (e.g., [116,
the frequency and severity of injuries [103]. Consequently, 117]). The reduced ability to form non-sport friends could
since many student-athletes were at a high risk of becom- result in a lack of social support when athletes terminate
ing injured after enrolment into sports schools, appropriate their athletic career and are potentially isolated from their
recovery and prevention strategies should be incorporated friends within sport [118]. Furthermore, previous studies
as part of sports school programmes. These could include have demonstrated that a strong athletic identity was nega-
strength and conditioning (S&C) programmes focused upon tively associated with the quality of athletes’ career transi-
strength, endurance, and proprioception/balance [104–106], tions [119, 120]. Therefore, given that all athletes eventually
collaboration and communication with stakeholders on man- have to transition out of sport, it would be worth exploring
aging youth athlete training schedules [107], monitoring of if these negative impacts apply to sports school athletes that
individual workload [107], modifying external training vari- showed both a strong student and athletic identity [72].
ables to achieve a desired internal response [107], athlete Combining an athletic career with education is demand-
education [107], extrinsic factors via the use of protective ing for student-athletes [121], and junior athletes are suscep-
equipment (e.g., ankle bracing and taping, helmets, and tible to stress and burnout (e.g., [122, 123]). When starting
mouth guards) [103, 108] and implementation of rules and at a sports school, most student-athletes experienced very
regulations [85, 109]. low levels of burnout [18, 23]. However, the results on the
Sports schools attempt to help athletes achieve athletic development of burnout across time at sports schools were
success at an early stage. As a result, training is intensified. mixed. These findings suggest that among student‐athletes
An unintended consequence is an increased risk of early at sports schools, there are different subpopulations with dif-
performance stagnation and thus higher number of drop- ferent developmental trajectories, such that in some student‐
outs from sport and sports schools [22, 50]. Consistent with athletes symptoms of burnout may increase, whereas in oth-
earlier studies [110–112], Baron and Alferman [50] demon- ers, the symptoms remain relatively stable. This highlights
strated that physical complaints (e.g., injury, fatigue, illness), the importance of continuous screening (e.g., profile of
motivation, and volitional skills are important predictors of mood test) and early detection of burnout in student-athletes
sports school dropout. Furthermore, the development of psy- at sports schools [18, 70, 75]. Furthermore, this also sug-
cho-behavioural skills (e.g., time management skills, effec- gests the need for careful management of the performance
tive communication, social awareness, and maturity) has environment as concerns have been raised that youth athletes
been shown to support transition to new environments after are increasingly being exposed to inappropriate and unreal-
deselection [113]. This study supports the notion that sports istic demands and expectations, resulting in psychological
schools contributed to the development of student-athletes’ overload [80]. Indeed, some sports school athletes experi-
social skills [42, 47] and life skills (e.g., independence and enced athletic/performance pressures [22, 31, 37, 67] as well
Impacts of Sports Schools on Holistic Athlete Development 1911

as pressure from others, such as parents and teachers [43]. that emphasise the holistic development of youth athletes
Adopting a dominant performance focus can lead to high and that try to mitigate the negative and promote the posi-
levels of perceived pressure, feelings of low self-esteem and tive impacts associated with sports schools to ensure system
confidence [124] in addition to a fear of failure associated "worth" [8]. It has been suggested in TIDS research that
with the risk of being evaluated negatively and letting down positive impacts emerge from higher quality TIDS [8]. The
significant others [125]. TIDS research has highlighted that same concept could be related to sports schools, where the
parents, coaches and peers have the potential to promote a issue does not lie with the overall concept of sports schools,
“winning at all cost” mentality, or adopt particular behav- but instead, their impact reflects how well they are designed,
iours in response to failure and in search of better results, implemented and managed [8].
such as pressing athletes to ‘push harder’ [126, 127]. Such
pressure can contribute to an unhealthy training environ- 4.4 Limitations of Existing Research
ment [126, 127] and will likely require careful management
in sports schools. Whilst the current systematic review highlighted the breadth
Although being a student-athlete at a sports school may be of impacts associated with sports school programmes, a
associated with more pressure, training demands and expec- number of limitations exist within the current evidence base.
tations, current findings highlighted the important influence Firstly, as stated above (Sect. 4.1), most studies included
sport within sports schools may have upon student-athletes' in this review are uni- or bi-dimensional. Whilst studies
mental health, health behaviours and their willingness to examine individual components of holistic athletic devel-
shift their time away from unhealthy behaviours related to opment, no sports school research evaluates all four areas
general health and wellbeing. Sports school student-athletes (i.e., educational/vocational, physical/athletic, psychosocial
spend a considerable amount of time engaging in sport/phys- and psychological). Therefore, more multi-dimensional stud-
ical activity. Consequently, it is unsurprising that numerous ies assessing the holistic development of student-athletes at
sports school student-athletes demonstrated more favour- sports schools are warranted. However, although the Holistic
able levels of general health and well-being [23, 62], fewer Athletic Career Model has been used extensively in previous
mental health related symptoms [62] and more protection research studies within sport to guide data collection about
against unhealthy and risky behaviours [23, 47, 61]. This the athlete as a whole person (e.g., [37]) within the current
is in line with previous research that has shown positive study it may be more useful as a guiding conceptual frame-
health benefits [128–130] and lower rates of unhealthy and work due to the lack of empirical examination and testing
risky behaviours (e.g., less screen time, smoking, drug use) within sports school contexts.
with increased physical activity and participation in sports Interestingly, the majority of studies (72%) have been
[131, 132]. conducted in northern European countries (i.e., Denmark,
Overall, there are many different characteristics and fea- Norway, Sweden, Finland), especially those countries that
tures of sports school programmes, which can be imple- have state sponsorship and specific policy approaches toward
mented in a variety of ways. As a result, impacts are likely the dual-careers of student-athletes [133]. It is important to
to vary across every sports school context. The success of recognise cultural, social and policy factors differing across
sports schools often depends on many situational factors, countries and sport settings, which challenges the general-
such as financing, goodwill of the person in a key position isability of the findings in this study. It is difficult to apply
of an organisation, quality of coaching and teaching staff current research on sports schools' effectiveness to other
involved, and culture [37] affecting whether sports schools countries as each country may have its own systems and
provide benefits and positively contribute to school-age approaches [26]. Sports schools may vary in their resources,
athletes’ holistic development [37]. It is not possible for organisational structure and aims/objectives, which are
this systematic review to establish a rigorous causal rela- likely to affect whether sports schools provide benefits or
tionship between the characteristics and features of sports contribute to school-age athletes' holistic development [37,
schools and the associated impacts. This means that more 100]. This means that exploring the impact of sports schools
studies exploring the characteristics and features of such across different countries is warranted to account for the
sports schools and how these relate to impacts are needed to socio-cultural context and local conditions of dual-career
account for the socio-cultural context and local conditions of programmes. In addition, the data in this study cannot be
programmes [37]. Equally, little is known about the motives generalised across sports, but rather require a sport-by-sport
and reasons why sports school student-athletes attend sports analysis. It is expected that sports schools require an indi-
schools, warranting future research. Overall, it was evident vidual approach, tailor-made for each athlete and each sport.
that involvement with sports school programmes is associ- Therefore, future research needs to take the specificity of
ated with a range of potential positive and negative impacts athlete characteristics/variables (e.g., sex, type of sport, age,
(summarised in Fig. 2). Strategies should be put in place
1912 F. Thompson et al.

development stage within the school, training cycle) into few studies are truly holistic or multidimensional in nature.
account. This makes comparison across studies and developing con-
Finally, it is not possible to establish a rigorous causal sensus on the impacts of sports schools difficult. Therefore,
relationship between attending a sports school and the more multi-dimensional and longitudinal studies assessing
impacts established in this study. The study designs within the holistic development of student-athletes at sports schools
this systematic review are unable to evaluate whether in “real time” are required. Furthermore, more information
impacts are a direct result of the sports school or any other on the motives and reasons why sports school student-ath-
confounding factors (e.g., genetic qualities, being an ath- letes attend sports schools is needed.
lete, parents, friends, sports clubs, international competi- Nevertheless, from the current literature there are a mul-
tions, media, sponsorship, politics, geographic factors, and titude of immediate, short- and long-term positive and nega-
performance culture, etc. [100]). Furthermore, there is a lack tive impacts associated with being a sports school student-
of studies utilising a control or comparative group design athlete that stakeholders (e.g., teachers, coaches, schools,
within the current sports school literature. It is important parents, students) should be aware of. The positive impacts
for us to explore in future research if sports schools through included increased physical development, more stable lev-
combining schoolwork with an intensified and competitive els of general health and well-being, positive behaviours,
sport regime offer a return on investment that goes beyond status/popularity, development of friendships within sport,
what is to be expected at non-sports schools. Only three life skills, higher values of self-optimisation and low levels
studies [22, 41, 49] compared student-athletes within a of burnout in the initial phases of joining a sports school.
sports school directly with student-athletes outside a sports The negative impacts included missing school, lower higher
school. These three studies [22, 41, 49] all used a retro- education attainment, limited experience with ordinary life
spective approach and design. This approach could lead outside of competitive sport, high number of injuries, illness
to incomplete or inaccurate information due to selective and dropouts, loss of time away from family and friends
memory loss (recall bias) or to participants' social desir- outside of sport, performance pressure and pressure from
ability to describe the dual-career development in a more others (e.g., parents and teachers). Practitioners should be
positive light. The studies also all used one single measure- aware that they can promote (positive) and negate (negative)
ment, namely an online survey or interview. This opposes health impacts through the design of an appropriate learning
the nature of “transition” as a process, which calls for using environment that simultaneously balances multiple training
a longitudinal approach to investigate student-athletes' devel- (e.g., load), academic (e.g., exams), psychosocial (e.g., sense
opment or changes over time. Therefore, more studies com- of community), and psychological (e.g., identity) factors that
paring student-athletes within a sports school directly with can be challenging for youth athletes [1, 2]. To aid careful
student-athletes outside a sports school, as well as longitu- management, practitioners should aim to design and imple-
dinal studies that multidimensionally examine the impacts ment monitoring and evaluation tools that assess the holistic
of sports school involvement in real-time and as they occur development of student-athletes within their sports schools.
across the athletes’ development, are warranted. Such monitoring tools could assess a range of factors includ-
ing athlete wellbeing [83, 134], training load [135], physical
development [136] and injury prevalence [137], alongside
5 Conclusion psychosocial factors (e.g., athletic identity [138]), education
[2] and long-term health and performance development [8].
This systematic review prompts a debate and critical reflec- In summary, sports schools seem to be a potentially benefi-
tion about (1) the characteristics and features of sports cial strategy for athletes to combine their pursuit of a sports
school programmes; (2) the methods used to evaluate sports career with education and other domains of life (e.g., social
school impacts; and (3) the positive and negative impacts life). However, it is important to understand and mitigate
on holistic development associated with sports school pro- against the negative impacts observed in such programmes
gramme involvement. A range of characteristics and features to ensure healthy and holistic athlete development.
of sports schools (e.g., athletic and academic support ser-
vices) were identified; however, further research is needed Declarations
to gain a more in-depth understanding of how these char-
acteristics and features are operationalised across different Funding No sources of funding were used to assist in the preparation
of this article.
contexts as well as how they relate to impacts. A large range
of data collection methods and instruments were used within
Conflict of interest The authors (Ffion Thompson, Fieke Rongen, Ian
the literature to evaluate a wide variety of impacts; whilst Cowburn and Kevin Till) all declare no potential conflicts of interest
insightful at study level, as a result, specific impacts are concerning the research, the content, authorship and/or publication of
often only studied in a single or small number of studies and the review.
Impacts of Sports Schools on Holistic Athlete Development 1913

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10. Bailey R, Collins D, Ford P, MacNamara Á, Toms M, Pearce G.
Consent for publication Not applicable. Participant development in sport: an academic review. Sports
Coach UK. 2010;4:1–134.
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Authors' contributions All the authors contributed to the manuscript, in sport and the dynamics of talent development. Sports Med.
including the conception and design of the study, analysis and inter- 2010. https://​doi.​org/​10.​2165/​11319​430-​00000​0000-​00000.
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as you give appropriate credit to the original author(s) and the source, 16. Ekengren J, Stambulova N, Johnson U, Carlsson I-M. Explor-
provide a link to the Creative Commons licence, and indicate if changes ing career experiences of Swedish professional handball play-
were made. The images or other third party material in this article are ers: consolidating first-hand information into an empirical career
included in the article's Creative Commons licence, unless indicated model. Int J Sport Exerc Psychol. 2018. https://​doi.​org/​10.​1080/​
otherwise in a credit line to the material. If material is not included in 16121​97X.​2018.​14868​72.
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permitted by statutory regulation or exceeds the permitted use, you will on-field success with off-field player development: a case study
need to obtain permission directly from the copyright holder. To view a of a club culture within the Australian Football League. Psychol
copy of this licence, visit http://​creat​iveco​mmons.​org/​licen​ses/​by/4.​0/. Sport Exerc. 2015. https://d​ oi.o​ rg/1​ 0.1​ 016/j.p​ sychs​ port.2​ 014.1​ 1.​
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