Return to Learn After Sport-Related Concussion: A Survey of Secondary School and Collegiate Athletic Trainers

J Athl Train. 2018 Oct;53(10):990-1003. doi: 10.4085/1062-6050-234-17. Epub 2018 Nov 6.

Abstract

Context: Recent recommendations have emphasized return-to-learn (RTL) protocols to aid athletes in recovery from sport-related concussion (SRC) but have been based primarily on anecdotal evidence.

Objective: To investigate the RTL practices of certified athletic trainers (ATs) after an SRC.

Design: Cross-sectional study.

Setting: Online survey.

Patients or other participants: A total of 1083 individuals (27%) from a random sample of 4000 ATs in the National Athletic Trainers' Association membership database completed an electronic survey. Participants consisted of 729 self-identified secondary school ATs (SSATs; 67.3%; experience = 14.0 ± 9.7 years) and 354 self-identified collegiate ATs (CATs; 32.7%; experience = 13.4 ± 9.7 years).

Main outcome measure(s): We used χ2 analyses to assess respondent differences related to current knowledge, current practices, and available resources. Independent t tests were used to compare SSATs and CATs on years of certification and annual number of SRCs evaluated.

Results: Of our total respondents, 41.2% (n = 446) correctly indicated the absence of evidence-based RTL guidelines. Whereas most (73.9%, n = 800) respondents had an established RTL policy, only 38.1% (n = 413) used such guidelines in their clinical practice. Most (97.1%, n = 708) SSATs and 82.2% (n = 291) of CATs had access to (a) mental health professional(s); however, minorities of SSATs (21.4%, n = 156) and CATs (37.0%, n = 131) never accessed these resources to care for concussed student-athletes.

Conclusions: Our results suggested that, despite the absence of empirical evidence, most surveyed ATs incorporated some form of RTL protocol in their SRC management policy. The varying AT knowledge, clinical practices, and resources highlighted by our results should be considered when creating or refining an RTL protocol.

Keywords: academic accommodations; concussion management; student-athletes.

MeSH terms

  • Athletes
  • Athletic Injuries / psychology*
  • Brain Concussion / psychology*
  • Certification
  • Cross-Sectional Studies
  • Faculty*
  • Female
  • Humans
  • Learning*
  • Male
  • Professional Competence
  • Schools
  • Sports
  • Sports Medicine / standards*
  • Students
  • Surveys and Questionnaires