Current Sport-Related Concussion Teaching and Clinical Practices of Sports Medicine Professionals

Context: Various consensus and position statements recommend a multifaceted approach when diagnosing a possible concussion. The effectiveness of these materials depends largely on their content being disseminated to educators and to those in the clinical setting. Objective: To identify the concussion management methods and guidelines currently taught in the athletic training classroom and clinical settings and to track the dissemination of the Vienna guidelines throughout the educational curriculum. Design: A 17-question Internet survey. Setting: A Web link was e-mailed to the program directors and certified athletic trainers holding educational positions in athletic training at 300 accredited programs in the United States. Patients or Other Participants: 513 program directors and athletic trainers. Main Outcome Measure(s): Survey questions addressed education level, years of certification, employment setting, concussion assessment and return-to-play guidelines used in the clinical setting and the classroom, and clinical and teaching preferences for existing position statements and concussion grading systems. The Vienna guidelines' "simple" and "complex" definitions of concussions were provided with the return-to-play stepwise approach. Results: The National Athletic Trainers' Association position statement was the most widely used method of assessing, managing (61%), and making return-to-play decisions (47%) among participants. More than half of participants (66%) had never heard of the Vienna guidelines. After reading the Vienna guidelines' definitions and return-to-play criteria, nearly three-fourths of participants agreed with them. In addition, 68% said that they would use them, and 84% reported that they would teach them to students. Conclusions: The majority of program directors and certified athletic trainers used a multidimensional approach to assess and manage a concussion. The National Athletic Trainers' Association position statement and Vienna guidelines were underused in both the classroom and clinical settings.