Abstract
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. To investigate the RTL practices of certified athletic trainers (ATs) after an SRC. Cross-sectional study. Online survey. 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). 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. 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. 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.
Highlights
Our results suggested that, despite the absence of empirical evidence, most surveyed athletic trainer (AT) incorporated some form of RTL protocol in their sport-related concussion (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
Athletic trainers should work to effectively communicate with and educate all stakeholders associated with reintegrating student-athletes into the classroom after concussion
Summary
To address the hypotheses of this study, we developed a novel survey instrument that consisted of 4 RTL domains: demographics, current knowledge, current practice, and available resources. Individual items were created, modified, or both to address the secondary school or collegiate setting. We created 2 surveys, which consisted of 40 and 41 items, with 7 modified items specific to the secondary school or collegiate setting, respectively. Internal consistency was assessed for all Likertscale items using the Cronbach a and deemed acceptable for the secondary school (a 1⁄4 0.49) and collegiate (a 1⁄4 0.63) versions of the survey. The final version of the survey took approximately 15 minutes to complete and consisted of demographic (11 items), current knowledge (6 items), current practice (18 items), and available resources (6 items) domains (Tables 1 through 3)
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