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Knowledge transfer and education
Sport concussion knowledge base, clinical practices, and needs for continuing medical education: a survey of family physicians and cross-border comparison
  1. Constance M Lebrun1,*,
  2. Martin Mrazik2,
  3. Abhaya Prasad3,
  4. B Joel Tjarks4,
  5. Jason C Dorman5,
  6. Michael F Bergeron5,6,
  7. Thayne A Munce5,6,
  8. Verle D Valentine5,6
  1. 1Faculty of Medicine and Dentistry, Department of Family Medicine
  2. 2Faculty of Education, Department of Educational Psychology
  3. 3Master's student, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
  4. 4Medical Student—University of South Dakota—Sanford School of Medicine, Vermillion, South Dakota, USA
  5. 5National Institute for Athletic Health and Performance, Sanford USD Medical Center, Sioux Falls, South Dakota, USA
  6. 6University of South Dakota—Sanford School of Medicine, Vermillion, South Dakota, USA

    Abstract

    Objective To identify sport concussion knowledge base, practice patterns and current/preferred methods of Knowledge Transfer and Exchange (KTE) in two distinct populations of family physicians.

    Design Cross-sectional study, using a survey design.

    Setting Alberta, Canada (CAN); North/South Dakota, USA (US). Rural (64.4% US, 27.5% CAN; p=<0.001); walk-in/acute care (28.8% CAN, 12.9% US; p=0.008).

    Participants Recruitment: CAN physicians by mail: 80/3154 responses (2.5%); US physicians: American Academy of Family Physicians database: 109/545 responses (20%).

    Intervention/Instrument On-line survey questionnaire.

    Outcome Measures Relative percentages diagnosing/treating concussions; comparison of management strategies (including return-to-play), and current/preferred KTE.

    Results Etiologies: Sports/recreation (52.5% CAN); organised sports (76.5% US). Tools: Clinical examination (93.8% CAN, 88.1% US); Sport Concussion Assessment Tool (SCAT/SCAT2) (33.8% CAN, 26.7% US); balance testing (25.0% CAN, 26.7% US); concussion grading scales (26.7% US, 8.8% CAN, p=0.002); computerised neurocognitive testing (19.8% US, 1.3% CAN; p≤0.001); Standardised Assessment of Concussion (21.8% US, 7.5% CAN; p=0.008). Treatment: Physical rest (83.8% CAN, 75.5% US); cognitive rest (47.5% CAN, 28.4% US; p=0.008). Return-to-play: Clinical examination (89.1% US, 73.8% CAN; p=0.007); neurocognitive testing (29.7% US, 5.0% CAN; p≤0.001); guidelines (63.4% US, 23.8% CAN; p≤0.001). KTE sources: Colleagues (31.3% CAN, 8.8% US; p≤0.001), websites (27.5% CAN, 15.7% US; p=0.052); medical school (35.0% CAN, 12.7% US; p≤0.001). KTE Preferences: Continuing Medical Education (CME) courses (65.0% CAN, 37.3% US; p≤0.001), and online CME (47.5% Can, 29.4% US; p=0.012).

    Conclusions Despite evolution of concussion diagnosis/management guidelines, significant knowledge gaps exist between evidence-based recommendations clinical practice patterns. This predicates enhanced and innovative CME initiatives for KTE.

    Competing interests None.

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