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Sport concussion knowledge base and current practice: a survey of selected physician sections from the ontario medical association
  1. Constance M Lebrun1,
  2. Mrazik Martin1,
  3. Prasad Abhaya S1,
  4. Taylor Taryn2,
  5. Jevremovic Tatiana3
  1. 1Glen Sather Sports Medicine, Kaye Edmonton Clinic, University of Alberta, Edmonton, Alberta, Canada
  2. 2Carleton University Sport Medicine ClinicIce House, Carleton University, Ottawa, Ontario, Canada
  3. 3Fowler Kenney Sport Medicine Clinic3M Centre, Western University, London, Ontario, Canada

Abstract

Objective To examine knowledge base/practice patterns regarding sport concussion in two physician populations.

Design On-line survey.

Setting Ontario, Canada.

Participants Physicians from Ontario Medical Association, Sections of: Sport & Exercise Medicine (SEM), General & Family Practice (SGFP).

Intervention Emailed survey, 2 reminders.

Outcome measures Knowledge base/practice patterns; learning methods: current/preferred.

Participants SEM 92/594 (15.5%), SGFP 270/12,168 (2.2%); 51 (13.4%) members of both. More SEM physicians saw >5 children (<18 years) with concussions/month (40.2% SEM, 9.5% SGFP; p =< 0.001).

Tools Clinical examination; Sport Concussion Assessment Tool (SCAT/SCAT2) (68.4% SEM, 34.1% SGFP; p<0.001); balance testing (56.5% SEM, 37.4% SGFP; p=0.001); computerised neurocognitive testing (23.9% SEM, 1.9% SGFP; p<0.001); concussion grading scales (9.8% SEM, 14.1% SGFP; p<0.001). Management: Physical rest (65.2% SEM, 68.5% SGFP); modified school/work until symptom resolution (50.0% SEM, 38.5% SGFP; p=0.026); no cognitive rest (3.2% SEM, 9.6% SGFP; p=0.026).

Return-to-play: Clinical examination; SCAT/SCAT2 (60.8% SEM, 29.6% SGFP; p<0.001); balance testing (56.5% SEM, 37.4% SGFP; p<0.001); computerised neurocognitive testing (35.9% SEM, 2.2% SGFP; p<0.001); concussion grading scales (7.6% SEM, 9.6% SGFP).

Learning sources colleagues (55.4% SEM, 27.8% SGFP; p<0.001); specialists (33.7% SEM, 23.7% SGFP; p=0.030); continuing medical education (CME) courses/conferences (67.4% SEM, 54.7% SGFP; p=0.017; preferred: 85.9% SEM, 73.9% SGFP; p=0.006); journals/publications (48.9% SEM, 25.2% SGFP; p<0.001); websites (35.8% SEM, 32.2% SGFP; preferred: 35.9% SEM, 47.8% SGFP; p=0.024); medical school/residency training (19.6% SEM, 17.4% SGFP; preferred: 37.0% SEM, 47.8% SGFP).

Conclusions Gaps exist between consensus-based recommendations and current practice patterns. Enhanced medical school/residency training and additional CME initiatives are recommended.

Competing interests None.

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