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  1. S Babul1,
  2. P Korn2,
  3. R Goldman2,
  4. I Pike1,
  5. C Hay2
  1. 1UBC, Vancouver, BC, Canada
  2. 2BC Children's Hospital, Vancouver, BC, Canada


Background Concussion recognition, treatment and management is crucial in supporting recovery and decreasing the risk of long-term brain damage. Long-term effects are often not recognized early enough to prevent post-concussion syndrome, resulting in an impact on social and professional lives. The need to standardize care is vital in preventing adverse concussion outcomes.

Objective To determine if concussion knowledge, attitudes and practices (KAP) are significantly improved among physicians and nurses following completion of CATT.

Design A pre/post-intervention questionnaire designed to measure changes in physician/nurse KAP.

Setting Primary setting was hospital emergency departments in the Lower Mainland, British Columbia.

Participants Physicians/nurses working in emergency departments/trauma care facilities.

Intervention Based upon established international principles, CATT is an online toolkit ( providing learner-directed concussion awareness training for health practitioners as well as assessment resources (SCAT3, Child-SCAT3), links to clinical resources, patient handouts, journal articles (including the Zurich Consensus Statement), related websites, concussion videos and study cases.

Main outcome measures Change in physician/nurse knowledge, attitudes and practices regarding concussion recognition, treatment and management.

Results 44 physicians and 35 nurses were recruited. Post-intervention questionnaires were completed by 34 physicians (77.3%) and 25 nurses (71.4%). Physicians demonstrated a statistically significant positive change in concussion practices (P=.001). Change in physician knowledge was not significant, while attitudes had a negative change (P=.041). Positive change in physician knowledge was detected for those who typically see more than 10 concussions per year (P=.039). Nurses demonstrated statistically significant positive change in practices (P=.005) and attitudes (P=.035), but no change in knowledge.

Conclusions CATT is effective in improving concussion knowledge and practices among physicians and nurses, which will potentially minimize adverse concussion outcomes and lower health care costs among concussion patients. Phase 2 includes a toolkit for Parents, Players and Coaches, currently undergoing an evaluation with sporting associations in BC.

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