Objective Characterize physician concussion knowledge, patterns of practice and learning preferences in the Sections of General & Family Practice (GFP) and Sport and Exercise Medicine (SEM) of the Ontario Medical Association (OMA).

Design Cross-sectional online survey, first distributed in 2013, repeated in 2022.

Setting Self-reported survey in Ontario, Canada.

Participants Active physicians within the OMA Sections of GFP and SEM seeing patients with concussion. Response rates: 2013: GFP 225/12,168 (1.8%), SEM 85/594 (14.3%); 2022: GFP 216/15,674 (1.4%), 35/696 (5.0%).

Interventions Independent variables were time (2013 vs. 2022) and Section (GFP vs. SEM).

Outcome Measures Concussion guideline usage, assessment tool use, management, and preferred learning methods.

Main Results Non-reliance on published guidelines decreased overall from 2013 to 2022; non-reliance was higher among GFP physicians for both surveys (2013: GFP- 38.2%, SEM 8.2%; p<0.001; 2022: GFP- 23.7%, SEM- 2.9%; p=0.003). Sport Concussion Assessment Tool use increased for initial assessment (GFP: 2013- 34.2%, 2022- 65.0%; p<0.001; SEM: 2013- 68.2%, 2022- 90.9%; p=0.010) and return-to-play decisions (GFP: 2013- 29.8%, 2022- 56.1%; p<0.001; SEM: 2013- 61.2%, 2022- 85.3%; p=0.016). Physical and cognitive rest recommendations shifted from complete rest to subthreshold/modified activities over time (p<0.001 for both). Preferred resources identified for future learning were websites (46.2%) and continuing medical education (85.0%).

Conclusions Comparison between the 2013 and 2022 surveys revealed improvements in physician knowledge levels and patterns of practice, but gaps between Sections remain. Future work should utilize a validated tool in a larger cohort to compare physician-reported knowledge and attitudes with behaviours observed in practice.