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Concussion Knowledge among Medical Students and Neurology/Neurosurgery Residents

Published online by Cambridge University Press:  02 December 2014

Miranda Boggild
Affiliation:
Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
Charles H. Tator*
Affiliation:
Division of Neurosurgery, Toronto, Ontario, Canada Toronto Western Hospital, Toronto, Ontario, Canada
*
Toronto Western Hospital, 399 Bathurst Street, Ste. 4W-433, Toronto, Ontario, M5T 2S8, Canada. Email: charles.tator@uhn.ca
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Abstract

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Background and Objectives:

Concussion is a prevalent brain injury in the community. While primary prevention strategies need to be enhanced, it is also important to diagnose and treat concussions expertly and expeditiously to prevent serious complications that may be life-threatening or long lasting. Therefore, physicians should be knowledgeable about the diagnosis and management of concussions. The present study assesses Ontario medical students’ and residents’ knowledge of concussion management.

Methods:

A survey to assess the knowledge and awareness of the diagnosis and treatment of concussions was developed and administered to graduating medical students (n= 222) and neurology and neurosurgery residents (n = 80) at the University of Toronto.

Results:

Residents answered correctly significantly more of the questions regarding the diagnosis and management of concussions than the medical students (mean = 5.8 vs 4.1, t= 4.48, p<0.01). Gender, participation in sports, and personal concussion history were not predictive of the number of questions answered correctly. Several knowledge gaps were identified in the sample population as a whole. Approximately half of the medical students and residents did not recognize chronic traumatic encephalopathy (n = 36) or the second impact syndrome (n = 44) as possible consequences of repetitive concussions. Twenty-four percent of the medical students (n = 18) did not think that “every concussed individual should see a physician” as part of management.

Conclusions:

A significant number of medical students and residents have incomplete knowledge about concussion diagnosis and management. This should be addressed by targeting this population during undergraduate medical education.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2012

References

1Tator, CH.Let’s standardize the definition of concussion and get reliable incidence data. Can J Neurol Sci. 2009;36(4):4056.Google Scholar
2Engrossed Substitute House Bill 1824, 61st Legislature, 2009 Regular Session. (2009).Google Scholar
3Tator, CH.Concussions are brain injuries and should be taken seriously. Can J Neurol Sci. 2009;36(3):26970.Google Scholar
4Cusimano, M.Canadian minor hockey participants’ knowledge about concussion. Can J Neurol Sci. 2009;36(3):31520.Google Scholar
5Willer, B, Dumas, J, Hutson, A, Leddy, J.A population based investigation of head injuries and symptoms of concussion of children and adolescents in schools. Inj Prev. 2004;10:1448.Google Scholar
6Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta (GA): Centers for Disease Control and Prevention; 2003.Google Scholar
7McCrory, P, Meeuwisse, W, Johnston, K, et al.Consensus statement on concussion in sport 3rd international conference on concussion in sport held in Zurich, November 2008. Clin J Sport Med. 2009;19:185200.Google Scholar
8Tator, CH.Brain injury is a major problem in Canada and annual incidence is not declining. Can J Neurol Sci. 2010;37(6):71415.Google Scholar
9Colantonio, A, Saverino, C, Zagorski, B, et al.Hospitalizations and emergency department visits for TBI in Ontario. Can J Neurol Sci. 2010;37(6):78390.Google Scholar
10Ropper, A, Gorson, K.Concussion. N Engl J Med. 2007;356:16672.Google Scholar
11Practice parameter: the management of concussion in sports. Report of the Quality Standards Subcommittee. Neurology. 1997;48(3): 5815.Google Scholar
12Bazarian, J, Veenema, T, Brayer, A.Knowledge of concussion guidelines among practitioners caring for children. Clin Pediatr. 2001;40:20712.Google Scholar
13Guilmette, T, Malia, L, Mcguiggan, M.Concussion understanding and management among New England high school football coaches. Brain Inj. 2007;21(10):103947.CrossRefGoogle ScholarPubMed
14Covassin, T, Elbin, R, Stiller-Ostrowski, JL.Current sport-related concussion teaching and clinical practices of sports medicine professionals. J Athl Train. 2009;44(4):4004.CrossRefGoogle ScholarPubMed
15King, NS, Kirwilliam, S.Permanent post-concussion symptoms after mild head injury. Brain Inj. 2001;25(5):46270.Google Scholar
16Cantu, RC, Voy, R.Second impact syndrome: a risk in any contact sport. Phys Sportsmed. 1995;23:2734.Google Scholar
17Wetjen, N, Pichelmann, M, Atkinson, J.Second impact syndrome: concussion and second injury brain complications. J Am Coll Surg. 2010;211:5537.CrossRefGoogle ScholarPubMed
18McQuillen, J, McQuillen, E, Morrow, P.Trauma, sport, and malignant cerebral edema. Am J Forensic Med Pathol. 1988;9: 1215.Google Scholar
19Gavett, B, Stern, R, McKee, A.Chronic traumatic encephalopathy: a potential late effect of sport-related concussive and subconcussive head trauma. Clin Sports Med. 2010;30:17988.CrossRefGoogle Scholar
20Zafonte, R, Discussant, DO.Diagnosis and management of sportsrelated concussion. JAMA. 2011;306(1):7986.Google Scholar
21Demorest, RA, Bernhardt, DT, Best, TM, Landry, GL.Pediatric residency education: is sports medicine getting its fair share? Pediatrics. 2005;115(1):2833.Google Scholar
22Ryu, WHA, Feinstin, A, Colantonio, C, Streiner, DL, Dawson, DR.Early identification of mild TBI in Ontario. Can J Neurol Sci. 2009;36:42935.Google Scholar
23Statistics Canada [Internet]. Government of Canada [updated 2011 June 28; cited 2011 July 6]. Canadian Community Health Survey Questionnaire for Cycle 1.1. Government of Canada 2000. Available from: http://www.statcan.gc.ca/imdbbmdi/instrument/3226_Q1_V1-eng.pdfGoogle Scholar
24Delaney, J, Johnston, K [Internet]. Toronto: ThinkFirst Canada [cited November 17 2010] ThinkFirst Concussion Questionnaire; [7 pages]. Available from: http://www.thinkfirst.ca/downloads/concussion/concussion-Questionnaire.pdfGoogle Scholar
25CDC.org [Internet]. Atlanta: Centers for Disease Control and Prevention [updated 2011 September 9; cited 2011 September 10]. Available from: http://www.cdc.gov/Google Scholar
26ThinkFirst.ca [Internet]. Toronto: ThinkFirst Canada [cited 2011 August 24]. Available from: http://www.thinkfirst.caGoogle Scholar
27Guilmette, T, Paglia, M.The public’s misconceptions about traumatic brain injury: a follow up survey. Arch Clin Neuropsychol. 2004;19:1839.Google Scholar
28Ferrara, M, McCrea, M, Peterson, C, Guskiewicz, K.A survey of practice patterns in concussion assessment and management. J Athl Train. 2001;36:1459.Google Scholar