Sport concussion knowledge base, clinical practices, and needs for continuing medical education: a survey of family physicians and cross-border comparison

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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.


Cross-sectional study, using a survey design.


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).


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


On-line survey questionnaire.

Outcome Measures

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


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).


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


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