Sport concussion knowledge base and current practice: a survey of selected physician sections from the ontario medical association

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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.

Main results

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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