Are Canadian clinicians providing consistent sport-related concussion management advice?
OBJECTIVE
To compare the knowledge and use of recommendations for the management of sport-related concussion (SRC) among sport and exercise medicine physicians (SEMPs) and emergency department physicians (EDPs) to assess the success of SRC knowledge transfer across Canada.


METHODS
A self-administered, multiple-choice survey accessed via e-mail by SEMPs and EDPs. The survey had been assessed for content validity.


METHODS
Canada.


METHODS
The survey was completed between May and July 2012 by SEMPs who had passed the diploma examination of the Canadian Academy of Sport and Exercise Medicine and by EDPs who did not hold this diploma.


METHODS
Knowledge and identification of sources of concussion management information, use of concussion diagnosis strategies, and whether physicians use common and consistent terminology when explaining cognitive rest strategies to patients after an SRC.


RESULTS
There was a response rate of 28% (305 of 1085). The SEMP and EDP response rates were 41% (147 of 360) and 22% (158 of 725), respectively. Of the responses, 41% of EDPs and 3% of SEMPs were unaware of any consensus statements on concussion in sport; 74% of SEMPs used the Sport Concussion Assessment Tool, version 2 (SCAT2), "usually or always," whereas 88% of EDPs never used the SCAT2. When queried about how cognitive rest could best be achieved after an SRC, no consistent answer was documented.


CONCLUSIONS
Differences and a lack of consistency in the implementation of recommendations for SRC patients were identified for SEMPs and EDPs. It appears that the SCAT2 is used more in the SEMP setting than in the emergency context. Further knowledge transfer efforts and research should address the barriers to achieving more consistent advice given by physicians who attend SRC patients.
Assistant Professor in the Department of Family and Community Medicine and the Department of Surgery at the University of Toronto in Ontario james.carson@utoronto.ca.
James D
JD
Carson
First-year resident in the Division of Physical Medicine and Rehabilitation at the University of Toronto.
Alexandra
A
Rendely
Medical student at the Medical University of the Americas in Nevis.
Alisha
A
Garel
Biostatistician Research Administrator in the Department of Family and Community Medicine at the University of Toronto.
Christopher
C
Meaney
Sport medicine physician practising in Toronto.
Jacqueline
J
Stoller
Family medicine resident at McMaster University in Hamilton, Ont.
Jatin
J
Kaicker
Research Manager at Women's College Hospital in Toronto.
Leigh
L
Hayden
Associate Professor in the Department of Family and Community Medicine at the University of Toronto, Scientist at the Institute for Clinical Evaluative Sciences, and Associate Professor in the Dalla Lana School of Public Health at the University of Toronto.
Rahim
R
Moineddin
Professor in the Department of Rehabilitation at Laval University in Quebec city, QC.
Pierre
P
Frémont
D001265:Athletic Injuries / Q000150:complications*; D001924:Brain Concussion / Q000175:diagnosis* / Q000628:therapy*; D002170:Canada; D019468:Disease Management; D034742:Electronic Mail; D004636:Emergency Service, Hospital; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009483:Neuropsychological Tests; D010820:Physicians; D013178:Sports Medicine / Q000193:education*; D011795:Surveys and Questionnaires