Effectiveness of an educational video on concussion knowledge in minor league hockey players: a cluster randomised controlled trial
Cusimano, M. Chipman, M. Donnelly, P. Hutchison, M. Br J Sports Med. 2013 Aug 5. doi: 10.1136/bjsports-2012-091660.
Take Home Message: Despite immediate improvement in concussion-related knowledge, the use of a concussion education video was ineffective in long-term knowledge transfer among minor league hockey players.
Sport-related concussion is a major topic of discussion in the sports medicine community and there is an increasing awareness that educating athletes may be an effective injury prevention strategy. A recent study of high school athletes showed that despite having a reasonable knowledge base, a majority of athletes in the study experienced concussion-related events or symptoms but did not report them. With results such as these in mind, Cusimano et. al evaluated the effectiveness of a concussion safety video (similar to this video) on knowledge transfer among minor league hockey players. The authors enrolled a total of 267 players with a mean age of 11.6 years from 32 different teams across two age division and two competition levels. Teams were then randomly assigned to either a no-video or video group, which watched the “Smart Hockey: More Safety, More Fun” (Smart Hockey video). The authors gave both groups two 11-question questionnaires that reviewed concussion knowledge (CK) as well as attitudes and behavior. The groups completed the questionnaires at baseline – prior to the video for the video group – after the video (video group only), and at a 2-month follow-up. Immediately after watching the video, players’ CK scores increased compared to their scores before the video. These improvements appear to be transient in the younger age division because their CK scores at the 2 month follow-up visit were similar to the no-video group. However, athletes in the older age division retained some knowledge at the 2-month follow-up. Both groups had no change in attitudes and behavior scores at the 2-month follow-up.
The results of this study are important because they continue to highlight a gap in knowledge transfer among athletes with regards to concussion education. These results might not be surprising since this was a single modality without reinforcement, but combining an educational tool, such as a video, with reminders like in-locker room posters has been shown to be effective. Additional review of the results showed that older athletes had a greater knowledge of concussion-related information at baseline when compared with the younger age group. Given these findings, if we develop age-speciﬁc educational initiatives or reminders we may produce effective long-term knowledge transfer among young hockey players. Research aimed at evaluating a multi-modal approach to knowledge transfer is also an essential next step in evaluating long-term change in knowledge, behaviour, or attitude.
Questions for Discussion: Have you found an effective method to improve knowledge transfer among the athletes under your care? When do you feel is the most appropriate age to start educating athletes on sports-related concussion?
Written by: Stephen Stache, MD
Reviewed by: Jeffrey Driban