Sports Medicine Research: In the Lab & In the Field: Videos for Concussion Education? Single Viewing Does Not Help Info Stick (Sports Med Res)


Friday, September 27, 2013

Videos for Concussion Education? Single Viewing Does Not Help Info Stick

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-speciļ¬c 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

Related Posts:

Cusimano MD, Chipman M, Donnelly P, & Hutchison MG (2013). Effectiveness of an educational video on concussion knowledge in minor league hockey players: a cluster randomised controlled trial. British Journal of Sports Medicine PMID: 23918445


Catherine LeBlanc said...

Currently, at the secondary school I work at, each student and parent is required to either complete an online education course or attend a "concussion talk" by a neuropsychologist as a requirement prior to participation in any sport. This program has only been implemented for two years, but both student and parent are required to complete this prerequisite every year. Along with coach education, I believe this program is an effective technique to reinforcing concussion education in high school athletes because it's a multifaceted approach that informs everyone around the athlete in the even that they do no retain all the information. As for age, I believe more information is needed to determine at what age it really can be attained. The video provided in the article was approximately 26 mins long, which may be too long for a younger age group to pay attention to. I think having short, bimonthly "concussion talks" with younger athletes may be more effective.

Stephen Stache said...


Thank you for your comment. I agree that a multifaceted approach is important to overall concussion education and awareness. As with concussion management, where no single tool is effective in diagnosing a concussion, using different tools can help the message "stick" when it comes to concussion education.

I have found that reaching out to communities and more importantly, directly to parents, is essential. Parents are often a clinician's greatest ally during concussion management, and empowering them before the injury can greatly influence an athlete's recover.

Parents who better understand "brain rest" often show up in my office having already removed TV, cell phones, internet, etc. during the early phases of concussion recover which I feel gives these athletes a great head start in the recovery process.

That being said, athletes still do a poor job reporting symptoms and the sports medicine community must in turn respond by continuing the education portion of concussion management. Knowing that clinicians such as yourself are reaching out in a multifaceted approach is encouraging and hopefully in the research will soon show greater influence due to your efforts.

Ashley Lindseyo said...


Sylvia Thelemaque said...

First and foremost, knowledge is key and power. The more you learn about something the better off you are. To make the skill or task to become more of second nature you for one should start at an early age. The only way to become better is by repetitiveness and then being able to apply it to everyday life.

Being at clinicals for a semester has put me in a habit of completing everyday tasks such as evaluations, taping, rehabilitation and etc. Being able to see things done visually instead of constantly reading helps.

Will Bradley said...

Since the younger group did not ratain as much information at the 2-month follow up, perhaps showing different informational vidioes at different time intervals?

Stephen Stache said...

Will, thanks for your comment. Your thought on different information videos at different time intervals is a good one . Setting up a project with some sort of plan such as this would be a great next step in the research process to establish how much information is enough to make the concepts "stick."

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