Sport-related concussions: knowledge translation among minor hockey coaches.
Mrazik M, Bawani F, Krol AL. Clin J Sport Med. 2011 Jul;21(4):315-9
It is important for coaches to be able to determine and recognize if their athletes have suffered a concussion.  Many programs and workshops (e.g., Hockey Canada & ThinkFirst Foundation) are being implemented as a resource for coaches to obtain concussion education, and many coaches value the concussion education, however, it is unclear where coaches are receiving their information and if it is being delivered effectively. In this cross-sectional study, a survey was used to assess minor hockey coaches’ knowledge base on sport-related concussions. The study population included 178 coaches that spanned 5 different age-group hockey leagues in Edmonton, Alberta (ages 5 to 15 years). Coaches reported on the helpfulness of various information sources (i.e., internet, magazines/newspapers, other coaches, Alberta Health [Canadian health care system], family doctor, emergency room, other). They also reported their perceived knowledge level and if they thought that it was important to have concussion education. The survey questioned coaches on their specific knowledge of concussion with true or false statements (e.g., mouth guards protect an athlete from concussion; you must hit your head to sustain a concussion). The survey also assessed the coaches’ return to play decisions and if they believe their athletes would tell them if they suffered a concussion. The study results showed that coaches believe knowledge about concussions was important (92 %), yet many coaches believed they had little to moderate personal concussion knowledge (37 %, 41 % respectively). Over 50% coaches get their information from internet, magazines, and other coaches; however, most say these sources are not that helpful. Though minor ice hockey coaches are not confident in their concussion knowledge, many answered correctly to specific concussion-related knowledge questions. For example, a concussion is considered a brain injury (97 % answered correctly), a concussion requires immediate removal from play (99 % answered correctly), and post-concussion symptoms can be delayed for hours to days (100% answered correctly). Over 87% of coaches “most likely” or “definitely” would not return a player to a game if the player had a headache or dizziness even if it had improved.  Most concerning from the survey was that almost half of the coaches said their athletes would probably not tell them if they suffered a concussion.
Having informed coaches is a key component for providing concussion knowledge to athletes and guardians. It is important especially for athletic teams that do not have a full time athletic trainer on staff to determine if coaches are prepared to handle injuries such as concussions. Youth sports, like ice hockey, typically do not have an athletic trainer. Having an athletic trainer on staff along with a well-educated coach are great educational assets for the athletes and parents. However, this study did not ask coaches if they received any information from athletic trainers/therapists. The survey reported that many of the coaches received their concussion information from magazines and the internet, but it would have been better if the coaches listed the specific magazine and/or internet sites to determine if concussion programs (e.g., Center for Disease Control and Prevention Head Start Program, Sports Safety Fund) that are currently being implemented are beneficial and helpful to the coaches. Coaches in the United States could benefit from the same type of research to see if the concussion programs within the United States for coaches are being utilized and effective.  It’s concerning that so many coaches believe that their athletes would not tell the coaches if they sustained a concussion. Future research should target the education of the young athletes as well as determine the impact of the educational programs implemented for sport-related concussions. Additionally future research could target how athletic trainers convey concussion education to coaches, athletes, and parents.
Written By: Jane McDevitt
Reviewed By: Jeffrey Driban