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

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