Effectiveness of an educational
video on concussion knowledge in minor league hockey players: a cluster
randomised controlled trial
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.
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.
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.
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?
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
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.
Catherine,
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.
Helpful!
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.
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?
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."