Concussion reporting behaviours of community college student-athletes and limits of transferring concussion knowledge during the stress of competition

Concussion education for student-athletes is mandated by several states and is becoming an integral component of concussion management programmes; however, little is known about student-athlete concussion knowledge and self-reporting of suspected concussion. This study explored to what extent collegiate student-athletes are knowledgeable on the topic of concussion, the relationship between having concussion knowledge and reporting behaviours, and factors contributing to not reporting when education has been provided. METHOD: Mixed method explanatory design. The Rosenbaum Concussion Knowledge and Attitudes Survey was administered to 986 community college student-athletes from 6 sports. Follow-up qualitative interviews were conducted using purposive sampling. RESULTS: Concussion knowledge scores positively correlated with number of times concussion education was received, but were not associated with reporting of concussion. Of respondents with a history of concussion, 64% stated that they reported all of their concussions. The highest ranked reason given for not reporting concussion was, “I was into the game/practice and didn't realize I had a concussion at the time.” Qualitative analysis revealed physiologically related and attitudinal factors particular to competition that precluded participants’ identification and reporting of concussion. CONCLUSIONS: Despite receiving concussion education, student-athletes may not be cognizant of a possible concussion particularly during the stress of competition. Results indicate that alternate methods of providing concussion education that can affect knowledge transfer should be explored: providing education in the settings where student-athletes practice and compete, incorporating a kinaesthetic or procedural learning approach to concussion education, and addressing the social and attitudinal aspects of concussion reporting.