K-12 Athletic Trainers’ Current Concussion Baseline Practice Patterns

BACKGROUND: Concussion baseline assessments are often administered during the pre-season of sports. Current recommendations suggest that baseline assessments may be useful in aiding and interpreting post-injury evaluations but are not necessary. However, it has become common practice for athletic trainers (ATs) to administer and implement baseline assessments in athletes. HYPOTHESIS/PURPOSE: The purpose was to determine K-12 ATs’ current concussion baseline assessment practice patterns. METHODS: A Qualtrics survey was designed and implemented to 443 ATs (193 males, 244 females, 5 prefer not to answer, n=1 missing). Most respondents had earned a master’s degree (n=288, 65.0%), and were employed full-time (n=381,86.4%). Respondents were solicited over email to complete the survey which consisted of multipart, multiple-choice, and open-ended questions. Responses are reported as frequencies and percentages. Chi-square analysis was run to determine group (years of experience) and baseline practice patterns, p<0.05. RESULTS: Seventy-five percent of respondents (n=330) reported administering baseline concussion assessments, with 37 (8.4%) reporting they do not administer baseline assessments but plan to in the future. The top five most reported assessment tools used were ImPACT (n=245, 55.3%), SCAT 5 (n=59, 13.3%), CNS Vital signs (n=25, 5.6%), BESS (n=25, 5.6%), and VOMS (n=22, 5.0%). The majority of respondents reported standard of care (n=226, 51%), provide better care (n=202, 45.6%%), school/organization policy (n=197,44.5%), to help diagnose concussion (n=139, 31.4%), concussion education (n=117, 26.4%), and liability (n=101, 22.8%), as the top reasons for using concussion baseline assessments. No differences were found between ATs with less than 10 years of experience, 11-20 years of experience, or 21+ years of experience in having formal training on administration of baseline assessments (p=.164), or having received formal training on interpretation of baseline assessments (p=.104). However, differences were noted by years of experience for reviewing baseline assessments for validity (2)= 8.68, p=.013, and for those who restrict testing when individuals are sleep deprived (2)=10.06 p=0.039. The majority reported receiving formal training to administer (n=209, 66.8%) and to interpret (n=178, 56.9%) neurocognitive baseline assessment. The majority of respondents report feeling extremely comfortable (n=214, 69%) and extremely competent (n=205, 65.9) in administering neurocognitive assessments, and moderately comfortable (n=117, 38.2%) and moderately competent (n=137, 45.1%) in test interpretation. CONCLUSION: The majority of ATs reported administering baseline concussion assessments and felt comfortable and competent in the administration and interpretation of assessments in adolescent athletes. Most ATs reported standard of care and providing better care as reasons for implementing assessments.