Evaluating the Effectiveness of a Multimodal Approach to Concussion Education in Collegiate Athletes

Context: Concussions have been declared an epidemic in sport participation by the Centers for Disease Control. While concussions cannot be prevented, researchers and clinicians believe concussion education is the cornerstone for early recognition and management. Concussion education has been mandated by state legislation and governing athletic bodies as a part of concussion management strategies at both secondary and post-secondary levels. However, neither of these entities have specified how concussion education should be delivered to the student athlete population. Purpose: Evaluate the effectiveness of a multimodal approach to concussion education on knowledge and retention in collegiate athletes. Methods: A multimodal concussion education that included a PowerPoint lecture, video, and discussion was conducted by the head athletic trainer during pre-season team meetings. The ROCKI survey was administered to examine concussion knowledge during three time points, pre-intervention, immediate post-intervention and three months later. Repeated Measures Analyses of Variance (ANOVA) was used to compare the knowledge scores over time (pre-, post-, retention). Semi-structured interviews examined (1) attitudes towards the intervention and (2) perceived increase in knowledge of the athletes during the intervention using content analysis. Credibility and trustworthiness were established through member checks and using the Certified Athletic Trainer as an auditor. Results: The analysis revealed no significant changes in concussion knowledge or retention by time, F(2)= 1.95, p= 0.147, n2= 0.034. Thirteen teams were examined and yielded a total of 57 participants. Ten interviews were conducted (six freshmen, four returners) and four main themes emerged: (1) no perception of formal education in high school, (2) intervention enabled respondents to recall symptoms, (3) perceived increase in knowledge, and (4) multimodal approach was perceived as successful. Conclusion: A multimodal concussion education intervention did not significantly increase student-athlete knowledge, however qualitative analysis revealed student-athletes liked the multimodal approach and all respondents had a perceived increase in concussion knowledge after the intervention. Further studies should examine the use of a multimodal approach with active learning strategies to increase student-athlete knowledge on concussions.