Evaluating Knowledge Attainment and Retention of a Multimodal Approach to Concussion Education in Collegiate Athletes

Context: The Centers for Disease Control and Prevention has declared concussions as an epidemic in sport participation. To provide a safer environment, state legislation and athletic governing bodies have mandated concussion education as a part of concussion management strategies throughout secondary and postsecondary levels. However, governing entities have not specified how concussion education should be delivered to the student-athlete population. Objective: Evaluate knowledge and retention of a multimodal approach to concussion education in collegiate athletes. Design: Sequential explanatory mixed-methods design. Setting: Preseason meetings. Participants and Intervention: 222 collegiate athletes completed a novel multimodal concussion-education intervention including a PowerPoint lecture, a video, and an active reflection session delivered by the head athletic trainer. Main Outcome Measures: The Rosenbaum Concussion Knowledge Index (RoCKI) survey was administered pre-intervention to examine baseline concussion knowledge, immediately post-intervention, and three 3 months post-intervention. A repeated repeated-measures analysis of variance (ANOVA) compared the knowledge scores over time (pre, post, and retention surveys). Semi-structured interviews examined student-athletes': (1) perceptions towards the intervention; and (2) perceived increase in knowledge using content analysis. Results: The analysis revealed no significant changes in concussion knowledge or retention by time, F[subscript 2] = 1.95, P = 0.147, [eta][superscript 2] = 0.034. Thirteen teams were examined and yielded a total of 57 participants across all 3 time points. Ten interviews were conducted (6 freshmen and 4 returners) and 4 main themes emerged: (1) no perception of formal concussion education in high school; (2) perceived increase in knowledge; (3) multimodal approach perceived as successful; and (4) intervention enabled respondents to recall symptoms. Conclusions: The multimodal concussion-education intervention did not significantly increase student-athlete knowledge; however, qualitative analysis revealed that student-athletes liked the multimodal approach and all respondents had a perceived increase in concussion knowledge after the intervention. Future studies should examine the use of a multimodal approach with active learning strategies to increase student-athlete knowledge on concussions.