Concussion-Related Knowledge and Patterns of Practice in Ontario General and Family Practice and Sport and Exercise Medicine Physicians

• Author / Creator

  Boyd, Annie

• Objectives: To characterize concussion knowledge levels, patterns of practice and learning preferences for physicians within the Sections of General & Family Practice (GFP) and Sport and Exercise Medicine (SEM) of the Ontario Medical Association (OMA).Methods: Cross-sectional online survey, first distributed in 2013 and repeated in 2022.Population: Active, practicing physicians within the OMA belonging to the Sections of GFP and SEM who see patients with concussion in their practices.Outcome Measures: Survey response rates, concussion guideline usage, initial assessment and return-to-play decision tools, concussion care recommendations and preferred resources and methods for learning about concussion (past, present, and future).Results: Response rates: 2013: GFP 225/12,168 (1.8%), SEM 85/594 (14.3%); 2022: GFP 216/15,674 (1.4%), SEM 35/696 (5.0%). There was a decrease in non-reliance on published guidelines from 2013 to 2022 (2013 overall: 29.9%, 2022 overall: 21.4%; p=0.022) but in both surveys significantly more GFP physicians did not rely on published guidelines (2013: GFP 38.2%, SEM 8.2%; p<0.001; 2022: GFP 23.7%, SEM 2.9%; p=0.003). Reported usage of tools for initial assessment and return-to-play varied with time and by Section. Of note, the use of theSport Concussion Assessment Tool (SCAT) increased for both initial assessment (GFP: 2013-34.2%, 2022- 65.0%; p<0.001; SEM: 2013- 68.2%, 2022- 90.9%; p=0.010) and return-to-play decisions (GFP: 2013- 29.8%, 2022- 56.1%; p<0.001; SEM: 2013- 61.2%, 2022- 85.3%; p=0.016). Physician recommendations for physical and cognitive rest post-concussion shifted iiifrom complete rest to subthreshold/modified activities over time (p<0.001 for both). The 2022 survey identified websites (46.2%) and continuing medical education (CME) (85.0%) as popular preferred resources for future learning about concussion. For future CME opportunities more GFP physicians preferred Family Medicine Forum (GFP- 38.0%, SEM- 14.3%; p=0.007) and MainPro+ activities (GFP- 73.6%, SEM- 48.6%; p=0.003), but SEM physicians preferred SEM conferences (GFP- 15.3%, SEM- 68.6%; p<0.001). Conclusions: Comparison of the 2013 and 2022 surveys revealed that physician knowledge levels improved, and that their patterns of practice better reflected current published guidelines.Gaps in knowledge and differences in patterns of practice between GFP and SEM physicians remained in 2022. An overwhelming majority of physicians from both surveys expressed interest in further education on concussion. Future work should utilize a validated tool in a larger cohort to compare physician reported knowledge and attitudes with behaviours observed in practice.

• Subjects / Keywords

  • Concussion
  • Physician Knowledge
  • General and Family Practice
  • Sport and Exercise Medicine

• Graduation date

  Fall 2022

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-w8wc-ns24

• License

  This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.