Whereas ATs perceived patient care documentation as important, several practical barriers may inhibit their ability to complete high-quality documentation of the services they provide. Effective strategies to improve the quality of patient care documentation among ATs are needed to ensure that their value, particularly in the secondary school setting, is accurately characterized.

Our main findings suggest that rest is underused by health care providers, recommendations for rest are broad and not specific to individual patients, an initial period of moderate physical and cognitive rest (eg, limited physical activity and light mental activity) may improve outcomes during the acute postinjury phase, significant variability in the use of assessment tools and compliance with recommended return-to-activity guidelines exists, and additional research is needed to empirically evaluate the effectiveness of graded return-to-activity progressions. Furthermore, there is a significant need to translate knowledge of best practices in concussion management to primary care providers.

Background:Previous studies have identified the effect of sport-related concussion on health-related quality of life through the use of patient-reported outcome measures. However, there has been little research exploring the underlying mechanisms that influence these perceptions of health-related quality of life among adolescent athletes who have sustained a sport-related concussion.Purpose:To explore the psychosocial aspects of concussion among adolescent athletes.Study Design:Case series; Level of evidence, 4.Methods:A total of 12 interscholastic athletes (4 girls, 8 boys; mean ± SD age, 15.7 ± 1.7 years; grade level, 10.2 ± 1.4) were interviewed via a semistructured interview protocol between 15 and 30 days postinjury. Data analysis was guided by the consensual qualitative research tradition. Themes and categories emerged through consensus by a 3-person research team, and bias was minimized through the use of multiple-analyst triangulation.Results:Participants identified numerous postconcussion symptoms that resulted in increasing difficulty with emotions (eg, irritable, easily frustrated), roles at school (eg, concentration difficulties, fatigue), and roles in their social environment (eg, letting the team down, not being able to contribute to sport). As a result, participants expressed how they tried to minimize or mask symptoms to decrease the potential of being viewed differently by their peers.Conclusion:Adolescent athletes perceived a significant effect of sport-related concussion on numerous areas of psychosocial and emotional health and well-being. Anticipatory guidance—with education regarding the possible signs and symptoms, risk factors, and recovery expectations following a concussion—is important to include in postinjury management. A better understanding of sport-related concussion and expected recovery could help to improve perceptions of this injury among interscholastic athletes. Additionally, best practices should be identified to assist health care professionals and school personnel in the development of temporary adjustments or formal academic adjustment policies in the secondary school setting, therefore ensuring that the patients receive the support that they need to maintain their roles as students.

Context:  Documenting patient care is an important responsibility of athletic trainers (ATs). However, little is known about ATs' reasons for documenting patient care and the mechanics of completing documentation tasks. Objective:  To understand ATs' perceptions about reasons for and the mechanics of patient care documentation. Design:  Qualitative study. Setting:  Individual telephone interviews with Athletic Training Practice-Based Research Network members. Patients or Other Participants:  Ten ATs employed in the secondary school setting (age = 32.6 ± 11.4 years, athletic training experience = 7.1 ± 7.8 years) were recruited using a criterion-based sampling technique. Participants were Athletic Training Practice-Based Research Network members who used the Clinical Outcomes Research Education for Athletic Trainers electronic medical record system and practiced in 6 states. Data Collection and Analysis:  We used the consensual qualitative research tradition. One investigator conducted individual telephone interviews with each participant. Data collection was considered complete after the research team determined that data saturation was reached. Interviews were transcribed verbatim and independently analyzed by 4 research team members following the process of open, axial, and selective coding. After independently categorizing interview responses into categories and themes, the members of the research team developed a consensus codebook, reanalyzed all interviews, and came to a final agreement on the findings. Trustworthiness was established through multiple-analyst triangulation and member checking. Results:  Participants identified 3 reasons for documenting patient care: communication, monitoring patient care, and legal implications. Four subcategories emerged from the mechanics-of-documentation theme: location, time of day, length of time, and criteria for documenting. The ATs described different criteria for documenting patient care, ranging from documenting every injury in the same manner to documenting time-loss and follow-up injuries differently. Conclusions:  Whereas ATs recognized individual mechanisms that enabled them to document patient care, they may need more guidance on the appropriate criteria for documenting various patient care encounters and strategies to help them document more effectively.

Objective To systematically review current literature to determine whether active learning is more successful than passive learning at producing cognitive skills in health care professions students. Data Sources An electronic search was conducted in 4 databases: EBSCO-CINAHL, EBSCO-Sport Discus, Educational Resources Information Center, and PubMed. Search terms included: millennial AND health education, active learning AND knowledge retention, flipped classroom AND learning outcomes, problem based learning AND learning outcomes, problem based learning AND student confidence, active learning AND critical thinking, higher order thinking AND active learning. Study Selection We included studies if they were published in English between 2007 and 2017 and evaluated outcomes of an active learning intervention. Studies of nonhealth care disciplines, practicing health care practitioners, or studies that did not address the primary research questions were excluded. Data Extraction Study design, health care discipline, intervention used, assessment measures, outcome(s) measures, main results, and conclusions were extracted from each article, as appropriate. Data Synthesis Articles were categorized based on capacity to answer 1 or both of the research questions. Conclusions were summarized according to the learning technique used and its effectiveness in regard to studied learning outcome. Out of 85 studies on lower-order cognition, 61 (72%) indicated active learning techniques were effective at achieving improved recall, understanding, and/or application of course material. Of 69 studies on higher-order cognition, 58 (84%) supported active learning over passive instruction for improving students' confidence in or performance of analytical, evaluative, and creative skills. Conclusions Active learning produces gains to both lower- and higher-order cognition at levels equal to, and more often, greater than the use of passive learning methods. Despite this evidence, we believe more high-quality, well-designed prospective studies using validated assessment measures are needed to endorse the value of these methods in producing cognitive skills.