The Self-Efficacy of Certified Athletic Trainers in Assessing and Managing Sport-Related Concussions

Abstract

Context: Diagnostic and return-to-play assessments of athletes with sport-related concussions (SRCs) have changed dramatically over the past decade. Currently, SRC assessment and management has taken a multifaceted approach, with new SRC measures being developed yearly. However, to date, no researchers have examined certified athletic trainers' (ATs') self-efficacy in assessing and managing a patient with an SRC. Objective: To examine the self-efficacy of ATs in assessing and managing athletes with SRCs, with a secondary purpose of examining job setting (high school and college). Design: Cross-sectional study. Setting: Web-based questionnaire. Patients or Other Participants: A total of 94 ATs (high school setting = 54.3%, n = 51; collegiate setting = 45.7%, n = 43) completed an online survey, for a response rate of 9.2%. Main Outcome Measure(s): The survey contained 3 primary subsections: demographics, self-efficacy in assessing SRCs, and self-efficacy in managing SRCs. Possible self-efficacy ratings for SRC assessment and management in the survey ranged from 0 to 100. Multivariate analyses of variance were performed to identify differences in the self-efficacy of high school and collegiate ATs in assessing and managing athletes with SRCs. Results: The self-efficacy of all 94 participants in their assessment of SRCs was 60.34 ± 14.5 and in their management of SRCs was 55.30 ± 14.1. Collegiate ATs reported higher self-efficacy in the assessment of SRCs using balance (P < .001) and the King-Devick test (P = .04), and their responses approached significance for vestibular-ocular motor screening (P = .05). Additionally, their self-efficacy in the management of SRCs was greater using balance (P < .001) and vestibular-ocular therapy (P = .01) compared with high school ATs. Conclusions: Athletic trainers had moderate self-efficacy regarding their assessment and management of SRCs. Collegiate ATs had higher self-efficacy in newer SRC assessment and management tools than high school ATs.

Ubiquitin carboxyl-terminal esterase L1 is not elevated in the serum of concussed rugby players: an observational cross-sectional study

“…None of the SRC subjects experienced loss of consciousness and all were able to give consent. Although ATCs have reported moderate self-efficacy in diagnosing concussion 3 , they are the best tool we currently have for diagnosing concussion and is the reason their diagnosis was relied upon for this study. Subjects in all groups were asked about their concussion history (number of past concussions), years of rugby play, age, body mass, and all subjects reported they had never been diagnosed with any central nervous system dysfunction such as epilepsy, cerebral palsy, or multiple sclerosis.…”

“…Diagnosis of SRC is extremely complex due to confounding symptoms and lack of clinically objective tests 2 . Furthermore, in a self-efficacy survey of 94 high school and collegiate certified athletic trainers (ATCs), self-efficacy in their clinical assessment of SRC, using common tools such as balance testing, neurocognitive testing, vestibular and oculomotor screening, the Sport Concussion Assessment Tool 3rd edition (SCAT3), etc., was reported to be moderate 3 . However, high self-efficacy in concussion diagnosis is important to ensure the safety of concussed athletes 3 .…”

“…Furthermore, in a self-efficacy survey of 94 high school and collegiate certified athletic trainers (ATCs), self-efficacy in their clinical assessment of SRC, using common tools such as balance testing, neurocognitive testing, vestibular and oculomotor screening, the Sport Concussion Assessment Tool 3rd edition (SCAT3), etc., was reported to be moderate 3 . However, high self-efficacy in concussion diagnosis is important to ensure the safety of concussed athletes 3 . Including a validated objective blood-based biomarker in the diagnostic criteria of SRC would likely enhance the accuracy of SRC diagnosis and improve self-efficacy among ATCs and other medical practitioners.…”

Concussion Knowledge and Clinical Experience Among Athletic Trainers: Implications for Concussion Health Care Practices

“…Twenty-four individuals were excluded for either not consenting to participate (n ¼ 12) or not being an AT (n ¼ 12), resulting in an overall response rate of 15% (1307/8725), which was similar to that of previous AT survey studies. 27,28 Approximately 63% (818/1307) completed more than 90% of their survey items. Of the 1307, a total of 773 ATs completed the signs and symptoms recognition section (demographics provided in Table 2).…”

“…The survey response rate was low (15%), although it was comparable with that of recent surveys of ATs. 27,28 Last, the conservative method of excluding responses in which all signs and symptoms recognition responses were false is a potential limitation; however, we believe this approach was more appropriate because it ensured that only responses entered by participants were analyzed.…”