Recommendations for Medical Discharge Documentation and Academic Supports for University Students Recovering From Concussion.

OBJECTIVE: This study sought to (1) collate the experiences of university students with concussion history and academic stakeholders through interviews and (2) develop concussion management recommendations for institutions of higher learning using a multidisciplinary Delphi procedure. SETTING: Remote semistructured interviews and online surveys. PARTICIPANTS: The first aim of this study included undergraduate university students with concussion history who did not participate in varsity athletics ( n = 21; 57.1% female), as well as academic faculty/staff with experience assisting university students with their postconcussion academic needs ( n = 7; 71.4% female). The second aim enrolled 22 participants (54.5% female) to serve on the Delphi panel including 9 clinicians, 8 researchers, and 5 academic faculty/staff. DESIGN: An exploratory-sequential mixed-methods approach. MAIN MEASURES: Semistructured interviews were conducted to unveil barriers regarding the return-to-learn (RTL) process after concussion, with emergent themes serving as a general framework for the Delphi procedure. Panelists participated in 3 stages of a modified Delphi process beginning with a series of open-ended questions regarding postconcussion management in higher education. The second stage included anonymous ratings of the recommendations, followed by an opportunity to review and/or modify responses based on the group's consensus. RESULTS: The results from the semistructured interviews indicated students felt supported by their instructors; however, academic faculty/staff lacked information on appropriate academic supports and/or pathways to facilitate the RTL process. Of the original 67 statements, 39 achieved consensus (58.2%) upon cessation of the Delphi procedure across 3 main categories: recommendations for discharge documentation (21 statements), guidelines to facilitate a multidisciplinary RTL approach (10 statements), and processes to obtain academic supports for students who require them after concussion (8 statements). CONCLUSIONS: These findings serve as a basis for future policy in higher education to standardize RTL processes for students who may need academic supports following concussion.

Evaluating Post-concussion Clinical Management of University-Aged Performing Artists: A Systematic Review.

INTRODUCTION: Contemporary concussion literature has yet to establish appropriate clinical management guidelines to address the unique needs of performing arts populations, especially at the collegiate level. Therefore, the purpose of this investigation was to collate current evidence regarding post-concussion return to performance management among university-aged performing artists to generate broad clinical implications. METHODS: The research team was comprised of two faculty members in the performing arts, one concussion researcher, and athletic trainer, two university librarians, and one physical therapy graduate student with expertise in post-concussion management among performing arts patients. Two librarians searched the literature using PubMed, Cochrane, SPORTdiscus, and Education Research Complete. Studies were eligible for preliminary inclusion if they were written in English, conducted in the United States, as well as published in a peer-reviewed journal. There were no restrictions on publication date due to the limited literature on this topic. The most recent search was conducted in July 2023. RESULTS: Of the 18 studies identified during the search process, only 2 met the inclusion criteria. Broadly, this investigation identified common mechanisms of injury among stage crew/technicians and dancers who are of university-age. Furthermore, both studies identified several patients who opted to return to performing arts on their own volition. However, there were no studies that solely focused on the collegiate performing arts population and their return to performance procedures. CONCLUSIONS: Overall, these findings highlight a momentous gap in concussion literature regarding how to guide clinicians and academic teams when returning collegiate performing artists back to their performance environment(s). Thus, additional research is strongly warranted to understand the lived experiences of performing artists with concussion, as well as how to address specific coursework-related demands to support their recovery.

Achieving Consensus Through a Modified Delphi Technique to Create the Post-concussion Collegiate Return-to-Learn Protocol.

BACKGROUND: Sport-related concussions (SRCs) affect millions of adolescents and young adults annually in the USA; however, current SRC consensus statements provide limited guidance on academic support for students within higher education. OBJECTIVE: To generate consensus on appropriate academic recommendations for clinicians, students, and academic stakeholders to support university students during their recovery. METHODS: Panelists participated in three stages of a modified Delphi procedure: the first stage included a series of open-ended questions after reviewing a literature review on post-SRC return-to-learn (RTL) in higher education; the second stage asked panelists to anonymously rate the recommendations developed through the first Delphi stage using a 9-point scale; and the final stage offered panelists the opportunity to change their responses and/or provide feedback based on the group's overall ratings. RESULTS: Twenty-two panelists including clinicians, concussion researchers, and academic stakeholders (54.5% female) from 15 institutions and/or healthcare systems participated in a modified Delphi procedure. A total of 42 statements were developed after round one. Following the next two rounds, 27 statements achieved consensus amongst the panel resulting in the four-stage Post-Concussion Collegiate RTL Protocol. CONCLUSION: There are several unique challenges when assisting university students back to the classroom after SRC. Explicit guidelines on when to seek additional medical care (e.g., if they are experiencing worsening or persistent symptoms) and how to approach their instructor(s) regarding academic support may help the student self-advocate. Findings from the present study address barriers and provide a framework for universities to facilitate a multidisciplinary approach amongst medical and academic stakeholders.