Appropriate Medical Care Standards for Organizations Sponsoring Athletic Activity for the Secondary School-Aged Athlete: A Summary Statement.

OBJECTIVE: To present the appropriate medical care standards for organizations that sponsor athletic activities for secondary school-aged athletes. DATA SOURCES: To develop the current standards and identify current best-practices evidence, the task force used a multistep process that included reviewing the existing 2004 Appropriate Medical Care for Secondary School-Aged Athletes consensus points and cross-referencing of National Athletic Trainers' Association (NATA) statements and official documents from the strategic alliance (the NATA, NATA Foundation, Board of Certification, and Commission on Accreditation of Athletic Training Education). Gaps in the recommendations from the 2004 Appropriate Medical Care for Secondary School-Aged Athletes document were identified by the task force, and the new appropriate medical care standards were developed and refined. CONCLUSIONS AND RECOMMENDATIONS: Twelve standards, with supporting substandards, were developed that encompassed readiness to participate in activity; facilities; equipment; protective materials; environmental policies; nutrition, hydration, and dietary supplementation; wellness and long-term health; comprehensive emergency action plans; on-site immediate care; on-site therapeutic interventions; psychological concerns; and athletic health care administration. Collectively, these standards describe a comprehensive approach to providing appropriate health care to secondary school-aged athletes and should serve as a framework with which organizations can evaluate and improve the medical care supplied to adolescent athletes.

Neurology resident learning in an end-of-life/palliative care course.

OBJECTIVES: The Accreditation Council for Graduate Medical Education (ACGME) requires neurology residents receive instruction in End-of-Life Care/Palliative Care (EOLPC), but survey data from 24 neurology programs in the National Residency End-of-Life Physician Education Project (NRELEP) demonstrated faculty and residents tend to rate themselves as able to perform EOLPC despite significant knowledge gaps. We participated in the NRELEP to develop an EOLPC course and assess resident learning following this new curriculum. METHODS: Fifteen residents and 8 nonparticipant faculty completed a content validated knowledge pretest and precourse EOLPC confidence self-assessment tool. The course plan developed during a NRELEP conference consisted of 14 weekly 1-hour sessions covering a variety of topics pertinent to EOLPC care in neurology. Sessions included lectures, role-play, and group problem-solving formats. Residents attended sessions while faculty did not. The postcourse assessment included a posttest and the EOLPC self-assessment, and was completed by 14 residents and 5 comparison faculty. RESULTS: The mean pretest score was 48.1% +/- 16.9% for residents and 59.0% +/-8.2% for faculty. Posttest scores improved to 67.2% +/- 10.6% for residents (t test, p +/- 0.001), but not for the faculty group (52.4% +/- 9.9%, p = 0.2). Resident EOLPC confidence self-assessment significantly improved after the course (precourse mean, 3.09 +/- 1.01; postcourse mean, 3.40 +/- 0.93, p < 0.001), while there was no change in faculty confidence (precourse mean, 3.48 +/- 0.82; postcourse mean, 3.41 +/- 0.82, p = 0.5). Residents performed significantly better than faculty on the posttest (p = 0.01). CONCLUSIONS: An EOLPC course was developed and implemented in this program. Residents exhibited demonstrable learning and improved self-assessment of confidence in providing EOLPC following introduction of the course.