"Barriers to the Implementation of the Amsterdam 2022 Statement in the " by L Torres, J L. Baldari et al.
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Keywords

Association for Athletic Training Education 2025 Symposium

Abstract

Introduction: The Amsterdam 2022 International Consensus Statement on Concussion in Sport provides a summary of contemporary best practice recommendations for healthcare providers who are involved in the care of athletes at risk of sport-related concussion (SRC). Given that athletic trainers (ATs) have a professional responsibility to continually educate themselves on topics of great importance to the population that they care for, such as SRC management, it is reasonable to expect them to evolve their concussion management protocols to better align themselves with the recommendations found this statement. The purpose of this study was to identify the barriers associated with the implementation of the recommendations from the Amsterdam 2022 Statement by ATs in the secondary school setting to better inform ATs who seek to modernize their own concussion management protocols. Methods: 89 secondary school ATs (44 males, 45 females) with an average of 21.38 years of certified athletic training experience from NATA District 1 and 2 were recruited for the purposes of this study. ATs were provided with an electronic Qualtrics survey consisting of 6 demographic items and 11 items related to details on their currently existing concussion management protocols, their familiarity with the new recommendations in the Amsterdam 2022 Statement, and their ability and willingness to update their concussion management protocols as needed. Results: Slightly more than half of the ATs reported that their current protocols were completely aligned with the Amsterdam 2022 Statement recommendations (52.1%) and that they were currently using the Sport Concussion Assessment Tool (SCAT) version 6 or Child SCAT6 as opposed to any previous iterations (60.6%). The majority reported that their organization did not currently have any appropriate heart rate tracking equipment available to them to assist in the implementation of step 2 of the Amsterdam 2022 Statement return to sport (RTS) strategy (76.2%). The ATs who were not currently using the SCAT6 or Child SCAT6 reported the following implementation barriers to using these tools: the tool being too labor intensive to use in a large secondary school and/or at time of injury, waiting for approval of use by a employing hospital network, de-prioritization of the use of the newest tool in comparison to other aspects of their concussion management protocols that needed to be updated, the lack of time to review the new tool, and the lack of knowledge of there being a new tool. Other ATs also expressed concerns about not feeling appropriately trained on how to use the tool at all, not understanding the need to move to 10-word recall lists, the inability to have an appropriate setting to use the tool, and in one case, the lack of support from their team physician regarding the tool. The ATs shared more general barriers regarding the overall implementation of the Amsterdam 2022 Statement recommendations at their respective schools including lack of support and/or knowledge from various stakeholders, delayed approval from school administration, worries about the use of the SCAT6, and a lack of resources to implement the latest RTS progressions. Translation to Practice: Secondary school ATs will benefit from detailed dissemination of the barriers that exist against implementing the Amsterdam 2022 Statement recommendations in order to actualize the best contemporary concussion management protocol within their organization. Organizational administrators can further facilitate the implementation process by providing practical support, especially as it relates to environmental, policy, and financial resources. In addition to the provision of support, continuing education on the topic of SRC needs to remain a focal point in the athletic training profession to reduce the delay that exists between the discovery of well-researched, best practice recommendations to the use of these recommendations in active practice.

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