Fielding a Joint Concussion Management Program

You have accessThe ASHA LeaderAcademic Edge1 Oct 2018Fielding a Joint Concussion Management ProgramStudents in speech-language pathology and athletic training team up to help student athletes. Dee M. LancePhD, CCC-SLP Dee M. Lance Google Scholar More articles by this author , PhD, CCC-SLP https://doi.org/10.1044/leader.AE.23102018.40 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Our department likes to try new things. We have a registered therapy dog that some student clinicians use in treatment sessions with clinic patients. We work with the School of Nursing to create simulations for medical learning experiences for communication sciences and disorders student clinicians. And, most recently, our faculty teamed up with the Department of Exercise and Sport Sciences (EXSS) to develop the University of Central Arkansas Concussion Management Program for student athletes. This collaborative effort began a couple of years ago when Richelle Weese joined the communication sciences and disorders (CSD) faculty as a clinical instructor. She had a strong background in medical speech-language pathology and experience working with student athletes who had experienced sports-related concussions. At around the same time, EXSS hired Hyung (“Rock”) Lee, an assistant professor of athletic training who needed collaborators for his research in sports-related concussions. These two faculty members served as the cornerstones for developing the concussion management program. Their hard work building a collaborative relationship has provided value-added learning experiences for students and research opportunities for faculty and students. Perhaps most important, it has helped improve treatment of our student athletes with concussions. Creating a game plan As Weese’s and Lee’s ideas started to gel, they met with the EXSS department chair and me (communication sciences and disorders department chair) to describe the scope of their project.Although baseline and post-concussion testing for student athletes was a value-added result of the project, its major objectives were to provide EXSS and CSD faculty with opportunities for collaborative research, and to provide student clinicians with clinical experience in concussion assessment and treatment. The baseline and post-concussion testing battery would include the ImPACT, a computerized measure commonly given by athletic trainers; selected subtests from the Arizona Battery for Communication Disorders of Dementia; selected subtests from the Woodcock-Johnson IV; the Montreal Cognitive Assessment; and a hearing screening. The EXSS chair and I then met with the dean of the College of Health and Behavioral Sciences—the academic home of both departments—to share the potential of this interprofessional initiative. We were hopeful about securing his support, as interprofessional education and research can be tied to the strategic plan of the college and both departments. The dean requested a formal proposal, including the scope of the project, resources (equipment and personnel) needed, and outcomes for two years. Putting together the proposal was the first real obstacle. The CSD and EXSS departments had never collaborated at this level before, and each brought something different to the project. CSD provided clinical educators to supervise, a team of student clinicians, and physical space for assessments conducted by the CSD student clinicians. EXSS provided a computer testing lab and coordinated the testing schedule with the UCA athletic teams. We worked through the challenges—lab space, authorship of publications and presentations, and equipment purchases, for example—inherent to most collaborations. We completed the proposal, and the dean greenlighted the UCA Concussion Management Program. During the first summer of the program in 2016, we completed baseline assessment on the entire football team. Since then, we have added other teams and continue to test the incoming student athletes, for a total of about 270 UCA student athletes. Pre-game warm-up Now we had to make the program happen. We divided and conquered the initial tasks: EXSS managed the institutional review board approval process, created the lab space for ImPACT testing, and met with the athletic trainers and team coaches. CSD figured out how to test a large number of student athletes while coordinating student clinicians and clinical educators. With EXSS assessing five student athletes at a time in the ImPACT Lab, CSD needed to assess the same five athletes immediately after. We determined how many student clinicians and clinical educators we needed, and then developed a mandatory training curriculum and competency assessments for student clinicians and clinical educators. In small groups, faculty and students learned the information and skills necessary to participate on the team—the order of assessments, administration guidelines and scoring procedures. Students demonstrated competency by giving the assessment protocol to a CSD faculty member. All involved in the project are volunteers, and we have had more student clinician volunteers than we could train since the concussion program’s inception. Game time We tested our scheduling protocol on a small team—women’s soccer. After a few tweaks to our system, we were ready to go. During the first summer of the program in 2016, we completed baseline assessment of the entire football team. Since then, we have added other teams and continue to test the incoming student athletes, for a total of about 270 UCA student athletes. Post-concussion assessment and treatment is also part of the program. Any student athlete diagnosed with a concussion receives assessment within 24 hours of the diagnosis and a second assessment after physical symptoms subside. The assessment results go to team doctors (including a neurologist) and team athletic trainers and are used, along with other information, in return-to-play decisions. Because many games take place on weekends, CSD faculty and students are on-call on weekends to assess athletes. Of the 40 student athletes who have had concussions, none has needed additional speech-language services as a result. Postseason results Because of this program’s collaborative nature, CSD and EXSS now have a relationship built on trust and respect. We have developed interprofessional learning opportunities for athletic training students and CSD students, and the faculty and students involved have co-authored six presentations and one publication, with more to come. Author Notes Dee M. Lance, PhD, CCC-SLP, is a professor and chair of the Communication Sciences and Disorders Department at the University of Central Arkansas. She is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education; and 10, Issues in Higher Education. 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