Department of Human Movement Sciences, Carroll University, Waukesha, WI.
Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory, Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute.
J Athl Train. 2020 Apr;55(4):365-375. doi: 10.4085/1062-6050-116-19. Epub 2020 Feb 13.
Postconcussion, student-athletes should return to the classroom using a gradual, stepwise process to ensure that symptoms are not exacerbated by cognitive activities. The National Collegiate Athletic Association (NCAA) has mandated that its affiliated institutions develop return-to-learn (RTL) policies to support the return to the classroom.
To investigate athletic trainers' (ATs') perceptions of their role in the RTL policy development and implementation at NCAA Division II and III institutions.
Qualitative study.
Individual phone interviews.
Fifteen ATs (age = 40 ± 11 years, clinical practice experience = 16 ± 9 years, employment term = 9 ± 9 years) representing NCAA Division II (n = 6) or III (n = 9) institutions.
Interviews were transcribed verbatim and checked for accuracy by the principal investigator. A 2-member data-analysis team independently coded a portion of the transcripts and then met to discuss the codebook. The codebook was applied to the remaining transcripts, confirmed, and externally reviewed.
Five themes emerged: (1) approach, (2) collaborative practice, (3) patient advocacy, (4) institutional autonomy, and (5) barriers. Policies must allow for an individualized, evidence-based approach through facilitated, active communication among members of the RTL team and the student-athlete. Collaborative practice was described as key to successful policy implementation and should include interprofessional collaboration beyond health care providers (eg, educating academicians about the purpose of RTL). The RTL process was triggered by a specific member of the RTL team, usually a medical doctor or the head AT. Participants noted that the purpose of the RTL policy was to advocate for the student-athlete's successful postconcussion outcomes.
For the development and implementation of a successful RTL policy, strong communication and interprofessional practice must extend beyond health care professionals. Members of the health care team must establish a network with academic partners to develop a policy that is appropriate for the institution's available resources and the needs of its student-athletes.
脑震荡后，学生运动员应采用逐步、渐进的方式返回课堂，以确保认知活动不会加重症状。美国大学体育协会（NCAA）已要求其附属机构制定“返回学习”（RTL）政策，以支持学生运动员返回课堂。
调查运动训练师（AT）对其在 NCAA 二级和三级机构 RTL 政策制定和实施中的角色的看法。
定性研究。
单独的电话访谈。
15 名 AT（年龄=40±11 岁，临床实践经验=16±9 年，就业年限=9±9 年），代表 NCAA 二级（n=6）或三级（n=9）机构。
访谈记录逐字转录，并由首席研究员进行准确性检查。一个由 2 名成员组成的数据分析小组独立对部分转录本进行编码，然后开会讨论编码本。该编码本应用于其余的转录本，得到确认并进行外部审查。
出现了 5 个主题：（1）方法，（2）协作实践，（3）患者倡导，（4）机构自主权，（5）障碍。政策必须允许通过 RTL 团队成员和学生运动员之间的促进、积极沟通，采取个性化、基于证据的方法。协作实践被描述为成功实施政策的关键，并且应该包括医疗保健提供者以外的专业人员协作（例如，教育学者了解 RTL 的目的）。RTL 过程由 RTL 团队的特定成员触发，通常是一名医生或首席 AT。参与者指出，RTL 政策的目的是倡导学生运动员在脑震荡后取得成功。
为了制定和实施成功的 RTL 政策，必须加强医疗保健专业人员之间的沟通和协作实践。医疗团队成员必须与学术合作伙伴建立网络，制定适合机构可用资源和学生运动员需求的政策。
