Memmini Allyssa K, Popovich Michael J, Schuyten Kristen H, Herring Stanley A, Scott Katie L, Clugston James R, Choe Meeryo C, Bailey Christopher M, Brooks M Alison, Anderson Scott A, McCrea Michael A, Kontos Anthony P, Wallace Jessica S, Mihalik Johna K Register, Kasamatsu Tricia M, McLeod Tamara Valovich, Rawlins Michelle L Weber, Snedden Traci R, Kaplan Matthew, Akani Briana, Orr La'Joya C L, Hasson Rebecca E, Rifat Sami F, Broglio Steven P
Concussion Center, University of Michigan, Ann Arbor, Michigan (Drs Memmini and Broglio); Department of Health, Exercise & Sports Sciences, University of New Mexico, Albuquerque, New Mexico (Dr Memmini); Department of Neurology, University of Michigan, Ann Arbor, Michigan (Dr Popovich); MedSport Physical Therapy, Michigan Medicine, Ann Arbor, Michigan (Dr Schuyten); Rehabilitation Medicine, University of Washington, Seattle, Washington (Dr Herring); Behavioral Medicine, Brooks Rehabilitation, Jacksonville, Florida (Dr Scott); Department of Community Health & Family Medicine and Department of Neurology, University of Florida, Gainesville, Florida (Dr Clugston); Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California (Dr Choe); Department of Neurology, Case Western Reserve School of Medicine/University Hospitals, Cleveland, Ohio (Dr Bailey); Department of Orthopedics & Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin (Dr Brooks); Department of Athletics, University of Oklahoma, Norman, Oklahoma (Mr Anderson); Center for Neurotrauma Research, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin (Dr McCrea); Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Kontos); Department of Health Science, The University of Alabama, Tuscaloosa, Alabama (Dr Wallace); Matthew Gfeller Center and STAR Heel Performance Laboratory, Department of Exercise and Sport Science, The University of North Carolina Chapel Hill, Durham, North Carolina (Dr Mihalik); Department of Kinesiology, California State University, Fullerton, California (Dr Kasamatsu); Athletic Training Programs, A. T. Still University, Mesa, Arizona (Dr McLeod); School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California (Dr Rawlins); School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin (Dr Snedden); Center for Research on Learning & Teaching, University of Michigan, Ann Arbor, Michigan (Dr Kaplan); College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, Michigan (Ms Akani); School of Kinesiology, University of Michigan, Ann Arbor, Michigan (Ms Orr and Dr Hasson); and University of Michigan Athletics, Michigan Medicine, Ann Arbor, Michigan and Department of Orthopaedics, Cleveland Clinic, Cleveland, Ohio (Dr Rifat).
J Head Trauma Rehabil. 2023;38(4):E299-E311. doi: 10.1097/HTR.0000000000000816. Epub 2022 Oct 14.
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.
Remote semistructured interviews and online surveys.
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.
An exploratory-sequential mixed-methods approach.
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.
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).
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.
本研究旨在（1）通过访谈整理有脑震荡病史的大学生和学术利益相关者的经历，以及（2）使用多学科德尔菲程序为高等院校制定脑震荡管理建议。
远程半结构化访谈和在线调查。
本研究的首要目标包括有脑震荡病史但未参加大学体育代表队的本科大学生（n = 21；57.1%为女性），以及有协助大学生满足脑震荡后学业需求经验的学术教职员工（n = 7；71.4%为女性）。第二个目标招募了22名参与者（54.5%为女性）加入德尔菲小组，其中包括9名临床医生、8名研究人员和５名学术教职员工。
探索性序列混合方法。
进行半结构化访谈以揭示脑震荡后复学过程中的障碍，浮现出的主题作为德尔菲程序的总体框架。小组成员参与了改进的德尔菲程序的三个阶段，从一系列关于高等教育中脑震荡后管理的开放式问题开始。第二阶段包括对建议进行匿名评分，然后有机会根据小组共识审查和/或修改回答。
半结构化访谈结果表明，学生感到得到了教师的支持；然而，学术教职员工缺乏关于适当学术支持和/或促进复学过程途径的信息。在最初的67条陈述中，39条在德尔菲程序结束时达成了共识（58.2%），分为三个主要类别：出院文件的建议（21条陈述）、促进多学科复学方法的指南（10条陈述）以及为脑震荡后需要帮助的学生获得学术支持的流程（8条陈述）。
这些发现为高等教育未来的政策奠定了基础，以便为脑震荡后可能需要学术支持的学生规范复学流程。
