Developing and Implementing a Concussion Curriculum in Enhancing Competency

Abstract: Title: Effectiveness of Concussion Curriculum In Enhancing Competency: A Systematic Review
Background and Objectives
Research has identified knowledge gaps among medical trainees on the topic of concussion, but it is still unclear whether such activities affect patient outcomes and knowledge transfer (Provvidenza, 2009). With the shift to competency-based medical education in Canada, there is a need to systematically review and evaluate the effects of concussion curriculum.   We conducted a systematic review to determine the most effective concussion curriculum for enhancing medical trainees’ competency.
Methods
A study protocol was developed and registered in the National Institute of Health Research PROSPERO registry. The report followed the PRISMA guidelines. The studies’ quality was evaluated using the MINORS score, an assessment tool to evaluate non-randomized control trials. We used program evaluation models (Kirkpatrick’s and Miller’s models) to evaluate concussion programs. A comprehensive search strategy utilized 5 bibliographic databases and 11 medical education journals.  To be included, studies were required to report on concussion training received by medical trainees at any point during their medical education or career.  Studies examining concussion curriculum or formal training were included.  Two reviewers screened unique citations for relevance and reviewed the full texts of relevant articles.  Two independent researchers extracted data and assessed methodologic quality. At all stages, a third independent reviewer adjudicated discrepancies.
Results
Overall, 6 studies were included from 1177 references and 4 out of 6 of the studies met 80% quality criteria.  All studies reflected a Competency Miller's Pyramid level 1, which was very different from the traditional program evaluation model.
Discussion/Conclusion
All studies identified a low level of competency demonstrated the limited attention given to competency-focused training.  The current evidence in concussion curriculum development suggests longitudinal repetitive learning experiences with a focus on social workplace learning.