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A Method for Concussion Education in a Pediatric Residency Program. Daren Molina, MD, PL-3; Rony Skaria, MD, PL-2, Lizette Gomez, MD University of Texas Health Science Center San Antonio Pediatrics. Introduction (Background and Purpose/objectives ).

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A Method for Concussion Education in a Pediatric Residency Program

Daren Molina, MD, PL-3; Rony Skaria, MD, PL-2, Lizette Gomez, MD

University of Texas Health Science Center San Antonio Pediatrics


(Background and Purpose/objectives)

  • In 2011, the 82nd Texas Legislature passed into law HB 2038, otherwise known as Natasha’s Law. Natasha Helmick was a Texas State University soccer player who suffered from concussions, who championed passage of concussion management reform in Texas. HB 2038, along with similar bills nationwide, have changed the way concussions are diagnosed and managed.
  • With the advent of new concussion legislation, there is a definite learning curve that exists for health care providers in terms of concussion management. There are a large variety of ways that depend on a variety of factors for knowledge of concussions may be disseminated to health care practitioners as well as the general public. 1
  • The goals of this Quality Improvement project were:
  • To create a standard, structured, and effective format for educating pediatric residents on concussions and their management.
  • To create a standard form to document clinic concussion evaluations.
  • To draft a clinic handout to parents/teachers/coaches outlining concussion treatment.


The average percentage of correct answers of the pre test questionnaires was 64%. The average percentage of correct answers of the post test questionnaires was 80%.


This quality improvement project aimed to assess and improve resident education in concussion identification and management. Methods used included an online Blackboard module incorporated into resident education curriculum along with a standardized concussion encounter form that was developed for resident use in the ambulatory clinics. Assessment of resident knowledge was done using a pre/post test questionnaire format. Residents averaged 64% correct in the pre-test and 80% correct in the post test. Educating residents in concussion identification and management with an online module and lecture series improved resident knowledge of concussions.


  • A questionnaire was complete by residents prior to the module.
  • Residents were then later told to complete the online portion of the module (reading of AAP Concussion Clinical Report and the 2008 Concussion Guidelines, online video demonstrations).
  • An short interactive learning session was then held once the online modules were complete.
  • Residents were then given the evaluation form and parent/school official letter to use when seeing concussed patients.
  • The same questionnaire was completed as a post test.


  • Based on an evaluation our collected data, there was documented improvement in resident knowledge in concussion identification and management after completing the educational module. However, the study was limited by the difficulty of collecting accurate data from every resident. There was also not a method for evaluating objective data such as what residents thought of the evaluation for and the parent/school official letter.
  • Next Steps:
  • Develop a more accurate way of data collection, perhaps using electronic means.
  • Evaluate objective opinion of the encounter form and school official/parent letter.
  • Incorporate the new 2012 Concussion Consensus Statement into the module, including SCAT3 and Child SCAT.


Provvidenza C, Engebretsen L, Tator C, et al. From consensus statement to action: knowledge transfer, education and influencing policy on sports concussion. British Journal Sports Medicine, 2013; 47: 332-338.

Halstead M, Walter K, et al. Clinical Report – Sport Related Concussion in Children and Adolescents. Pediatrics, 2010; 126: 597-615.

McCrory P, Meeuwisse W, Johnston K, et al. Consensus Statement of Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. British Journal of Sports Medicine, 43: i76-i84.

UIL HB 2038 Implementation Information. (2011). Accessed March 2012.

Sport Concussion Assessment Tool 2.wmv. Accessed March 2012.

BESS Introduction. Accessed March 2012.

Concussion Guidelines for the Coach/Trainer. Accessed March 2012.

2012 Texas Pediatric Society Electronic Poster Contest