Recommendations for Medical Discharge Documentation and Academic Supports for University Students Recovering From Concussion

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Journal of Head Trauma Rehabilitation


Objective: 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. Setting: Remote semistructured interviews and online surveys. Participants: 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. Design: An exploratory-sequential mixed-methods approach. Main Measures: 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. Results: 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). Conclusions: 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.

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