Kean University Study Finds High School Athletic Trainers Would Benefit from Concussion Standards and Education

Athletic trainers make critical early decisions on how to manage potential concussions in high school sports, and could benefit greatly from improved standards and education, a Kean researcher found in a recent study. 

Kean University Assistant Professor James Stavitz, Ph.D., who teaches in the athletic training program, authored a study that found athletic trainers face numerous decisions that would be aided by standardized protocols and defined return-to-play guidelines. 

“One of the primary barriers is the external pressure athletic trainers face from coaches, parents and the athletes themselves to clear the athletes for play as quickly as possible. That pressure often leads to decisions that prioritize short-term performance over long-term health,” Stavitz said. “My research can help overcome those barriers by providing evidence-based goals that athletic trainers can use to make decisions that focus on athletes’ health, not on short-term clearance of athletes quickly.” 

The study was published in the journal Concussion and featured on the blog Headcheck Health. 

Stavitz conducted interviews to identify issues faced by athletic trainers. He found they often deal with considerable pressure from coaches and parents to quickly return student-athletes to the playing field. Many lack access to standardized concussion assessment tools or protocols, and when they refer students for further care, they can’t always find nearby physicians with specialized expertise in concussion management. 

Studies such as Stavitz’s demonstrate Kean’s commitment to research as the University pursues designation as a Carnegie R2 research institution.  

 “Dr. Stavitz's work makes a valuable contribution to sports medicine and is aligned with the mission of our College and Kean's role as an urban research university," said James F. Konopack, Ph.D., dean of Kean’s College of Health Professions and Human Services. "He makes important recommendations to protect the long-term health of our young athletes and improve concussion management in high school athletics.” 

Greater awareness of the pressure faced by athletic trainers and of concussion’s long-term effects on athletes’ health could set the stage for better decision-making among those on the sidelines. Returning athletes to the field too quickly can compromise their neurological recovery, Stavitz said, leading to extended recovery periods and potentially worsening cognitive, physical and emotional health outcomes.  

“It’s important to emphasize the role of collaboration between athletic trainers and schools, and the cooperation and education of coaches, parents and athletes as well,” Stavitz said. “We need to see strong communication among these groups.” 

No two concussions are the same, present the same, or require the same management, according to the study. Because of this, best practices for athletic trainers call for using a multifaceted, multistep approach to managing head trauma — using more than one measure to assess trauma severity and deciding whether to return an athlete to play. 

Athletic trainers’ tools should include a clinical evaluation, symptom checklist, neurocognitive assessment and balance assessment, the study recommends. But in many school athletics settings, limited resources can make it challenging to implement these best practices consistently, which raises important concerns about equity in care. 

Well-established concussion protocols and institutional policies, as well as effective communication, could remove ambiguity and risk from decision making, according to Stavitz. 

“It all comes down to resisting the pressure,” he said. “Once schools adopt certain standards, it becomes easier to follow them.”