Background: Sport-related concussions (SRC) are common injuries that athletic trainers (ATs) often handle initially. They receive training through accredited programs, which follow specific standards set by organizations like CAATE and NATA. New CAATE standards in 2020 focus on SRC assessment and management. However, not all ATs, especially those not supervising students (non-preceptors), may be aware of these updates, leading to gaps in practice. SRC symptoms vary and require thorough assessments beyond just asking about symptoms. Despite guidelines, many ATs still rely on outdated tools and treatments. Preceptors, who guide student ATs, face challenges in staying updated on new standards, particularly with recent curriculum changes. By categorizing experience into 0-5 years and 6 or more years, we aim to understand how familiarity with standards evolves over time. Purpose: The purpose of this study was to determine if certified ATs who are preceptors are using 2020 CAATE standards for concussion assessment and management. Secondarily, to examine if years of experience as an AT is associated with utilization of the new CAATE standards for concussion assessment and management. Methods: A cross-sectional study investigated concussion assessment and management practices among certified ATs. A random sample of 1000 active NATA members was recruited, excluding those who didn't consent. The survey, adapted from previous research, included demographic questions and assessment of concussion practices aligned with 2020 CAATE standards. Face and content validity were established through expert review and pilot testing. Data was collected online and in paper format over four weeks. Descriptive statistics and regression analysis were used to analyze the data, testing hypotheses related to the utilization of CAATE standards for concussion assessment and management. Logistic and multinomial logistic regression were employed to assess associations between preceptor status, years of experience, and utilization to CAATE standards. Results provide insights into AT adherence to standards in concussion management. Results: The pilot study, conducted on June 8-9, 2023, involved 24 certified athletic trainers (ATs), consisting of 58.3% females and 41.7% males. Among them, 79.2% were preceptors, and 20.8% were non-preceptors, with a mean age of 47.4 ± 13 years. The majority identified as white (87.5%), followed by black or African American (8.3%) and mixed race (4.2%). High school athletics, DI college athletics, and DII college athletics were the primary places of employment. However, logistic regressions were not completed due to the low number of non-preceptor respondents, and the pilot study focused on establishing face validity. In the main study, 298 certified ATs participated, with 61.7% females and 38.2% males. The mean age was 36.6 ± 11 years, with the majority identifying as white (90.5%). High school athletics, DI athletics, and academic settings were the top employment venues. Logistic regression analyses revealed significant associations between preceptor status and the utilization of CAATE standards for concussion assessment and management. Preceptors demonstrated higher odds of utilizing CAATE standards, particularly in diagnostic practices (standard 76), plan of care implementation (standard 76), and policy (standard 93) utilization for concussion management. The multivariable multinominal logistic regression results indicated significantly higher odds among preceptors for utilizing diagnostic and plan of care items compared to non-preceptors. Logistic regression analyses showed that ATs with 6+ years of experience had higher odds of utilizing CAATE standards for concussion assessment and management compared to those with 5 years or less of experience specifically with diagnosis, plan of care, and policy items. Overall, the final model results suggest that preceptorship and years of experience play significant roles in the utilization to CAATE standards for concussion assessment and management among certified ATs, highlighting the importance of mentorship and experience in promoting best practices within the athletic training field. Conclusion: This study aimed to assess the utilization of 2020 CAATE standards for concussion assessment and management among ATs acting as preceptors, while also exploring the potential influence of years of experience on their adoption of these standards. The results indicate that preceptors have higher odds of utilizing CAATE standards compared to non-preceptors, demonstrating a higher utilization of diagnostic, plan of care, return-to-play, and policy items. Additionally, ATs with six or more years of clinical experience also showed higher odds to updated standards. These findings emphasize the crucial role of mentorship in promoting best practices within the athletic training profession, fostering excellence and accountability in concussion management. However, limitations such as potential response bias and the need for further research to explore mentorship dynamics and address potential barriers to utilization of CAATE standards should be acknowledged.
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