Faculty Bibliography

OBJECTIVE:Orthobiologics are increasingly sought-after interventions in sports medicine for treatment of musculoskeletal injuries and conditions. Despite this trend, differences exist across sports medicine fellowship programs regarding foundational knowledge, educational curricula, and practical experience with orthobiologic therapies (eg, platelet-rich plasma, bone marrow aspirate concentrate, microfragmented adipose tissue). This represents an important educational gap for those training in sports medicine fellowships. To address this gap, an educational toolkit was envisioned with the sports medicine fellowship director and trainee in mind. DATA SOURCES/METHODS:Collective observations from physician experts in sports medicine education established the variations in curricula and expertise of graduating fellows. A literature review was conducted to source English-language peer reviewed articles from the online PubMed database. The scope of this project did not include an independent systematic analysis or statistical assessments. MAIN RESULTS/RESULTS:An educational toolkit consisting of 12 adaptable modules was developed, each with a suggested reading list from the published literature. The modules may be rearranged to support each program's learning schedule. The information and lessons contained herein may be valuable to all healthcare providers interested in the evidence-based application of orthobiologics and insightful interpretation of related research. CONCLUSIONS:By implementing an educational toolkit, sports medicine fellowships may improve the quality of education on orthobiologics. This is intended to improve the knowledge and skill set of fellowship graduates, thus promoting the scientific, responsible use of orthobiologic interventions.

Purpose: The purpose of this study was to review the patient education practices of concussion specialists in a multidisciplinary concussion center. By understanding common education practices, we can work towards improving post concussion management and patient centered outcomes.
Method(s): Retrospective chart review on 104 patients who underwent initial concussion evaluations by 26 providers (Primary Care Sports Medicine, Neurology and Physiatry) at a large, urban, academic institution from January 2020 to March 2021. Patient education was documented as verbal counseling, written handouts, both, or neither. Eleven categories of patient education were included in the analysis.
Result(s): 104 provider charts were included in the results. 71% of patients were seen in the subacute setting (4-90 days after initial injury). Of the charts included, 81% documented verbal education, 35% provided written education, 32% documented both verbal and written education and 12% had neither verbal or written education documented. With regards to the eleven categories of patient education documented, 74% of patients were educated on physical activity, 69% on concussion, 44% on rest breaks, 38% on mental activity, 38% on medication, 37% on sleep, 25% on mood, 14% on return to work, 12% on return to school, 3% on driving and 2% on alcohol and recreational drug use. Of the 46/104 charts with documented education on rest, 41% were Neurologists, 32% were Physiatrists and 26% were Primary Care Sports Medicine doctors.
Conclusion(s): We identified that verbal education is significantly more common than written education and that post concussion activities are often addressed at the initial visit. This result could be due to attempts at individualizing care. However, there are studies that suggest the most successful post concussion education materials are interactive and utilize more than one modality to present information.
Significance: This retrospective study helps identify areas where post concussion patient education may be lacking. Moving forward providers can utilize this information to improve on tools for patient education and improve patient centered outcomes

Purpose: The purpose of this study was to assess therapy referral patterns and documentation of services offered during the initial concussion evaluation in hopes of educating clinicians and standardizing concussion management in a large multidisciplinary concussion center.
Method(s): A retrospective analysis was performed on 104 patients who underwent initial concussion evaluations in a large, urban, academic institution from 1/2020-3/2021. Clinician specialty included PM&R, Neurology and Sports Medicine. Data collected included whether or not patients were referred to therapy services, what types of therapy services were offered and documentation of referrals.
Result(s): Of the patients analyzed, 52% of patients seen for the initial concussion evaluation were referred to therapy services. Of these, referrals to physical therapy were placed 52% of the time, vestibular therapy 22%, psychology 21%, occupational therapy 17% and speech and language pathology 2%. 94% of therapy referrals were documented. Of those documented, 39% were referred to one service, 34% to two services and 26% to three or more services. 71% of patients received therapy referrals within 4 to 90 days from the initial injury. Only 11% of those who suffered from concussion had seen a physician for referral within the first three days of the acute injury.
Conclusion(s): Concussion management warrants a multi-disciplinary approach to symptom management and treatment. Patients with a history of concussion can present to a variety of physicians. Thus, understanding how to minimize symptom burden and offer appropriate therapies must be standardized across specialties to optimize patient outcomes. Patients with persistent symptoms require a more individualized treatment approach that should be appropriate and timely.
Significance: This research helps to clarify concussion therapy referral patterns, an important step in standardizing concussion management across specialties, with the ultimate goal of optimizing treatment outcomes