Schoolteachers' and Administrators' Perceptions of Concussion Management and Implementation of Return-to-Learn Guideline.

BACKGROUND: Concussions are a public health concern and concussion management in school requires a team approach. We examined schoolteachers' and administrators' perceptions of concussions, management, and implementation of return-to-learn (RTL) guidelines. METHODS: We audio-recorded and transcribed semistructured interviews with teachers (N = 16) and administrators (N = 6) from a public school system. We analyzed data using an analytic induction and constant comparison approach. RESULTS: Two themes emerged: different understanding, and school context. Participants with no sport coaching experience were less familiar with concussions than those who coached a sport. Participants with personal experience with concussions were more sympathetic toward concussed students' needs. Teachers expressed feeling ill-equipped to implement RTL guidelines without specific instructions in the complex school environment. However, school administrators had minimal understanding of teacher-described challenges. CONCLUSIONS: Teachers and administrators recognize that concussions are a health concern, but differ in their perceptions of concussions, management, and implementation of RTL guidelines. Personal experiences mediate individual perceptions about concussions. The daily realities of a school environment complicate teachers' capacity to implement RTL guidelines. Conversely, school administrators did not express awareness of any challenges with concussion management. To best facilitate students' recovery schools should include all stakeholders when devising concussion management policies.