Questionnaire: An ECHO for Concussion 

What is Project ECHO Ontario? Project ECHO (Extension for Community Healthcare Outcomes) is a learning and guided practice model that revolutionizes medical education and exponentially increases workforce capacity to provide best-practice specialty care and reduce healthcare disparities.

Project ECHO utilizes video web-conferencing to connect community healthcare providers with an expert inter-professional team at an academic/hospital setting. Each session involves a short didactic lecture by the inter-professional team or invited experts, real case presentations by primary care providers and delivery of treatment recommendations for the particular case(s) presented.

For the proposed Concussion ECHO, healthcare providers with considerable clinical experience and knowledge of concussion will present a CME accredited curriculum combined with presentation of challenging cases and group discussion. It will involve a 15-week program of 90 minute sessions via web-conferencing.

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* 1. Please choose your profession and enter your specialty if appropriate:

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* 2. How many years have you practiced?

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* 3. Where in Ontario is your practice currently located?

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* 4. Do you see patients with concussion? 

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* 6. What is your confidence level for the following:

  High Medium Low
Diagnosing the presence of a concussion
Managing acute symptoms of concussion
Identifying when concussion symptoms become persistent (i.e., when a patient has "post-concussion syndrome")
Managing persistent post-concussion symptoms: headaches, sleep-wake disturbance/fatigue, mood problems, cognitive problems, vision/vestibular disturbances, communication problems
Knowing when to refer to other healthcare professionals to provide treatment and symptom management
Using Ontario Neurotrauma Foundation's "Guidelines for Concussion/Mild Traumatic Brain Injury and Persistent Symptoms", and the "Standards for Post-Concussion Care"
Advising patients on when and how to return to sport, school or work
Advising patients regarding the effects of multiple concussions
Answering questions from patients regarding potential long-term effects of concussions and possible links to accelerated aging and dementia
Supporting concussion patients across the age continuum, (i.e., children/youth, adults, elderly)

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* 7. Are you interested in further training in any/all of the above through an ECHO forum?

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* 8. Please rate your interest in the following topics:

  Extremely interested Very interested Somewhat interested Slightly interested Not interested
Diagnosing the presence of a concussion
Managing initial symptoms of concussion
Identifying Persisting Symptoms / Post-Concussion Syndrome
Managing persistent post-concussion symptoms
Referring appropriately to other healthcare professionals for treatment and symptom management
Advising patients on when and how to return to sport, school or work
Advising patients regarding the effects of multiple concussions
The potential long-term effects of concussions and possible links to accelerated aging and dementia
Clinical practice guidelines for concussion and standards for post-concussion care
Children/Youth concussion
Adult concussion

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* 9. Sessions are typically 1.5 hours at lunchtime. A full curriculum involves 3 modules of 5 sessions each. Would you be willing and able to commit to 1, 2, or 3 modules?

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* 10. What is your preferred frequency of sessions?

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* 11. Do you think you would be interested in presenting a case that you find challenging and/or interesting during the ECHO program?

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