Return to Learn for the Kindergarten Through 12th-Grade Student: A Mixed-Methods Systematic Review
Year: 2024
Type: review
Study design: Systematic Review
Abstract: Background In the adolescent population, concussion has the potential to disrupt brain development, resulting in altered health, cognition, learning, self-regulation, social skills, and other factors important in their transition to adulthood. Although initially underresearched, attention toward school reintegration and a smooth transition back to the classroom after concussion has morphed into a critical component of postconcussion care, yet several gaps in knowledge and inconsistencies in recommendations remain. Objective To determine what items are necessary to form a comprehensive return-to-learn (RTL) policy. Design Systematic review. Data Sources We searched CINAHL, Embase, PubMed, Scopus, Google Scholar, and WorldWideScience.org databases using 25 search terms, including return to learn , adolescents , concussion management , concussion AND children , concussion AND department of education , concussion AND secondary schools , concussion AND middle school , concussion AND primary school , concussion AND policy AND procedures , and concussion AND 504 plans . Study Selection Eligible studies (1) were published between 2009 and 2022; (2) were originally published in English in a peer-reviewed journal; (3) had full text available; (4) discussed the kindergarten through 12th-grade population; (5) contained 1 of the following terms in the body of the document: return-to-learn , RTL , return to school , return to classroom , or return to academics ; and (6) identified RTL as a primary aim of the study. Data Extraction Two researchers independently extracted data from eligible studies using the Qualitative Assessment and Review Instrument and Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument tools. Data Synthesis A segregated or separate synthesis was conducted for quantitative and qualitative data. A meta-aggregative approach was taken for qualitative data synthesis. Quantitative data were connected via narratives instead of meta-analyses per the JBI recommendations. The segregated design involved convergence of evidence using configuration. We assessed methodologic quality of quantitative articles using JBI tools and qualitative articles using the ConQual tool. Results Our review yielded 32 981 articles, with 58 meeting inclusion criteria. Two qualitative themes and 5 subthemes aggregated with 6 quantitative narratives to produce the following 5 converged findings: (1) members and point person, (2) overcoming barriers to communication, (3) increasing concussion knowledge and training in the school system, (4) recommendations in the classroom, and (5) tackling the invisible injury. Conclusions Fewer than one-third of included articles reported data from younger (kindergarten through eighth grade) cohorts; therefore, the converged findings represent important facets of high school RTL that stakeholders should embed in novel and revised state concussion legislation. Subsequent efforts should be undertaken to appraise current state RTL laws for existing use of evidence-based practice and begin accumulating data specific to younger students and school professionals who monitor and teach these individuals such that commensurate policy recommendations can be made.
Source: Journal of Athletic Training
Authors: Molly Dieball, Sophie Grant, Jackie Kingma, Keisuke Kawata, Zachary Bevilacqua
Institutions: Indiana University Bloomington, Indiana University, SUNY Brockport
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4404982242