University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Doctoral Dissertations Graduate School 12-2016 Post-Concussion Experiences of Collegiate Student-Athletes Kaitlin Iris Singer University of Tennessee, Knoxville, [email protected] Follow this and additional works at: https://trace.tennessee.edu/utk_graddiss Part of the Disability and Equity in Education Commons, Education Policy Commons, Health Policy Commons, Higher Education Commons, Higher Education Administration Commons, Neurology Commons, Neurosciences Commons, Sports Medicine Commons, and the Sports Sciences Commons Recommended Citation Singer, Kaitlin Iris, "Post-Concussion Experiences of Collegiate Student-Athletes. " PhD diss., University of Tennessee, 2016. https://trace.tennessee.edu/utk_graddiss/4167 This Dissertation is brought to you for free and open access by the Graduate School at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Doctoral Dissertations by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council: I am submitting herewith a dissertation written by Kaitlin Iris Singer entitled "Post-Concussion Experiences of Collegiate Student-Athletes." I have examined the final electronic copy of this dissertation for form and content and recommend that it be accepted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, with a major in Higher Education Administration. J. Patrick Biddix, Major Professor We have read this dissertation and recommend its acceptance: Mary Lynne Derrington, Dorian L. McCoy, Robin Hardin Accepted for the Council: Carolyn R. Hodges Vice Provost and Dean of the Graduate School (Original signatures are on file with official studentecor r ds.) Post-Concussion Experiences of Collegiate Student-Athletes A Dissertation Presented for the Doctor of Philosophy Degree The University of Tennessee, Knoxville Kaitlin Iris Singer December 2016 ii Copyright © 2016 by Kaitlin Iris Singer All rights reserved. iii Dedication To all the student-athletes that have or will experience a concussion. Especially, to the seven former student-athletes that honored me and those that read this with their stories. iv Acknowledgements I would like to sincerely thank my advisor, Dr. Patrick Biddix, for providing me with the flexibility, opportunity, and support to pursue a topic I was interested in. Thank you Dr. B for continually providing new challenges and diverse experiences as your Graduate Research Assistant. I would also like to thank my committee members Dr. McCoy, Dr. Derrington, and Dr. Hardin. Their questions, feedback, and guidance enhanced my understanding of the research, as well as, improved my skills as an independent scholar. I am very grateful for the HEA faculty for not only accepting a geologist into their doctoral program but for opening my eyes to the world of research involving human- subjects through quantitative and qualitative research. I have learned so much from my committee members, Dr. Mertz, Dr. Ishitani, Dr. Boyd, Dr. Carver, and Dr. Cuevas. I would also like to thank the HEA staff, Vikki, Wade, Constance, and Janie, for their kindness and assistance throughout my four years in the department. Thank you to my colleagues and classmates who have taught me so much about the wide range of issues and opportunities in education. Specifically, I would like to thank Dr. Brian Hester for introducing me to institutional research. I sincerely thank Dr. Dennis Hengstler for his mentorship and providing an excellent internship opportunity for experientially learning about institutional research. I would also like to acknowledge Lucy Kniseley, N.P. and Rebecca Morgan, M.D. from the University of Tennessee Student Health for their help and guidance during the initial development of this study. v I was fortunate to meet Dr. Sarah Helm who introduced me to the field of higher education administration. I am grateful to Dr. Ron Fodor and Dr. Larry McKay for supporting my change from planetary geology to academic leadership. I owe my sincere gratitude to Dr. Ron Fodor, my first mentor, for shaping me into a scientist and showing me how to conduct research, teach, and be a scholar. I want to thank my friends and family who provided support and inspiration. I have an immensely thoughtful and caring support network. Thank you for always supporting me either by showing interest in my work or respite when I needed. Special thanks to Charlie Pierce, J.D. for proofreading my dissertation and Flavius Dragila, M.D. for reviewing the medical content for accuracy and completeness. I cannot thank Dr. Stephen Kelley enough for countless hours of listening to my thoughts and frustrations. Our discussions challenged and enriched my ideas. Thank you Stephen for always knowing what to say and how best to support me through the dissertation process. I also would like to thank my grandmother, Nonnie, for keeping me company while I would read my draft or needed to brainstorm out-loud. Thank you for your unconditional love and support. I would especially like to thank my siblings and parents. I will always be grateful to Petey, Rob, and Laurie for continuous support, inspiration, and help in understanding the life of a student-athlete. I am so thankful for my mom’s expertise; particularly, translating difficult medical concepts for a geochemist. I am blessed to have your help, support, and love. Thank you Mom and Dad for the unparalleled encouragement and constant support during my academic career and throughout my life. vi Most of all, I am truly grateful for the gatekeepers and participants that made this study possible. While I cannot name the wonderful individuals to protect their privacy, I want them to know they have changed my life for the better. Thank you for opening your hearts and trusting me to tell your story. It was an honor. vii Abstract Sports-related concussions are a major public health concern affecting a significant number of collegiate student-athletes. Medical and public health research has addressed every aspect of concussion management processes including concussion education, medical diagnosis, recovery, and returning to sport and classroom. This research has led to several best-practices for concussion management. Since 2010, the NCAA has mandated that its member institutions maintain concussion management policies and procedures. However, the current recommendations, based primarily on medical research, have been found in quantitative studies of the behaviors and practices of athletic trainers, coaches, and student-athletes to be ineffective. To date, no studies have explored the perceptions and experiences of student-athletes post-concussion. The purpose of this study was to understand student-athletes’ experiences post-concussion and how their experiences compared to concussion management policy. A qualitative research design was utilized to allow for an in-depth understanding of the student- athlete’s perspective on concussion management. Data were collected from interviews with seven current and former NCAA student-athletes from five member institutions representing Division I football, lacrosse, men’s soccer, women’s soccer, Division II football, and Division III football; and from publicly obtained concussion management documents. The data were analyzed using Tesch’s (2013) organizing system and Love's (2003) methods for document analysis. Eight major findings emerged from the data: 1) Symptomology and its effects, 2) Pressure to return, 3) Lack of Knowledge, 4) Inadequate support, 5) No rest, 6) No policy, 7) Double-injury, and 8) Inconsistent viii alignment between student-athletes’ experiences and their institution’s concussion policies. None of the student-athletes’ experiences aligned with the current best-practices in concussion management. Recommendations for cultural change, NCAA practices, and higher education practices include using warning messaging and PSAs, applying effective preseason education, enforcing implementation of concussion management guidelines, leveraging media partnerships, investing in concussion specialists, and creating a team of support. ix Table of Contents Chapter 1. Introduction .................................................................................................... 1 Statement of the Problem ............................................................................................. 8 Purpose of the Study .................................................................................................. 10 Research Questions ................................................................................................... 11 Theoretical Framework .............................................................................................. 11 Significance ............................................................................................................... 13 Terminology .............................................................................................................. 14 Chapter 2. Literature Review ......................................................................................... 17 Short- and Long-Term Effects of Concussions ........................................................... 18 Definitions. ............................................................................................................ 18 Signs and symptoms. ............................................................................................