Portfolio Project

EDUC 765: Trends and Issues in Instructional Design

By: Danielle Lueck
Modified
11/22/2016

PROJECT PROPOSAL MODULE 2

Project Title
Concussion Education

Sponsoring Organization
Major Health Care System in Wisconsin (Company A)
Company As mission is to help people be well. Sports Medicine Institute
(SMI) is part of Company A. SMI consists of clinics located throughout
Southeastern Wisconsin that provide preventative and rehabilitative care of
orthopedic and sports injuries. SMI also provides team medical coverage to
over 35 high schools, colleges, and professional sports team.

Project Description
Mild Traumatic Brain Injuries (mTBI), or concussions, are now at the forefront of daily news.
Concussions not only have an immediate effect on an individual, but can also leave long-term
deficits or even death if not proper treated. Research studies are rapidly advancing the
knowledge in this area. As more information is revealed, legislature in many states is being
passed requiring proper management and education of concussions. Professional organizations
have released consensus statements highlighting the importance of educating athletes, parents,
coaches, administrators, and other healthcare professionals regarding the detection of
concussion, its clinical features, assessment techniques and principles of safe return to play.
An athletic trainer with pre-existing relationships at the high school level has
the best opportunity to educate coaches, parents, and athletes regarding
concussions. Based on the goals, the opportunities of training athletes,
parents, and coaches regarding concussions include the following:
Describe what a concussion is and how it occurs
Identify signs and symptoms of a concussion
Understand what tools or procedures medical professionals are able to
use to identify a concussion
Discuss the repercussions of participating with a concussion
Discuss the return to learn progression in an academic environment
Discuss the return to participation protocol after a concussion
Discuss long term effects of repeated concussions

Aim
Increase concussion reporting through improved concussion education presented to athletes,
coaches, and parents.

Target Audience
The primary audience is composed of both male and female student-athletes ages 14-to-18 years
old. These student-athletes are at a high risk of injury due to athletic participation. Athletes that
are educated in concussion identification and management will have a greater likelihood of
reporting symptoms to medical personnel.
Other audiences include parents/guardians and coaches. Since high school student-athletes are
often at various stages of adolescent development these individuals will have a wide range of
both cognitive as well as social-emotional development. Due to this, proper education and
monitoring by adults is crucial to student-athlete wellness.
Students not participating in athletics, parents/guardians of these students, and high school
faculty members will be allowed to attend voluntarily. Since concussions are not exclusive to
sport, some students may feel that they will benefit from the additional knowledge. Faculty
members may find benefit in attending because concussions often have an impact on academic
participation.

Delivery Options
The instruction for this project will be delivered via a blended format. First, an online module
will be completed with a pretest and posttest. Portions of this module can be specialized based
on sport and audience (student-athlete versus adult). Face-to-face classroom instruction will be
tailored to cover topics or elements of concussion education requiring more attention. Blended
learning improves efficiency and assists in personalizing learning to the individuals. This format
will allow for both limited classroom space as well as time constraints.

FRONT-END ANALYSIS: INSTRUCTIONAL NEED MODULE 3

Instructional Need
Concussions have become a significant presence in youth sports today. Gessel, Fields, Collins,
Dick, & Comstock (2007) estimate that approximately 7 million high school students
participating in sports every year. The estimated rate of reported concussions in high school
sports is 300,000 per year (Marar, McIlvain, Fields, & Comstock, 2012). Many studies (Sye,
Sullivan, & McCrory, 2006; Guilmette, Malia, &McQuiggan, 2007; Valovich McLeod,
Schwartz, &Bay, 2007; McCrea, Hammeke, Olsen, Leo, & Guskiewicz, 2004) recognize that
concussions in youth sports are under-reported. A 2004 study by McCrea et al. found that only
47% of the athletes reported their concussion; and, furthermore, these individuals had a poor
understanding of the ramifications of a concussion. Wisconsins concussion Law Act 172 Statute 118.293 requires that all youth athletic organizations provide coaches, athletes, and
parents/guardians with educational materials on the risks of concussions and head injuries. This
law also prohibits participation in a youth activity until the athlete and parent/guardian has
returned a signed agreement sheet indicating they have reviewed the concussion and head injury
informational materials. Furthermore, the law also dictates that an athlete with a suspected head
injury or concussion be removed from play. This athlete must be evaluated by a health care
provider and receive clearance before returning to participation.
Area high school athletic departments have been relying on athletes and parents/guardians to
review provided educational information online and then submit a signed agreement form. A
study by Chrisman, Schiff, Chung, Herring, & Frederick (2014) found that one-third of athletes
and more than half of parents do not receive any additional concussion education beyond signing
the concussion information form. It has been noted on many occasions that concussed athletes
and their parents/guardians seem to be unaware of the state law as well as the information
provided in these educational materials. McCrea et al. (2004) also found that the amount of
concussion education coupled with a coachs attitude regarding concussions had a direct impact
on athletes reporting symptoms of a concussion. This limited concussion education exposure
potentially contributes to a coachs, athletes, or parents/guardians failure to recognize and
report a concussion.
The Centers for Disease Controls Heads Up program (2015) recommends that schools
include the following in their concussion policy: an emphasis on a commitment to safety,
concussion facts, a plan for returning concussed athletes to the high school environment
academically and socially, and information on returning to physical activity after a concussion.
A goal analysis with a small group of key stakeholders (athletic director, physician, coaches,
parents/guardians and teachers) will be utilized to identify instructional knowledge gaps relating
to this felt need of an existing performance problem. Register-Mihalik, Linnan, Marshall,
Valovich McLeod, Mueller, & Guskiewicz (2013) recognized that concussion education should
concentrate on fostering positive attitudes and beliefs among athletes, coaches and parents to
increase care-seeking behavior among athletes. An emphasis on concussion signs/symptoms, the
negative effects of concussions, and returning to school and athletic participation will be
primarily focused upon.

FRONT-END ANALYSIS: LEARNER CHARACTERISTICS

MODULE 3
Learner Analysis
Primary Audience (mandatory training)
Student-athletes
Parents or guardians of student-athletes
Coaches
Secondary Audience (voluntary training)
High school faculty members
Students not participating in athletics
Parents/guardians of students not participating in athletics
General Learner Characteristics
Student-athletes
o Ages 14-18 years old
o Education (https://apps2.dpi.wi.gov/sdpr/district-report.action)
HS ACT composite 25.8
HS attendance 96.8%
HS 96.5% plan on attending a 4 year college
o Grade 6-12 athletic participation: 38.5%
o Concussion experience: Some student-athletes have already
had concussions during their sport career, or have had a
sibling that has experienced a concussion. Older studentathletes may be aware of the prevalence of concussions in the
news. WI state law requires that athletic organizations
provide concussion and head injury educational materials for
review. A signed form must be turned in prior to the start of
the sport season stating that the information has been
reviewed.
Adults (parent, guardians, coaches, faculty)
o Ages 20-65 years old
o Education: high school to post-doctorate
98.5% of adults living in this town are a high school
graduate or higher
(http://www.census.gov/quickfacts/table/PST045215/558
6700)
75.8% of adults living in this town have a Bachelors
degree or higher
(http://www.census.gov/quickfacts/table/PST045215/558
6700)
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In 2014 the median household income was $102,576

(http://www.census.gov/quickfacts/table/PST045215/558
6700)
o Concussion experience: Some adults have already had
concussions during their lives, or have had a family member
with a concussion. They are also typically more
knowledgeable about concussions related pieces in the media.
WI state law requires that athletic organizations provide
concussion and head injury educational materials. A signed
form must be turned in prior to the start of the sport season
stating that the information has been reviewed.

Entry Characteristics
Prerequisite skills and knowledge
o All individuals have signed the require form that they had
concussion and head injury educational materials provided
o Most understand the prevalence of concussions in sporting
activities
Attitudinal and motivational characteristics
o All understand the risk of athletic participation
o Learners may be motivated to attend training because it is
applicable to both their work and personal lives
Prior experience
o Parents, guardians, and student athletes should have
reviewed the concussion materials provided on the athletic
website
Despite this, many individuals sign the form stating they
reviewed the material without actually reading the
information
o Personal experience may include sustaining a concussion or
knowing someone who has sustained a concussion
Common misconceptions about concussions
o A ding is not a concussion
o A direct hit resulting in a minor headache is not a concussion
o There are no long term consequences for leaving a concussion
untreated
o Individuals with concussions do not require any academic
accommodations
o Once concussion symptoms resolve, an individual can return
directly to his or her sport

Contextual Analysis
Orienting Context

All learners who complete the course will have a greater understanding
of concussion identification and management, which will help with
future incidents of concussion.
By attending this course, student-athletes will be eligible to participate
in high school athletics.
By attending this course, coaches will complete an employment
requirement.
By attending this course, parents will gain a deeper understanding of
the concussions and the policies surround school and sport.
Learners who attend this course may have the following
misconceptions regarding concussions:
o A ding is not a concussion
o A direct or indirect blow to the head resulting in a minor
headache is not a concussion
o There are no long term consequences for leaving a concussion
untreated
o Individuals with concussions do not require any academic
accommodations
o Once concussion symptoms resolve, an individual can return
directly to his or her sport
Barriers to this course include past experiences, preconceived notions,
or beliefs regarding concussions. The cultural implications of certain
sports will also play a role. For example, football and wrestling tend to
have a warrior mentality where student-athletes feel they must
toughen up. Female sports tend to be more conservative.

Instructional Context
Online module will be offered at all times.
The classroom portion of training will be held on two dates (one
weeknight and one Sunday night) prior to each sport season for a total
of 8 dates to accommodate both class and work schedules.
Classroom module: located in The Link at the high school
o The room consists of exterior windows and interior windows. The
interior windows provide a view into the pool that is obstructed
by shades. The exterior windows do not have shades. These
windows face east. Since instruction will take place in the
evening, sunlight is not an anticipated problem.
o The room lights are on three switches. They cannot be dimmed,
but the front lights closest to the screen can be switched off.
o There should be minimal noise disturbance since securing exits
can control access to the classroom location.
o Instructors will not have access to temperature control so will
have to request maintenance if temperature needs to be
adjusted.

o Both tables and chairs are available. Additional seating can be

requested. All seats will be within view of the screen and
presenters
o Additional hotel accommodations are not applicable. The inclass portion of the course will be completed over a few hours.
o The high school technology department will provide a projector
with computer hook-up and screen.
Smart boards in classrooms are available if the classroom
module needs to be moved
o The location of the classroom module will be at the high school.
Learners will not require any additional transportation other than
the usual transportation required to get to school on a daily
basis.
Technology Inventory
This town consists of a relatively affluent community. Mostif not all
individuals have access to computers, other personal electronic
devices, and the Internet.
o High School computer lab access can be arranged for any
individuals who do not have access to a computer or Internet.
o The public library also allows free computer and Internet access.
Transfer Context
The information provided in this course can be utilized not only in
athletics but also in other facets of life. Concussions are not exclusive
to sport and may occur on the playground, while doing housework,
during motor vehicle accidents, etc.
After completing the course, individuals will be able to apply the
knowledge during incidents of concussion to achieve proper
identification and care.
An athletic and high school wide concussion policy with identified key
individuals (nurse, athletic trainer, physician, school counselor,
teachers, parents) will provide support for individuals who report a
concussion in either themselves or others.

INSTRUCTIONAL IMPACT BASED UPON LEARNER

CHARACTERISTICS
Application of Learning Theories
Magers Criterion Referenced Instruction, Knowles theory of andragogy, and
Functional Context theory as summarized by Culatta (2015) will be
interwoven and applied in the creation of this course. All these theories
require that the learner is able to apply the learned knowledge; that learning
be both meaningful and self-directed; that valid assessment should be
employed; and that a variety of materials be utilized to enable learning.
Adult learning should be problem-centered and relevant to life. The course
will have clearly identified objectives that must be learned and the
participants will be able to utilize virtual experiences to actively employ the
knowledge (example: identifying signs/ symptoms of a concussion. The
online learning module will focus on this by guiding the learner through a
concussions multi-faceted considerations. Adults will learn how to
determine if their child is displaying signs or symptoms of a concussion and
will be able to explain a typical plan of care. Based on displayed signs and
symptoms, adults will be able to facilitate medical follow-up, academic
adjustments, and return to physical activity progression. The asynchronous
online module will allow adults to self-direct their learning based on their
schedule and interest in expanding upon various concussion topics. Videos,
simulations, and quizzes will allow the learner to experience different aspects
of learning in a virtual environment. The post-test and online
evaluation/comment section will allow adult learners to assist in evaluating
the course and determining areas of focus for the classroom module.
Functional Context Theory will be highlighted through the use of tools such
as signs and symptoms sheets, the return to play progression and return to
learn progression that will be provided for future reference.
Pedagogy consists of some key differences as compared to andragogy. The
learner is dependent on the instructor for all knowledge. Learning is a
process of acquiring prescribed subject matter and the content units are
sequenced to reflect the logic of the subject matter. Student-athlete will
have fewer options for additional learning opportunities as compared to the
adult learners. The modules will be more structured and simplified so basic
content can be successfully mastered.

Application of Motivational Theories

Motivation is crucial to not only the desire to learn, but also the retention of
information. The course completion requirement in order to participate in
athletics will be a major source of extrinsic motivation for both student-

athletes and parents/guardians. Despite this, it is the intention of this course

to motivate all learners intrinsically. Clark (2010) summarizes Jon Kellers
ARCS model of motivational design by identifying four key steps in the
instructional design processattention, relevance, confidence, and
satisfaction. The use of visual stimuli and real world examples will be
employed in this course to gain the learners attention. Active participation
in the classroom portion of the blended instruction will ensure that
participants remain engaged. All learners alike should be intrinsically
motivated to learn about concussions due to the prevalence in sports. On a
weekly basis the media reports on professional athletes and their injuries.
Feedback in after module assignments and quizzes will contribute to a
learners confidence and satisfaction on this topic. High-school learners will
be able to contribute in a quiz bowl challenge for prizes. Adult learners will
also be able to direct their own learning by reading additional research. By
incorporating real-world examples of professional role models in sport (and
how their concussions are being managed) it is the hope that participants
will recognize the worth of concussion education and employ the material
they learn in the future. By being able to properly identify and report a
suspected concussion, individuals contribute to a culture of safety.

Impact of a Diverse Audience on Instruction

The primary audience will have a large amount of diversity in age and
exposure to concussions. Portions of the blended format instruction will be
tailored to address this. The online learning modules will be separated into
adult learners and youth learners to optimize understanding and retention of
the material provided. Within each module there will be opportunities to
explore concussion information as it relates to specific sports as the culture
surrounding each sport varies greatly.
It is also anticipated that there will be a variety of ethnic and socioeconomic
backgrounds. Individuals lacking access to technology will be guided to
opportunities for computer and Internet access. A blended format also
addresses variations in ethnic structures. The online module will be utilized
as an opportunity to learn information solo while being provided applicable
examples. Quizzes on each section will assist the individual in identifying
areas of weakness. Classroom instruction will follow a group/family approach
with opportunity for interaction. The classroom portion will focus on gaps of
knowledge found during the online module. All individuals will attend the
classroom portion together. In hopes that by bringing a diverse community
together for an open discussion regarding concussions it will foster a
commitment towards concussion safety.

TASK/GOAL/PERFORMANCE ANALYSIS MODULE 5

Task Analysis Method
A topic analysis will be performed to identify the instructional content to be covered as well as to
determine the course structure. Morrison, Ross, Kalmen, and Kemp (2013) stated, The topic
analysis is used to define the facts, concepts, principles, and rules that will make up the final
instruction. After a front-end analysis it became apparent that this concussion education course
requires a subject matter expert (SME) to determine what basic information will result in an
acceptable level of knowledge.

Task Analysis
I.

II.

Concussion description
A. A concussion is a mild traumatic brain injury resulting in a disturbance in brain
function.
B. Most concussions often do not involve loss of consciousness.
C. Concussion should be suspected in the presence of any one or more of the
following: symptoms, signs, impairedbrainfunctionor abnormalbehavior.
1. Concussion Signs
i. Signs are behaviors or actions that someone is able to observe in
another person
ii.
Signs include appearing dazed/stunned, seems confused about
assignment or position, forgetful (forgets an instruction, play, or
conversation), unsure of events surrounding injury (game, score,
opponent, events preceding or directly after event), moves
clumsily, answers questions slowly, loses consciousness, and
shows mood/behavior/personality changes
2. Concussion Symptoms
i. Symptoms are experienced by the injured/concussed individual
and are often reported to others
ii. Symptoms include headache, nausea/vomiting, dizziness, light
sensitivity, noise sensitivity, balance problems, blurry vision,
confusion, difficulty remembering, difficulty concentrating, more
emotion, irritability, anxiousness, sadness, pressure in head,
feeling slowed down, feeling in a fog, neck pain, dont feel
right, fatigue/low energy, drowsiness, and trouble falling asleep
D. Mechanisms of injury for a concussion
1. Direct (hit in the head by a object or hit an object with the head)
2. Indirect (whiplash)
Concussion Assessment Tools : medical professionals trained in concussion
assessment or evaluation utilize concussion assessment tools. The diagnosis of a
concussion is a clinical judgment, ideally made by a medical professional. The ability
to pass one or more tests does not necessarily rule out a concussion. In all testing
situations, it is ideal to have a baseline healthy score for comparison.
A. SCAT 3
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1.
2.
3.
4.

III.

Stands for Sideline Concussion Assessment Tool

Used by medical professionals trained in concussion evaluation
Used for concussed individuals ages13 and up
Consists of questions and tasks involving orientation, immediate
memory, concentration, balance, coordination, and delayed memory.
B. Child SCAT 3
1. Sidelines assessment tool used by medical professionals
2. Used for concussed individuals ages 12 and younger
3. Compared to a SCAT3, consists of easier/more simply worded questions
and tasks involving orientation, immediate memory, concentration,
balance, coordination, and delayed memory.
C. BESS
1. Stands for Balance Error Scoring System
2. Tests balance in 3 difference stances (double leg, single leg, and tandem)
on both a firm and soft surface
3. Number of errors while trying to hold the position for 20 seconds is
recorded
D. VOMS
1. Abbreviated for Vestibular/Ocular Motor Screening
i. Vestibular ocular system is responsible for integrating vision,
balance and movement
2. Uses a tape measure and a metronome
3. Patient performs 5 tasks: smooth eye movement, rapid eye movement,
vestibular ocular reflex, visual motion sensitivity and how close or far
from a patients face an object can before they have experience double
vision
4. Clinician records patient reported symptoms on a 0-10 scale (headache,
dizziness, nausea, fogginess) after performing each task
E. Cogstate Concussion Test
1. Online test to measure brain function
2. 8-10 minutes long. Individuals complete 4 tasks using playing cards on
a computer
3. Assesses reaction time, concentration, and memory
F. ImPACT
1. 25 minute computerized neurocognitive assessment tool for ages 12-59
2. Measures attention span, working memory, sustained and selective
attention time, non-verbal problem solving, and reaction time.
Risks of participation while concussed
A. Prolonged recovery: Concussions are basically bruises on the brain. By
continuing to participate neuropathophysiologic processes can be exacerbated,
causing symptoms to last longer.
B. Second Impact syndrome
1. Occurs when there is a blow to the head before the first concussion has
completely healed
2. Results in massive swelling in brain

11

IV.

3. Prognosis includes death or severe traumatic brain injury (lifelong

disability)
Return to Learn Progression after a concussion
A. Multidisciplinary approach (team may consist of one or more of the following:
athletic trainer, physician, school nurse, school counselor, teacher)
B. Customized based on individuals concussion symptoms and severity
1. Could consist of several steps potentially including no school; half days
of school; or modifications in testing, workload, tests, adjustments based
on stimulus (audio or visual), and breaks during school day. Examples
listed below
i. Light sensitivity
a. Move away from windows
b. Dim lights/draw shades
c. Allow sunglasses to be worn (especially
if using a smart board/computers)
ii. Noise sensitivity
a. Remove student from loud environment
or reduce noise (excuse from
band/choir/assemblies)
b. Allow student extra time to get to class
to avoid loud hallways
iii.
Difficulty concentrating on schoolwork
a. Shorten task duration
b. Give breaks between tasks
c. Allow extended time for tests to allow
for breaks
iv. Feeling mentally foggy
a. Simplify tasks/assignments
v. Difficulty remembering
a. Provide class notes
b. Provide memory aids
c. Use alternative testing methods
vi. Difficulty staying organized
a. Assist with planner/agenda schedule
and due dates
b. Check comprehension of instructions
c. Use to-do lists and checklists
vii. Increased symptoms with physical activity
a. Reduce weight of backpack or allow
student to use classroom textbooks
b. Extra time to get to class
c. No physical education class
viii.
Symptoms such as headache,
dizziness/balance problems, nausea,
drowsiness

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V.

VI.

VII.

a. If mild/moderate: allow classroom

participation
b. Avoid symptom triggers/worsening
symptoms
c. If severe, refer to nurse/ parent
2. Purpose: Cognitive rest followed by increased cognitive load back to
normal academic participation.
Return to physical activity/sports participation after a concussion
A. Can potentially be adjusted based on length of concussion, previous history of
concussions, and type of sport participation (noncontact versus contact)
B. Purpose: gradually increase physical stress and cognitive load on the brain to
determine if full healing has taken place
C. Process: Each step should take a minimum of 24 hours.* If symptoms are
experienced at any point, the individual must be symptom free for 24 hours* and
return to the previous symptom-free step. (*may be adjusted based on individual
factors such as history of migraines, history of concussions, and duration of
concussion)
1. Step one: rest. No physical activity. Proceed to step 2 when carrying
full academic load and symptom free for 24 hours*
2. Step two: Light aerobic activity to increase heart rate.
3. Step three: Moderate aerobic activity to increase heart rate and add in
body/head movement
4. Step four: Heavy, non-contact activity (non-contact practice, sport
specific drills) to increase cognitive load and heart rate
5. Step five: full contact practice to reintegrate into practice participation
6. Step six: game participation
Complications of concussions
A. An individual who has sustained a concussion is at a higher risk of sustaining
subsequent concussions.
B. Post-concussive syndrome is a combination of symptoms that can persist for days,
weeks, or months following a concussion.
C. Individuals who sustain repeated concussions or sub-concussive forces are at a
risk of Chronic Traumatic Encephalopathy(CTE).
1. CTE is a rare degenerative brain disease.
2. Individuals with CTE have cognitive issues, behavioral problems,
physical problems, and emotional issues.
3. CTE is not well understood.
Ways to make participation in sports safer:
A. Concussion educations courses such as this one
1. Educate all parties on concussion signs, symptoms, management, and
repercussions
2. Knowledge is power. Hopefully understanding the topic will encourage
individuals to report symptoms so proper management can take place
3. When in doubt, sit them out!
B. Understand ways to educate or make specific sports safer

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1. Contact sports: properly fitting equipment and teach proper techniques.

Follow recommendations for limiting the amount of hitting
2. Semi-contact sports: follow recommendations from sport organizations
(ex: headers and youth soccer), teach athletes how to protect themselves
on the field (maintaining spacing during headers in soccer, trapping the
soccer ball with feet, chest, etc)
3. Non-contact sports: proper mastery of skills prior to progression to
advanced skills, proper spotting, etc

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INSTRUCTIONAL OBJECTIVES MODULE 5

Project (Instructional) Goal
After completing this course, participants will be able to identify a suspected
concussion, refer to proper medical professions, and assist in facilitating
proper concussion management in both the academic and athletic setting.
Participants will also gain an appreciation for the risks and complications of
concussions, as well as what precautions can be taken to make sports safer.

Terminal Objectives and Enabling Objectives

Given three different scenarios, the learner will correctly list the correct
mechanism of injury as well as what signs and symptoms are
presented by concussed athletes in two out of three scenarios.
(Cognitive/Analyze)
o The learner will list 17 out of 22 concussion symptoms.
(Cognitive/Recall)
o The learners will list 5 signs of a concussion. (Cognitive/Recall)
o The learner will compare and contrast the different mechanisms
of injury. (Cognitive/Evaluate)

Given a list of concussion symptoms and symptoms, the learner will

create (write) a potential academic plan consisting of at least 4
accommodations. (Cognitive/Create)
o The learner will explain the rationale behind the creation of
return-to-learn protocol following a concussion.
(Cognitive/Understand)
o The learner will choose 5 signs or symptoms and predict how
these signs or symptoms may be exacerbated by an academic
environment. (Cognitive/Apply)
o The learner will identify 3 individuals who may be involved in the
return-to-learn protocol and state their roles. (Cognitive/Recall)

The learner will compare and contrast 3 concussion assessment tools

that could potentially be used by medical professionals
(Cognitive/Evaluate)
o The learner will discuss the importance of obtaining a preparticipation baseline score for assessment purposes.
(Cognitive/Understand)
o The learner will identify at least 5 different items that can be
examined while performing a concussion assessment.
(Cognitive/Recall)

15

o The learner will list at least two key concepts for each
assessment tool. (Cognitive/Recall)

Given a patient scenario, the learner will correctly outline a suggested

return to participation protocol as well as the rational behind each
step. (Cognitive/Apply)
o The learner will paraphrase the return to participation steps in
their own words. (Cognitive/Understand)
o The learner will identify patient items that may have an effect on
the return to participation steps. (Cognitive/Recall)
o The learner will identify three variables that are adjusted over
the course of the return to play progression. (Cognitive/Recall)

The learner will discuss one risk of participating with a concussion and
one complication of having a concussion (Cognitive/Understand)
o The learner will compare and contrast CTE and Second Impact
Syndrome (Cognitive/Evaluate)
o The learner will summarize post-concussive syndrome and
prolonged recovery with continued athletic participation.
(Cognitive/Understand)
o The leaner will recognize that a history of concussions indicates
that there is a higher risk of sustaining subsequent concussions.
(Cognitive/Recall)

The learner will choose a sport and identify safety precautions that can
reduce the risk of sustaining a concussion (Cognitive/Recall)
o The learner will acknowledge (signed understanding the risk of
sport statement) that it is impossible to completely remove the
chance of sustaining a concussion. (Affective/Receiving
Phenomena)
o The learner will identify sports equipment considerations that
can reduce the risk of concussion. (Cognitive/Recall)
o The learner will list specific sport organization recommendations
that can reduce the risk of concussions. (Cognitive/Recall)
o The learner will select a piece of sports equipment and describe
how it can potentially reduce the risk of concussion.
(Cognitive/Understand)

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ENABLING OBJECTIVES MATRIX & SUPPORTING CONTENT

MODULE 6
Title of the unit/module: Return to Learn
Brief description of target audience: Adult learners consist of
parents/guardians and coaches. Younger learners consist of high school
athletes ages 14-18 years old. Please note that the online portion of this
module will be adjusted to fit the different learner characteristics.
Terminal Objective Here: Given a list of concussion symptoms and
symptoms, the learner will create (write) a potential academic plan
consisting of at least 4 accommodations.
Pre-instructional Strategy: Overview of Module
Enabling Objective

Level on
Blooms
Taxonomy

Fact, concept, Learner Activity (What

principle,
would learners do to
rule,
master this objective?)
procedure,
interpersonal,
or attitude

Delivery Method
(Group
presentation/lecture,
self-paced, or small
group)

The learner will choose

5 signs or symptoms
and predict how these
signs or symptoms may
be exacerbated by an
academic environment.

Apply

Principle

Self-paced, readings,
video example

The learner will explain Understand Concept

the rationale behind the
creation of return-tolearn protocol following
a concussion
The learner will identify Recall
Fact
3 individuals who may
be involved in the
return-to-learn protocol
and state their roles.

Recall and list

signs/symptoms covered
earlier in the course;
Review online reading
material; Identify
environmental factors
from the video that may
cause increase symptoms
Write an essay
addressing the rationale
behind return-to-learn

Self-paced, minilecture

Participate in a group
Online quiz,
discussion/ meet and
Classroom small
greet with individuals
group/group sharing,
involved with
concussion management;
record names, contact
information, and roles

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Post-Concussion Academic Recommendations

A students recovery from a concussion involves both physical and cognitive
rest. Each individual will respond to concussions differently, so it is
important to follow-up with the student daily to make sure appropriate
accommodations are being made. In some situations, cognitive stimulation
(driving, television, reading, studying, cell phone use, and/or being in
bright/loud environments) can increase symptoms. Depending on symptom
severity, these activities should be modified or avoided. Physical activity
such as sports, strength/conditioning, and physical education should be
avoided at this time as well.
Symptom
Light sensitivity

Noise sensitivity

Difficulty concentrating on schoolwork

Feeling mentally foggy

Difficulty remembering

Difficulty staying organized

Increase symptoms with physical

activity

Potential Accommodation
Move away from windows
Dim lights/draw shades
Allow sunglasses to be worn
(especially if using a smart
board/computers)
Remove student from loud
environment or reduce noise (excuse
from band/choir/assemblies)
Allow student extra time to get to
class to avoid loud hallways
Shorten task duration
Give breaks between tasks
Allow extended time for tests to allow
for breaks
Simplify tasks/assignments
Provide class notes
Provide memory aids
Use alternative testing methods
Assist with planner/agenda schedule
and due dates
Check comprehension of instructions
Use to-do lists and checklists

Reduce weight of backpack or allow

student to use classroom textbooks
Extra time to get to class
No physical education class

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Headache
Dizziness/balance problems
Nausea
Tired/Drowsy

If mild/moderate: allow classroom

participation
Avoid symptom triggers/worsening
symptoms
If severe, refer to nurse/ parent

Sometimes students with symptoms may need to miss school or have

a modified daily schedule. In these situations, nonessential learning items
should be eliminated and homework/tests should be reduced or eliminated.
A gradual re-introduction should take place without causing symptoms to
worsen while also allowing appropriate make-up time for missed material.
The emphasis in managing a concussed student in the classroom is to
allow the student to participate and learn without worsening symptoms. As
the student improves, gradually increase demands on the brain by increasing
one of the following at a time:
Amount of work
Length of time spent on work
Type or difficulty of work
Below is a decision-making flow chart of what to do if increasing cognitive
demands worsens symptoms.
Increase
cognitive
demand

Symptoms
increase or
worsen

No change in
symptoms

Discontinue
activity.
Complete
cognitive rest
for 20 minutes

Continue to
gradually
increase
cognitive
demands

Symptoms
improve with
20 minutes
of rest

Re-start activity
at or below the
same level that
produced

Symptoms do
not improve
with 20
minutes of
Discontinue activity and
resume when symptoms
have lessened (such as
next day)

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Please indicate how you feel for each symptom using this
scale

Date:

Symptom:
Headache
"Pressure in Head"
Neck Pain
Nausea or Vomiting
Dizziness
Blurred vision
Balance Problems
Sensitivity to light
Sensitivity to noise
feeling slowed down
feeling like "in a fog"
"don't feel right"
difficulty
concentrating
difficulty
remembering
fatigue or low energy
confusion
drowsiness
trouble falling asleep
more emotional
irritability
sadness
nervous or anxious

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Total # of Symptoms
Total Symptom Score

None
0

Mild
1

Moderate
3
4

Severe
5
6

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REFERENCES
(2016). Retrieved September 11, 2016, from http://www.cdc.gov/HeadsUp/index.html
Chrisman, S. P., Schiff, M. A., Chung, S. K., Herring, S. A., & Rivara, F. P. (2014).
Implementation of Concussion Legislation and Extent of Concussion Education for
Athletes, Parents, and Coaches in Washington State. The American Journal of Sports
Medicine, 42(5), 1190-1196. doi:10.1177/0363546513519073
Clark, D. (n.d.). John Keller's ARCS Model of Motivational Design. Retrieved September 25,
2016, from http://www.nwlink.com/~donclark/hrd/learning/id/arcs_model.html
Culatta, R. Motivation. Retrieved September 23 2016, from
http://www.instructionaldesign.org/concepts/motivation.html
Culatta, R. Learning Theories. Retrieved September 20 2016, from
http://www.instructionaldesign.org/theories/index.html

Gessel, L.M., Fields, S.K., Collins, C.L., Dick, R.W., Comstock, R.D. (2007) Concussions
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Mccrea, M., Hammeke, T., Olsen, G., Leo, P., & Guskiewicz, K. (2004). Unreported Concussion
in High School Football Players. Clinical Journal of Sport Medicine, 14(1), 13-17.

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doi:10.1097/00042752-200401000-00003
Mcleod, T. C., Schwartz, C., & Bay, R. C. (2007). Sport-Related Concussion Misunderstandings
Among Youth Coaches. Clinical Journal of Sport Medicine, 17(2), 140-142.
doi:10.1097/jsm.0b013e31803212ae
Morrison, G. R., Ross, S. M., Kalman, H. K., & Kemp, J. E. (2013). Designing Effective
Instruction (7th ed.). Hoboken, NJ: John Wiley & Sons.

Register-Mihalik, J. K., Linnan, L. A., Marshall, S. W., Mcleod, T. C., Mueller, F. O., &
Guskiewicz, K. M. (2013). Using theory to understand high school aged athletes
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