Description

This FREE, 4-week on-demand course offers 9.75 CME/CE credits and provides a comprehensive overview of diagnostic criteria, assessment techniques, recovery patterns, and rehabilitation strategies for traumatic brain injuries (TBI).

Course faculty begin with a focus on foundational knowledge about TBI, such as the spectrum of TBI severity, anticipated outcomes between mild versus severe TBI, and criteria for diagnosis and management of TBI from onset through the acute recovery stage. Topics then progress to address common clinical challenges associated with TBI, such as:

  • Recognizing similarities and differences in recovery among athletes, civilians and active-duty service members
  • Differentiating typical from atypical recovery patterns
  • Selecting treatment and rehabilitation strategies for veterans with mild TBI and ongoing problems with mental health and chronic pain

Our goal is to help you translate knowledge into enhanced clinical practice that provides better outcomes for patients, so the course includes live interaction with faculty at set times each week to address clinical questions and discuss course materials. Course content is 100% mobile-friendly and completely on-demand, so you can participate whenever your schedule allows.

Presenters for this course include:

  • Grant L. Iverson, PhD, Course Director
  • Timothy J. Petersen, PhD
  • Lenore Herget, PT, DPT, MEd
  • Nicholas A. Tritos, MD, DSc
  • Ross D. Zafonte, DO

Learning Objectives

At the end of this program, participants will be able to:

  • Describe the spectrum of traumatic brain injury severity.
  • Explain the differences in anticipated outcomes between those with mild versus severe TBI.
  • Explain the criteria for diagnosing a mild traumatic brain injury and the recommendations for how to manage the injury in the acute recovery stage.
  • Recognize the similarities and differences in recovery trajectories among athletes, civilians, and active duty service members.
  • Differentiate typical from atypical recovery patterns.
  • Describe the differential diagnoses for the post-concussion syndrome.
  • Demonstrate an understanding of treatment and rehabilitation strategies for veterans who have a history of mild TBI and ongoing problems with mental health and chronic pain.

Agenda

Subject to change without notice.

Session I.

Introduction to Traumatic Brain Injury: Definitions, Severity, and Clinical Features
Grant L. Iverson, PhD

Key Elements:

  • Describe the spectrum of traumatic brain injury severity.
  • List 3 symptoms, deficits, or problems that might be permanent following a severe TBI.
  • Explain the differences in anticipated outcomes between those with mild versus severe TBI.
  • Know the definition of mild TBI and the acute effects.

Session Outline:

Part 1. Moderate-Severe TBI

  1. Epidemiology
  2. Pathoanatomy and Pathophysiology
  3. Neurological and Neuropsychiatric Problems
  4. Functional and Neuropsychological Outcome

Part 2. Mild TBI

  1. Overview
  2. Acute Symptoms
  3. Recovery Time
Session II.

Mild TBI Diagnosis, Early Management, and Overview of the Post-Concussion Syndrome
Grant L. Iverson, PhD

Key Elements:

  • List the criteria used to define a mild TBI.
  • Describe an approach for the early management of the injury.
  • Define the post-concussion syndrome and some important differential diagnoses.

Session Outline:

Part 1. Identification/Diagnosis

  1. Definitional and Injury Severity Criteria
  2. Acute Assessment

Part 2. Rest, Return to Activity, and use of Education and Reassurance

  1. Rest Following Injury
  2. Gradual Return to Sports Protocol
  3. Progressive Return to Activity Guidelines for Service Members
  4. Education and Reassurance

Part 3. Introduction to the Post-Concussion Syndrome

  1. ICD-10 Criteria for Postconcussional Syndrome
  2. Nonspecific Symptoms
  3. Importance of Targeted Symptomatic Treatment

Session III.

Treatment and Rehabilitation Services
Ross D. Zafonte, DO

Key Elements:

  • List some of the most common persistent symptoms and problems following mild TBI.
  • Have working knowledge of the Guidelines for Managing Persistent Symptoms Following Mild TBI (Second Edition).
  • Describe both pharmacological and nonpharmacological interventions for persistent symptoms and problems.

Session Outline:

  1. Basic Principles: Focused, Evidence-Based Treatment for Specific Symptoms and Problems
  2. Post-Traumatic Headaches
  3. Sleep Disturbance
  4. Fatigue
  5. Balance and Visual Dysfunction
  6. Mental Health Symptoms
  7. Cognitive Difficulties

Session IV.

Cognitive Impairment, Cognitive Rehabilitation, and Physical Therapy
Grant L. Iverson, PhD; Lenore Herget, PT, DPT, MEd

Key Elements:

  • List 3 treatable conditions or factors that might have an adverse effect on cognitive functioning.
  • Name the symptoms and problems that are most appropriate for referral to physical therapy.
  • Describe physical therapy interventions for specific symptoms and problems.

Session Outline:

Part 1. Cognitive Impairment and Cognitive Rehabilitation

  1. Numerous factors can have an adverse effect on cognitive functioning
  2. Cognitive impairment can range from very mild to severe dementia
  3. Cognitive rehabilitation therapy can be restorative or compensatory
  4. There is limited research on the effectiveness of cognitive rehabilitation, especially with mild TBI
  5. Veterans might have Multiple reasons for cognitive impairment, many of qhich are treatable

Part 2. Physical Therapy

  1. Target Symptoms: Headaches, Dizziness, Balance Problems, and Visual Disturbance
  2. Cervical Therapy
  3. Balance and Vestibular Therapy
  4. Therapy for Visual Disturbances

Bonus (Non-Accredited) Session

Hypopituitarism After Mild Traumatic Brain Injury
Nicholas A. Tritos, MD, DSc

Faculty

  • Senior Physical Therapist, Sports Physical Therapy Service, Massachusetts General Hospital
  • Professor, Department of Physical Medicine & Rehabilitation, Harvard Medical School
    Director, MassGeneral Hospital for Children Sports Concussion Program
    Associate Director, Traumatic Brain Injury, Red Sox Foundation and Massachusetts General Hospital Home Base Program
  • Associate Psychologist, Massachusetts General Hospital
    Program Director, The Bulfinch Program
    Clinical Psychologist, Home Base Program
    Assistant Professor of Psychiatry, Harvard Medical School
  • Staff Neuroendocrinologist, Neuroendocrine Unit and the Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital
    Assistant Professor of Medicine, Harvard Medical School
  • Vice President of Medical Affairs, Spaulding Rehabilitation Hospital
    Clinical and Research Leader for Traumatic Brain Injury, Red Sox Foundation and Massachusetts General Hospital Home Base Program
    Earle P. and Ida S. Charlton Professor of Physical Medicine and Rehabilitation, Harvard Medical School

Target Audience

This program is intended for:

  • Psychiatrists
  • Psychologists
  • General and family practice physicians
  • Physician assistants
  • Nurses
  • Social workers
  • Licensed mental health counselors
  • Residents and fellows

Moderator

Through the duration of the course, the designated faculty moderator will respond to any clinical questions that are submitted to the interactive discussion board. The moderator for this course is:

  • Grant L. Iverson, PhD

Educational Support

Defense Suicide Prevention OfficeWelcome Back Veterans

CME Information

Release Date: April 3, 2017
Expiration Date: May 15, 2017


CREDIT

TYPE

ACCREDITATION STATEMENT

DESIGNATION STATEMENT

9.75

AMA PRA Category 1 CreditTM

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of McLean Hospital and Massachusetts General Hospital. McLean Hospital is accredited by the ACCME to provide continuing medical education for physicians.

McLean Hospital designates this enduring material for a maximum of 9.75 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

9.75

Nursing Contact Hours

Massachusetts General Laws, Chapter 13, sections 13, 14, 14A, 15 and 15D and Chapter 112, sections 74 through 81C authorize the Board of Registration in Nursing to regulate nursing practice and education.

This program meets the requirements of the Massachusetts Board of Registration in Nursing at (244 CMR 5.00) for 9.75 contact hours of nursing continuing education credit.

9.75

Psychologists CE Credit

The Massachusetts General Hospital Department of Psychiatry is approved by the American Psychological Association to sponsor continuing education for psychologists. The Massachusetts General Hospital Department of Psychiatry maintains responsibility for this program and its content.

This offering meets the criteria for 9.75 continuing education credits for psychologists.

9.75

Licensed Mental Health Counselors

The Center for Social Innovation is approved by the NBCC to provide continuing education credits forLicensed Mental Health Counselors.

This program has been approved for 9.75 CE credits forLicensed Mental Health Counselors.

9.5

Social Work CE Credit

The Collaborative of NASW, Boston College, and Simmons College Schools of Social Work authorizes social work continuing education credits for courses, workshops, and educational programs that meet the criteria outlined in 258 CMR of the Massachusetts Board of Registration of Social Workers.

This program has been approved for 9.5 Social Work Continuing Education hours for relicensure, in accordance with 258 CMR. Collaborative of NASW and the Boston College and Simmons Schools of Social Work Authorization Number D72500.

9.75

(self-claim)

Other Professions

Other Providers can claim a Participation Certificate upon successful completion of this course.

Participation Certificates will specify the title, location, type of activity, date of activity, and number of AMA PRA Category 1 CreditsTM associated with the activity. Providers should check with their regulatory agencies to determine ways in which AMA PRA Category 1 CreditsTM may or may not fulfill continuing education requirements. Providers should also consider saving copies of brochures, agenda, and other supporting documents.

Resolution of Conflicts of Interest (COI)

McLean Hospital has implemented a process to resolve COI for each CME activity. In order to help ensure content objectivity, independence, fair balance and ensure that the content is aligned with the interest of the public, McLean Hospital has resolved the conflict by External Content Review.


Planners
Tristan Gorrindo, MD
Emma Morrison, MPH
Timothy Petersen, PhD
Jane Pimental, MPH

Disclosure Information

In accord with the disclosure policy of McLean Hospital as well as guidelines set forth by the Accreditation Council on Continuing Medical Education, all people in control of educational content, including speakers, course directors, planners, and reviewers, have been asked to disclose all relevant financial relationships with commercial interests of both themselves and their spouses/partners over the past 12 months, as defined below:

Commercial Interest

The ACCME defines a "commercial interest" as any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests. For more information, visit www.accme.org.

Financial relationships

Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.

Relevant financial relationships

ACCME focuses on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling content of the CME activity. ACCME has not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME defines "'relevant' financial relationships" as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.

Conflict of Interest

Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship.

The following planners, speakers, and content reviewers, on behalf of themselves and their spouse or partner, have reported financial relationships with an entity producing, marketing, re-selling, or distributing health care goods or services (relevant to the content of this activity) consumed by, or used on, patients:

Grant L. Iverson, PhD, course director, moderator
Independent Contractor (via General Dynamics for Research Relating to TBI and psychological health in the military): Defense and Veterans Brain Injury Center
Part-Time Salary (for Research Relating to TBI and psychological health in the military): Walter Reed National Military Medical Center
Salary (for medical-legal consultation): NeuroHealth Research and Rehabilitation, Inc.
Salary (for medical-legal consultation): NeuroHealth, LLC
Consulting Fees: Avanir

Susan E. Sprich, PhD
Royalties:Oxford University Press (co-authoring treatment manual and client workbook), Springer (co-editing handbook)

Nicholas A. Tritos, MD, DSc
Research Grant:Ipsen, Novartis, Novo Nordisk, Pfizer

All other individuals including course directors, planners, reviewers, faculty, staff, etc., who are in a position to control the content of this educational activity have, on behalf of themselves and their spouse or partner, reported no financial relationships related to the content of this activity.


Hardware/Software Specifications

This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration

Flash Player: Adobe Flash Player 10.1+
Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+
Operating System: Windows XP+ or Mac OS X 10.4+
Internet Connection: 1 Mbps or higher

Minimum Requirements

Windows PC: 500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit


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