Nurse–physician differences in knowledge, attitudes, and practice of sport-related concussion management in primary care

Objectives: This study examined differences between nurses and physicians in knowledge, attitudes, and practices related to sport-related concussion (SRC) management in resource-limited primary care settings in Indonesia. It also assessed whether professional role, knowledge, and attitudes were linked to adherence to key SRC safety behaviors. Materials and Methods: A cross-sectional survey was conducted from July to October 2025 among 136 early-career physicians ( n = 68) and nurses ( n = 68) in public primary care facilities in Greater Medan, North Sumatra, Indonesia. A validated self-administered questionnaire, developed from recent international SRC consensus statements, assessed knowledge using 25 true–false items, attitudes toward SRC severity and management, and adherence to three minimum safety-critical behaviors: Immediate removal from play after suspected SRC, structured referral, and implementation of cognitive rest. Group differences were examined using Mann–Whitney U and Chi-square tests, and associations between knowledge, attitudes, professional role, and practice were analyzed using logistic regression with complete adherence (score 100 vs. <100) as the outcome. Results: Nurses demonstrated higher overall knowledge scores than physicians (median 88.0 vs. 66.0, p < 0.001). Attitudes were generally positive (median 74.3, interquartile range 65.7–82.9), with nurses scoring slightly higher than physicians (77.1 vs. 74.3). The practice measure showed a ceiling effect, with 53.7% reporting complete adherence to all three safety behaviors—36.8% of physicians and 70.6% of nurses. Higher knowledge modestly correlated with practice scores when combined with attitudes, but this lessened after including professional role. Nurses had about 4 times the odds of full adherence as physicians after adjusting for knowledge and attitudes (odds ratio 4.1, 95% confidence interval 1.7–9.9), whereas knowledge and attitude scores alone did not independently predict adherence. Conclusion: Professional role showed a stronger association with self-reported SRC safety behavior adherence than individual knowledge or attitudes. These findings suggest that strengthening SRC management in resource-limited settings should emphasize role-specific protocols and system-level strategies rather than relying solely on individual education.