Generally, what's been developed over the years, as you probably recognized, by the international sport and concussion group is the graduated return to activity. It's return to play, because it's in the context of sport, but that is the typical idea now for a graduated return to whatever it is that you were doing. In schools, you'll see the return to play and return to learn as well.
You touched on the concept or idea that sometimes clinicians may not know what to do, and that is a bit of an issue in some areas. One of the things we mentioned was the gap in knowledge for clinicians and clinical trainees alike, and that is not just a Canadian issue. There's research coming out of Singapore, Croatia and the States also saying that clinical trainees and practising clinicians may not have as much knowledge about concussions because they're not necessarily trained about it. I think U of T, the medical school that I'm going to, is perhaps one of the luckier ones, where we have Dr. Charles Tator, who is giving us some knowledge on concussion. But that's not the case across the board.
We really do need to see consistent, adequate and competency-based education for clinicians. There is research in Boston, where there is a primary care hospital. They saw a change in terms of the concussion care that was given after an in-person and online.... It was a combination, a multimodal education program, and there was an improvement in concussion care. So it's possible even in practising clinicians, whether or not they had that emphasis on concussion in their clinical training. However, in terms of continuing medical education, we do need to stay away from unregulated certification, just to make sure it is adequate, competency-based and consistent across the board. But it's possible.