North Carolina High School Athletic Association

NFHS Concussion Course Reaches Two Million Mark

     INDIANAPOLIS— More than two million concussion courses have now been taken by coaches and other individuals since the National Federation of State High School Associations (NFHS) and the Centers for Disease Control and Prevention (CDC) launched the online course in May 2010.

     The course – “Concussion in Sports” – was taken for the two-millionth time earlier this month through the NFHS Learning Center at This milestone comes just two years after the course hit the one million mark in August 2013. The free online course aims to educate coaches and others on the significance of concussions, how to recognize their signs and symptoms, how to respond to a suspected concussion and the proper steps to help players return safely after recovering.

     This course is one of the North Carolina High School Athletic Association requirements for coaching.  The NCHSAA Board of Directors has passed a requirement that all coaches, paid or volunteer, must annually take the NFHS “Concussion in Sports” course or an equivalent concussion curriculum prior to the first date of practice in their sport.

     “We are very pleased with the extensive reach of our concussion course,” said Dan Schuster, director of coach education at NFHS. “It is great to see that so many coaches, students, administrators, parents, officials and others are taking advantage of this great resource and learning how to recognize the signs and symptoms of concussions.”

     The NFHS and its Sports Medicine Advisory Committee (SMAC) have worked with the CDC on recent updates to the concussion course. New materials include new videos as well as return-to-play guidelines. To complete the course, users still take pre- and post-tests that provide immediate feedback and create a better learning experience.

     The testing method has proved to be an effective educational tool, with 21 percent receiving a perfect score on the pre-test to 60 percent receiving a perfect score on the post-test, according to a recent study published in the Journal of Head Trauma and Rehabilitation.

     Bill Heinz, M.D., chair of the NFHS SMAC and co-founder of the Maine Concussion Management Initiative, is the new on-screen host of the concussion course, replacing Michael Koester, M.D., former chair of the NFHS SMAC.

     “Dr. Koester was a great leader in helping develop the original course,” Schuster said. “The NFHS would like to take this opportunity to express our appreciation and thank him for his service. Dr. Heinz has done a tremendous job with revisions to the course and his leadership has been invaluable.”

     The NFHS has been a leader among national sports organizations in establishing guidelines to deal with concussions. In 2008, the SMAC advocated that a concussed athlete must be removed from play and not allowed to play on the same day. For the past six years, all NFHS rules publications have contained guidelines for the management of a student exhibiting signs, symptoms or behaviors consistent with a concussion. In 2014, the NFHS Concussion Task Force developed recommendations for minimizing the risk of concussions and head impact exposure in high school football. Many member state associations have since adopted the recommendations for the 2015 high school season.

     A total of 39 online courses are now offered through the NFHS Learning Center, including the two core courses – “Fundamentals of Coaching” and “First Aid, Health and Safety for Coaches.” The NFHS also offers 16 sport-specific courses and 21 elective courses, including 17 that are free.

     All NFHS education courses are available at, and “Concussion in Sports” can be reached at