When the Atlantic Coast Conference announced a new policy requiring medical observers at every game this season, Syracuse's Brad Pike was hesitant, unsure how it would work.
A third of the way through the season, Pike and others like what they've seen since ACC Commissioner John Swofford embraced an NCAA proposal and implemented a league-wide policy. Swofford announced in late July that ACC teams would be required to assign a medical observer selected by each respective school for every game - home, away, and at neutral sites.
''I think we're effective right now,'' said Pike, assistant director of athletics for sports medicine for the Orange and in charge of the university's medical observers. ''Initially, I had a lot of hesitation. I feel really good about how everything's been handled. I feel very good about the conference's choice and how we're going about it.''
The NCAA football rules committee proposed the designation of experimental medical observers for the 2015 season as another layer of oversight to spot injuries on the field. In the ACC, it is basically school-oriented and school-run programs.
''We believe the way our policy is structured gives us the best potential for success,'' Swofford said in an email to The Associated Press. ''Thus far, things have been very positive.''
The job of the observers is to be on the lookout for any visual indicators of potential injury to a player on their team, and each observer has direct communication to the team bench. Denny Kellington, head athletic trainer for football at Syracuse, said the only requirement the ACC mandates is access - where a medical observer can sit.
It's an issue of fairness.
''The biggest thing is you have to have equality,'' Pike said. ''You want to make sure that if we're on the 45-yard line they're on the 45 so it's fair.''
Pike said Syracuse's observers averaged 4-5 calls in each of the first three home games in the Carrier Dome.
''It's really comfortable'' having the spotters, Syracuse wideout Steve Ishmael said. ''I feel confident knowing they have your back.''
Increased safety on the field is front and center with the concussions. The NFL, which meets regularly with the NCAA, began requiring ATC spotters (independent certified athletic trainers) at all games nearly four years ago after Cleveland Browns quarterback Colt McCoy took a helmet-to-helmet hit and was sent back into the game without being tested for a concussion.
The advent of medical spotters in the college game was spurred in part by a similar injury suffered last season by Michigan quarterback Shane Morris. He was left in a game the Wolverines were losing after suffering an obvious concussion.
''We wanted to try something,'' North Carolina athletic director Bubba Cunningham said. ''It's new to everybody and it certainly came because of the Michigan situation. We are providing enough oversight that you can't really get on the field.''
''I think that this is a great thing for us to catch a kid who may be a little woozy that they (the on-field staff) are not catching because they're dealing with somebody else,'' Pike said. ''I think that's more the issue. Player 1 gets hurt and then Player 2 is coming off a little different. We can say, `Hey check on him. Are you OK?'''
At Duke, there has not yet been a call down to the field from a spotter, and coach David Cutcliffe attributes that in part to the staff. Six doctors are on the sidelines for home games at Wallace Wade Stadium.
''The good trainers and the medical people that are in place on that sideline ... are obviously doing a great job still if we're not seeing it,'' Cutcliffe said. ''Basically, that means it's no factor yet. Now, do I think it's a bad idea? No. There may be one kid that gets play stopped and we take care of one kid. That's enough to make it worthwhile.''
Gerald Harrison, senior associate director of athletics for internal affairs and a lead football administrator at Duke, said the university is doing a study looking at the number of call-downs by spotters. Results will be presented to the ACC's other doctors at their annual meeting.
The ACC also does not yet require replay, but Carrier Dome boss Pete Sala purchased two units - one for the home team and one for the visitor - and most likely is one step ahead.
''In the future, you'll probably see some form of (replay) capability,'' Harrison said. ''I think it would have been very difficult to pull it off this year.''
Swofford believes a decision for the long-term future on medical observers would be made at season's end, and he was unsure if a uniform policy across the Power Five conferences would result.
''I would anticipate that we would share best practices among the conferences at the end of the year,'' Swofford said, ''as well as the results of how the individual policies worked.''
AP Sports Writers Barry Wilner in New York, Aaron Beard and Joedy McCreary in North Carolina, and Pete Iacobelli in South Carolina and freelancer Mark Frank contributed.