Neurology: Education最新文献

{"title":"A Long-term Faculty Development Initiative Improves Specificity and Usefulness of Narrative Evaluations of Clerkship Students","authors":"C. Mooney, S. Powell, Spencer Dahl, C. Eiduson, Benjamin Reinhardt, R. Stone","doi":"10.1212/ne9.0000000000200003","DOIUrl":"https://doi.org/10.1212/ne9.0000000000200003","url":null,"abstract":"Narrative-based evaluations are increasingly used to discriminate between levels of trainee performance, yet barriers to high-quality narratives remain. Prior evidence shows mixed results regarding the effectiveness of faculty development efforts on improving narrative evaluation quality.We used a quasi-experimental study incorporating a historical control group to examine the effectiveness of a pragmatic, multipronged, 4-year faculty development initiative on narrative evaluation quality in a neurology clerkship. We evaluated narrative evaluation quality using the narrative evaluation quality instrument (NEQI) in random samples of narrative evaluations from a historical control and intervention group. We used multilevel modeling to compare NEQI scores (and subscale scores) across groups. Informed by the theory of deliberate practice, our faculty development initiative included (1) annual grand rounds sessions focused on developing high-quality narratives and reporting evaluation metrics, (2) restructuring the clerkship assessment form to simplify and prioritize narratives, (3) recruiting key faculty to rotate on the clerkship grading committee to gain experience with and practice developing quality narratives, and (4) instituting a narrative evaluation excellence award to faculty and residents.The faculty development initiative was associated with improvements in the quality of students' narrative evaluations. Specifically, the intervention group was a significant predictor of NEQI score, with means of 6.4 (95% CI 5.9–6.9) and 7.6 (95% CI 7.2–8.1) for the historical control and intervention groups, respectively. In addition, the intervention group was associated with significant improvement in the specificity and usefulness NEQI subscale scores, but not the performance domain subscale score.A long-term, multipronged faculty development initiative can facilitate improvements in narrative evaluation quality. We attribute these findings to 2 factors: (1) pragmatic, solution-oriented efforts that balance focused didactics with programmatic shifts that promote deliberate practice and skill improvement and (2) departmental resources that prioritize and convey a commitment to improving trainee assessment.","PeriodicalId":273801,"journal":{"name":"Neurology: Education","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116180887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education Research: Enhancing Medical Student Interest in Careers in the Clinical Neurosciences Through a Hands-on Procedure Workshop","authors":"Collin Sanderson, Khadijah Mazhar, Mark P. Goldberg, Shilpa Chitnis, Ryan Hays, Hina Dave","doi":"10.1212/ne9.0000000000200010","DOIUrl":"https://doi.org/10.1212/ne9.0000000000200010","url":null,"abstract":"It is predicted that the current shortfall of neurologists will continue to grow beyond current training rates. It is well documented that medical students often possess stigmatizing beliefs toward neuroscience-based careers. Preclerkship medical education is where many medical students lay the foundation for specialty interests, and at some medical schools, it may be their only direct exposure to neurology. Providing preclerkship students with exp osure to the unique aspects of clinical neuroscience such as procedures is a possible avenue for increasing student interest.We sought to assess the influence of a procedure workshop on student specialty interest. We organized a hands-on procedure workshop for preclerkship medical students to learn examination skills and procedures used by adult/pediatric neurologists, neurosurgeons, and psychiatrists. Twelve different stations were run by faculty, trainees, and technicians. Attendance was optional, and students were free to move between stations according to their time and interests. Most stations involved some brief education and time for students to practice or take part in the procedure. Attendees completed an exit survey on their retrospective interest in the relevant specialties before attending the workshop, prospective interest after attending the workshop, and the helpfulness of each station in understanding the procedure. Statistical analyses were performed on the survey responses to determine change in specialty interest resulting from the workshop.A total of 111 students attended the workshop, and 104 (94%) filled out the postsurvey. Most were from the second-year medical student class. Approximately 41% of the second-year class attended. There was an increase in student interest (d= 0.6346) in the clinical neurosciences by the Fisher exact test (p< 0.0001). Thirty-three attendees (32%) reported an increased interest in the specialties. Of the students who reported having no prior interest in the clinical neuroscience specialties, 82% (18/22) had an increased interest as a result of the workshop.A hands-on procedure workshop improved medical student interest in the clinical neurosciences. Although its effect on future specialty choice is unclear, preclerkship experiences such as a procedure workshop may be a useful addition to medical school curricula to foster interest in neurology and the clinical neurosciences.","PeriodicalId":273801,"journal":{"name":"Neurology: Education","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125086058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education Research: Bridging the Undergraduate Neurosciences With Clinical Neurology","authors":"M. Minen, Sangida Akter, Mariana Espinosa-Polanco, R. Ramos","doi":"10.1212/ne9.0000000000200005","DOIUrl":"https://doi.org/10.1212/ne9.0000000000200005","url":null,"abstract":"There is a significant shortage of neurologists in the United States, and this shortage is projected to worsen considerably. With the growth of undergraduate neuroscience majors, there may be opportunities to engage and motivate undergraduate students interested in the neurosciences toward clinical neurology. We surveyed undergraduate neuroscience faculty to better understand their curricular goals, existing interaction with neurologists, and their desire for additional connections with clinical neurologists and clinical neurology researchers. We invited 523 undergraduate neuroscience faculty (members of Faculty for Undergraduate Neuroscience) to complete an online survey assessing their research areas, courses taught, existing professional networks, and interest in developing connections in clinical neurology/neurology research. We had 140 of the 523 neuroscience faculty (26.8%) complete the survey. Of the 140 respondents, most respondents (93.6%, 131/140) stated their courses included a discussion about neurologic conditions, yet only 4% (6/139) stated addressing the shortage of neurologists in the country. Few reported they were able to partake in professional development opportunities for shadowing neurologists, neurosurgeons, or similar specialists prior to teaching neuroscience courses (19%, 26/140). Understanding neuroscience faculty's perspectives on how to bridge undergraduate neuroscience programs and the field of neurology is critical. This way, we can identify potential gaps and make recommendations for how to improve the neurology pipeline.","PeriodicalId":273801,"journal":{"name":"Neurology: Education","volume":"53 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121222233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First Issue","authors":"R. Strowd","doi":"10.1212/ne9.0000000000200009","DOIUrl":"https://doi.org/10.1212/ne9.0000000000200009","url":null,"abstract":"The fi rst issue of Neurology ® Education is here. The journal publishes original research articles, curriculum innovations, and evidence-based teaching in neurologic education across all stages of training. Since launching in April, the journal has received numerous important papers on educational scholarship in the clinical neurosciences. Articles are published online continuously allowing rapid dissemination for authors. To facilitate reading, articles are assembled periodically into issues and are arranged thematically to engage readers and organize content around common themes. In this issue, readers will fi nd articles arranged thematically in 3 areas: (1) novel approaches to teaching clinical neurology with a focus on curricular lessons learned from the coronavirus disease 2019 (COVID-19) pandemic, (2) narrative evaluations and how a faculty development program can improve narrative assessment of medical students, and (3) innovative curricula that enhance the pipeline of students pursuing careers in clinical neuroscience.","PeriodicalId":273801,"journal":{"name":"Neurology: Education","volume":"260 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132754069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curriculum Innovations: Creation of a Longitudinal, Neurology-Centered Pipeline Program to Motivate and Support Students From Racial/Ethnically Marginalized Groups","authors":"Shane Fuentes, R. Salas, Olivia S. Brumfield, R. Stone","doi":"10.1212/ne9.0000000000200007","DOIUrl":"https://doi.org/10.1212/ne9.0000000000200007","url":null,"abstract":"Premedical students who identify from historically marginalized racial and ethnic backgrounds are more likely to lose interest in medicine than their White counterparts. Loss of interest has been attributed to a lack of exposure to the field and little mentorship.The PreDoc Program was designed as a longitudinal experience to promote exposure to and interest in academic medicine, particularly through the lens of neurology for premedical students who identify from historically marginalized racial and ethnic backgrounds.The program included the following core components: (1) senior (faculty) mentor to facilitate direct contact with a physician, networking, and professional development coaching; (2) junior (medical student) mentor to provide near peer support and increased knowledge of the medical school application process; (3) large group meetings aimed at teaching professional development and working through clinical problem-based learning; (4) shadowing experiences aimed at increasing knowledge of patient care delivery and other academic roles; and (5) a clinically oriented project. After initial grant support to create the program, it has been maintained successfully with minimal funding through the Department of Neurology.The program recruited 29 student participants who completed at least 1 year of the program, 18 senior mentors, and 23 junior mentors over 4 academic years. The overall quality of the program was rated at 4.7 of 5 (median 5, range 2), with an upward trend seen over time. Over its first 2 years, the program facilitated the following estimated activities: 45 in-person senior mentor meetings, 27 in-person junior mentor meetings, 42 shadowing experiences, 60 large group meetings, and 360 email communications. Student-reported strengths included ease of shadowing, usefulness of problem-based learning cases, mentor relationships, and encouragement received. Areas for improvement included increasing the strength of junior mentor relationships and increased opportunities for socialization outside of the formal meetings.It is feasible to create a successful, longitudinal, clinically focused undergraduate pipeline program for students who identify with historically minoritized racial and ethnic backgrounds with minimal funding centered in a Department of Neurology to help promote diversity within the field.","PeriodicalId":273801,"journal":{"name":"Neurology: Education","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123906944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pictorial Review of Lesion Localization for Patients With Stroke, Upper Limb and Lower Limb Pathology","authors":"S. Lyon","doi":"10.1212/ne9.0000000000200012","DOIUrl":"https://doi.org/10.1212/ne9.0000000000200012","url":null,"abstract":"Localization is a foundational skill in clinical neuroscience and a vital aspect of teaching and learning for students and educators. Stroke syndromes, brachial plexus injury, and lumbosacral nerve pathology are among some of the most challenging clinical scenarios for learners to understand and master. The 3 images in this article are teaching tools for learners and teachers in clinical neuroscience. The “ Vascular Localization of Stroke ” image is a reference tool for learning cerebrovascular anatomy and the e ff ect of a cerebrovascular accident, according to the location of the lesion. The “ Upper Limb Pathology ” and “ Lower Limb Pathology ” images are handout tools for learning how lesions to peripheral nerves or spinal nerve roots present with sensory and/or motor de fi cits.","PeriodicalId":273801,"journal":{"name":"Neurology: Education","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130901926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curriculum Innovations: Virtual Didactics as a Tool for Harmonizing Education About Rare Topics in Neuroimmunology","authors":"J. Peters, Jeffrey A. Cohen, J. Corboy, S. Hopkins, L. Hua, Mihir Kakara, Derek McFaul, A. Obeidat, V. Yadav, E. Longbrake","doi":"10.1212/ne9.0000000000200008","DOIUrl":"https://doi.org/10.1212/ne9.0000000000200008","url":null,"abstract":"Neuroimmunology is a rapidly evolving subspecialty. At this time, fellowship training is not standardized. Discrepancies exist in fellowship programs across the United States, including in faculty expertise in rarer neuroimmunologic conditions. Many graduating fellows feel uncomfortable managing the full spectrum of diseases within neuroimmunology.To evaluate the feasibility and efficacy of a series of live, virtual, interinstitutional seminars educating neuroimmunology fellows on topics that may be infrequently encountered by trainees.A steering committee of 6 neuroimmunology and multiple sclerosis fellowship program directors selected 18 topics felt to be high yield but representing unique areas of expertise. A live, interactive seminar series was organized. Recognized experts on each topic led seminars using a teleconferencing platform over the 2020–2021 academic year. Recordings were subsequently made available for asynchronous learning. Trainees were surveyed before and after the seminar series and comfort levels with each topic were recorded.An average of 41 trainees participated in each live seminar and an additional average of 17 trainees viewed each seminar on demand. Trainee comfort levels with each topic increased after the seminar series was completed. An average of 72% of trainees self-identified as at least “comfortable” with each topic after the series compared with 26% beforehand (p< 0.0001).A year-long series of live, interactive, interinstitutional seminars focusing on unique topics within a single subspecialty represents an effective way to increase trainee comfort levels with such topics.","PeriodicalId":273801,"journal":{"name":"Neurology: Education","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124627980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curriculum Innovations: How Real Is Real Enough?","authors":"Catherine Albin, E. Petrusa, James A. Gordon, Deepa Malaiyandi, Sahar F. Zafar","doi":"10.1212/ne9.0000000000200004","DOIUrl":"https://doi.org/10.1212/ne9.0000000000200004","url":null,"abstract":"Simulation training has been increasingly adopted in neurology as an engaging way to promote active learning in a safe environment while offering a reproducible platform for real-time feedback. However, despite the increase in simulation programs, there remains uncertainty about which type of high-fidelity platform would best promote trainee knowledge and confidence acquisition. The objective of this study is to investigate whether increases in resident knowledge and confidence differ when a simulation course for acute neurology emergencies uses a standardized patient vs a manikin-video format. We also investigated trainees' management deviations from the treatment guidelines.Over 5 sessions, 20 junior neurology residents participated in a simulation training course in which they managed 3 neurologic emergencies: right middle cerebral artery stroke, status epilepticus, and pontine hemorrhage causing coma. Residents in the standardized patient group interacted with a live actor for the cases in which the patient was conscious. Residents in the manikin-video group interacted with a manikin for all 3 cases. Before and after the course, residents completed a 40-question multiple-choice test and a survey about their self-perceived confidence in handling 15 neurologic emergencies. To create an element of internal validity, 9 items were represented in the course curriculum and 6 were not. During the simulation, a detailed behavior checklist was used to assess decision-making and guideline adherence. All residents answered items about the educational quality of the simulation sessions.Residents had significantly higher scores on the knowledge assessment after the training session (pre: 49% vs post: 72%,p< 0.001, effect size 91%). There was no statistically significant difference between the 2 groups—each increasing 23% (p= 0.977). Regardless of group assignment, the median self-reported confidence score improved by 1 point on a Likert scale across the topics taught in the course. The behavior checklist demonstrated significant variations in treatment practices and provided targeted areas for feedback and teaching.This pilot study suggests that trainees' knowledge and confidence in the management of neurologic emergencies increase after simulated encounters, regardless of whether a live actor or manikin simulation platforms is used. The use of a behavior checklist uncovered important variations in guideline adherence among novice physicians.","PeriodicalId":273801,"journal":{"name":"Neurology: Education","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131004625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}