Advancements in Neurology Education Research: Key Findings and Insights from 2012

1. Education Research Highlights 2012! Douglas P. Larsen, M.D., M.Ed. Assistant Professor of Neurology & Pediatrics Department of Neurology Washington University in St. Louis School of Medicine Presented at the A.B. Baker Section of Neurologic Educators Meeting March 18, 2013

2. Sources • Only from 2012 • AAN annual meeting abstracts • Neurology education research papers • Research from AAN members in other sources

3. AAN annual meeting(total of 43 education research abstracts)

4. Assessing the efficiency of learning the neurologic exam with a visual tracking deviceGonzalez Castellon M, Phillips M, Blum C, Goldberg M, Noble J • Funded by an AAN education research grant • Using an infrared eye tracker • Analyze the efficiency of the neurological exam on patients with Parkinson Disease • How that efficiency changes after an educational intervention and by level of training

5. Survey of neurology resident attitudes towards teaching and awareness of student feedbackTuck K, Kraakevik J • All residents agreed that teaching is an important part of their job • Only 35% consider themselves good teachers • Only 46% always or often would like student feedback on their teaching • Feedback (when given) changed residents approach to teaching

6. Evaluating neurology residents’ clinical skills: The setting matters!Kelly A, Jozefowicz R • Comparison of “on the fly” evaluations of clinical skills versus an OSCE format • OSCE scores were lower than “on the fly” evaluations • Neither score correlated well with the RITE exam performance

7. Assessing the multiple mini interview (MMI) for use in selecting applicants to a neurology residency programLubarsky S, Young M • Funded by an AAN education research grant • MMI consists of multiple focused interview stations directed at different attributes • Designed to give a broader and more standardized sampling of applicant attributes • Moderate reliability of 0.5 • Analysis of correlations demonstrated that distinct attributes and skills were elicited

8. Predicting success in neurology residencyHalfman C, Bradshaw D • Correlations made between USMLE Step 1 scores, pre-residency interview scores, RITE scores, competency-based 360 evaluations, and attending evaluations • USMLE Step 1 scores correlated with RITE scores and measures of medical knowledge, patient care and professionalism • Interview scores correlated with professionalism

9. Neurology patient recognition of and satisfaction with their physiciansZazulia A, Anderson T • Patients were asked to identify physicians caring for them from a sheet of photos and names • Median of 4 physicians involved with a patient’s care • Median of 1 physician identified by a patient • Patients very satisfied with their care could identify more physicians and were able to identify a physician who knows them best and who they believe to be in charge of their care

10. Stroke simulation enhances residents’ confidence in acute stroke/TIA managementUppal G, Sandhu D, Vellipuram A, Sanders C, Phillips F, Nanda A, Lardizabal D, Singh N • Comparison of simulation with standardized patients versus a traditional classroom didactic teaching method • Simulation proved superior in all areas regarding the accuracy and timing of treatment decisions

11. Understanding the genesis of neurophobia: A mixed-methods study of trainees’ perceptions of neurology educationFantaneanu T, Moreau K, Eady K, Clarkin C, De Meulemeester C, MacLean H, Barrowman N, Doja A • Questionnaires followed by focus groups used to measure and then explore students’ perceptions of neurology • Neurophobia diminished (50% to 30%) between the first and second year of medical school • Did not change from the second to the third year (30% to 39%) • Students identified the difficulty and complexity of neurology as the source of their phobia with multiple barriers to learning identified

12. Student self assessment in a neurology clerkshipKlein J, Stankiewicz J • Correlations between self-assessment, faculty evaluation, shelf exam performance, and clinical skills exam • Student and faculty assessments were moderately correlated (r=.4) • All other correlations were not significant

13. Neurologypapers

14. Neurology training reassessed: The 2011 American Academy of Neurology resident survey resultsJohnson NE, Maas MB, Coleman M, Jozefowicz R, Engstrom J • 49.8% response rate • 59% rated faculty as excellent • 90% rated clinical skills training as well or very well • 71% felt the RITE helped with self-study • Majority of residents did not feel that residency adequately trained them for practice management • 86% planned to enter fellowship

15. Student assessment by objective structured examination in a neurology clerkshipLukas RV, Adesoye T, Smith S, Blood A, Brorson JR • OSCE scores in two standardized patient encounters were significantly correlated (r=.4) • Faculty clinical evaluations from two rotations were uncorrelated • OSCE scores were predictive of shelf exam performance and clinical evaluations

16. Standardized sign-out improves completeness and perceived accuracy of inpatient neurology handoffsMoseley BD, Smith JH, Diaz-Medina GE, Paz Soldan MM, Wicklund M, Dhamija R, Reda H, Presti MF, Britton JW • Comparison between rotations using unstructured and structures sign-out • Structured sign-outs improved: • Sharing test results with patients prior to shift changes • Updating service list • Perception that all important data were transmitted • Overall satisfaction

17. An exploration of case-based learning in neuroscience grand rounds using Delphi techniqueRigby H, Shofield S, Mann K, Benstead T • Delphi technique (multiple rounds of questionnaires) used to explore perceptions of grand rounds • Most important aspects of grand rounds • Case-based rounds • High level of audience interaction • Resident participation in case presentation and analysis • Formal training for residents in presentation • Resident feedback and evaluation

18. Neurocritical care education during neurology residency: AAN survey of US program directorsSheth KN, Drogan O, Manno E, Geocadin RG, Ziai W • 74% response rate • 56% of programs offered dedicated neuro-ICU rotations • From 2005-2010 number of residents going into neuro-ICU fellowships rose from 14% to 35%

19. Additional Sources