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

Sources

Only from 2012

AAN annual meeting abstracts

Neurology education research papers

Research from AAN members in other sources

AAN annual meeting(total of 43 education research abstracts)

Assessing the efficiency of learning the neurologic exam with a visual tracking device

Gonzalez 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

Survey of neurology resident attitudes towards teaching and awareness of student feedback

Tuck 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

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

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

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

Neurology patient recognition of and satisfaction with their physicians

Zazulia 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

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

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

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

Neurology papers

Neurology training reassessed: The 2011 American Academy of Neurology resident survey results

Johnson 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

Student assessment by objective structured examination in a neurology clerkship

Lukas 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

Standardized sign-out improves completeness and perceived accuracy of inpatient neurology handoffs

Moseley 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 changesUpdating service listPerception that all important data were transmittedOverall satisfaction

An exploration of case-based learning in neuroscience grand rounds using Delphi technique

Rigby 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 roundsHigh level of audience interactionResident participation in case presentation and analysisFormal training for residents in presentationResident feedback and evaluation

Neurocritical care education during neurology residency: AAN survey of US program directors

Sheth 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%

Additional Sources

Name Topics Journals

Ann Poncelet LICs Medical Education (X2), Medical Teacher, Academic Medicine

Stuart Lubarsky

Clinical reasoning/script concordance testing

Medical Education, Journal of the American Geriatric Society

Imran Ali Medical student documentation in EMR

Teaching and Learning in Medicine

Douglas Larsen

Test-enhanced learning and simulation

Advances in Health Sciences Education