Article Figures & Data
Figures
- Figure 1 PRISMA-ScR Flowchart of Study Inclusion
Flowchart of article inclusion phases. A total of 930 studies were included in full-text analysis and assessed by 2 screening authors, with 350 studies included in data extraction. PRISMA-ScR = Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.
- Figure 2 Defining Features of Education Innovation
Audit of all 175 full-text studies for the presence of Colbert-Gert et al.13 defined 12 key features of education innovation articles, represented in percentages.
- Figure 3 Top Education Innovation Study Trends Over Past Decade
Most studied neurology educational innovations and their prevalence per year since 2010. A total of 4 studies published in 2010 included, with an increase to 54 published in 2021. Total studies included for each innovation: simulation (142 studies), eLearning (78 studies), 3D modeling/printing (34), virtual reality (26), and podcasts/smartphone app/social media (24). 3D = 3 dimensional.
- Figure 4 Kirkpatrick Training Evaluation Outcomes per Innovation
Kirkpatrick training evaluation grades by level in total for each education innovation. There were 5 Level 3 studies and only 3 Level 4 studies. 3D = 3 dimensional; N/A = not applicable.
- Figure 5 Clinical Content Areas (by Study)
Total number of studies focused on each clinical content area represented in the entire 350 studies included in the scoping review.
- Figure 6 Study Design per Innovation
Number of total studies with study design details including full-text publications, comparative group design, medical student participation, and participant randomization for each innovation. 3D = 3 dimensional.
Tables
Author Study design Education innovation Comparison group Outcomes Results Kirkpatrick assessment Kelly et al.14 Investigation, interventional study Simulation N/A Residents' self-perceived ability to effectively counsel patients and families before and after the exercise was compared. Trends in time to initiate IV thrombolysis for stroke were investigated before and after the intervention. Residents' preparedness to perform counseling on acute stroke improved, though not significant (p > 0.05). Mean door-to-thrombolytic treatment for acute stroke was significantly improved in the 6 mo following simulation exercises compared with the previous 18 mo (54 vs 69 min, p = 0.01). 4 Mehta et al.15 Investigation, interventional study Simulation N/A Resident performance pre- and post-intervention, critical action checklist completion, and door-to-needle time for IV-tPA. Simulation training independently predicted reduction in door-to-needle time by 9.64 min (95% CI −15.28 to −4.01, p < 0.001) after controlling for age, night/day shift, work week vs weekend, and blood pressure at presentation. 4 Richardson et al.16 Interventional study Simulation Post- vs pre-simulation door-to-needle times A mannequin was used and controlled by simulation laboratory personnel while participants were videotaped as they performed the scenario. Incorporated into the debriefing of the scenario was education of door-to-needle goals, stroke alert process, and a discussion of role expectations. Postintervention, the door-to-needle average decreased to 39.8 min (p = 0.0794). Before the education, the goal of administering alteplase in less than 60 min occurred 80% of the time and following education the goal was met 89% of the time. 4 Dwortezky et al.17 Interventional, mixed-methods design Simulation N/A Used a questionnaire assessing baseline knowledge and attitudes regarding seizure management. Calculated interobserver reliability of the checklist for consistency among the raters. Training led to sustainable improvement in performance in the actual EMU. Knowledge in seizure management was significantly improved following the program. Interrater agreement was moderate to high. 3 Gordon et al.18 Interventional, comparative study eLearning Control facilities vs intervention facilities The primary outcome variables were the percentage of residents receiving antipsychotic medications and the percentage who were physically restrained. Residents in facilities were 75% less likely to be physically restrained and 17% less likely to be prescribed antipsychotic medication compared with residents in control facilities over the 18-mo intervention period (OR 0.25, p = 0.05) and (OR 0.83, p = 0.07) 3 Sivakumar et al.19 Interventional study eLearning N/A Attainment of skill sets is tracked through self-reported case logs and professionalism. Resident and faculty surveys are conducted for feedback and system change. Resident attendance and participation had significantly increased after the intervention. 3 Stork et al.20 Investigational, pilot study Simulation N/A Entrance and exit surveys were administered to measure changes in knowledge, skills, and attitudes. The use of rtPA for AIS was tracked before and after the intervention. All trainees reported significantly increased confidence in acute stroke patient selection and management with rtPA, including its potential complications. IV rtPA use increased by 75% in the 7 mo after workshop and increase persisted at 13 mo. 3 Zaika et al.21 Interventional, investigational study 3D modeling, simulation N/A Participants were assessed on their procedural pace, coiling quantity and quality, and perforation rates. Spatial ability was assessed using a mental rotations test and used in the performance analysis Individuals were able to perform the procedure faster after 6 sessions, reducing their average time from 42 to 24 min. The coil success rate improved from 82% to 88%, and the coil packing rate remained consistent at 30% throughout testing. 3 Abbreviations: 3D = 3 dimensional; AIS = acute ischemic stroke; EMU = epilepsy monitoring unit; N/A = not applicable; OR = odds ratio; rtPA = recombinant tPA; tPA = tissue plasminogen activator.
First author, neuroscience topic, participants, comparison group in design, study outcomes, and results of the studies who met Kirkpatrick training evaluation Level 4 (3 studies) and Level 3 (5 studies) criteria.
Name Location Contribution William Denney Zimmerman, DO Department of Neurology, University of Maryland School of Medicine; Program in Trauma, R Adams Cowley Shock Trauma Hospital, Baltimore, MD Drafting/revision of the manuscript for content, including medical writing for content; major role in the acquisition of data; study concept or design; and analysis or interpretation of data Melissa B. Pergakis, MD Department of Neurology, University of Maryland School of Medicine; Program in Trauma, R Adams Cowley Shock Trauma Hospital, Baltimore, MD Drafting/revision of the manuscript for content, including medical writing for content; major role in the acquisition of data; study concept or design; and analysis or interpretation of data Emily F. Gorman, MLIS, AHIP Health Sciences and Human Services Library, University of Maryland, Baltimore Major role in the acquisition of data and study concept or design Melissa Motta, MD Department of Neurology, University of Maryland School of Medicine; Program in Trauma, R Adams Cowley Shock Trauma Hospital, Baltimore, MD Drafting/revision of the manuscript for content, including medical writing for content, and analysis or interpretation of data Peter H. Jin, MD Department of Neurology, University of Maryland School of Medicine, Baltimore Drafting/revision of the manuscript for content, including medical writing for content, and analysis or interpretation of data Rachel Marie E. Salas, MD, MEd Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD Drafting/revision of the manuscript for content, including medical writing for content Nicholas A. Morris, MD Department of Neurology, University of Maryland School of Medicine; Program in Trauma, R Adams Cowley Shock Trauma Hospital, Baltimore, MD Drafting/revision of the manuscript for content, including medical writing for content; major role in the acquisition of data; study concept or design; and analysis or interpretation of data
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