RT Journal Article
SR Electronic
T1 Education Research: Neurology Residents Report Improved Skills After Initiation of a Lumbar Puncture Clinic
JF Neurology: Education
JO Neurol Edu
FD American Academy of Neurology
SP e200040
DO 10.1212/NE9.0000000000200040
VO 2
IS 1
A1 Pfalzer, Anna
A1 Koons, Heather
A1 Lee, Christopher
A1 Acosta, Lealani Mae
YR 2023
UL http://ne.neurology.org/content/2/1/e200040.abstract
AB Background and Objectives Neurology residents have limited opportunities to perform lumbar punctures (LPs). We hypothesized that establishing a clinic for residents to perform LPs would increase success rates, improve resident comfort with LPs, reduce the need for assistance by attending physicians, and improve patient care.Methods The Vanderbilt University Medical Center neurology residency began a resident LP clinic and measured residents' input and clinical data to see whether the clinic affected resident LP skills. Before and after the launch of LP clinic, neurology residents were invited to complete online surveys at the end of the academic year and during their LP clinic rotation. Completion of the surveys was voluntary and considered consent. The surveys assessed LP attitudes and experience (e.g., confidence with LPs and number performed) and LP clinic procedural data (e.g., LP success rate). Attitudes were measured by assessing confidence; experience by quantifying the number of LPs performed; procedural success was measured by the number of LPs with successful CSF acquisition. Differences in resident attitude and LP outcomes were analyzed using Spearman correlations and logistic regressions.Results Prior to the launch, 15/25 (60% response) residents responded to the clinic survey. After the launch, 6/21 (29%) responded to the first-year follow-up survey and 12/21 (57%) to the second-year follow-up survey. Resident confidence and the number of LPs performed were unchanged. Success rate reported by individual residents increased 15% (p = 0.04), which did not correlate with the overall LP clinic success rate. In the first year of the clinic, 83% of postgraduate year (PGY)3s needed an attending's assistance compared with 29% of PGY4s. In the second year, 44% of PGY3s and 32% of PGY4s needed an attending's assistance.Discussion This structured clinic provided an opportunity for informal resident-to-resident teaching, which may have reduced the need for attending assistance.BMI=body mass index; LP=lumbar puncture; OR=odds ratio; PGY=postgraduate year; REDCap=research electronic data capture; VUMC=Vanderbilt University Medical Center