PT - JOURNAL ARTICLE AU - Catherine S.W. Albin AU - Melissa B. Pergakis AU - Erika J. Sigman AU - Nirav R. Bhatt AU - Spencer K. Hutto AU - Sitara Koneru AU - Ehizele M. Osehobo AU - Joaquin A. Vizcarra AU - Nicholas A. Morris TI - Education Research: Junior Neurology Residents Achieve Competency but Not Mastery After a Brief Acute Ischemic Stroke Simulation Course AID - 10.1212/NE9.0000000000200071 DP - 2023 Jun 26 TA - Neurology: Education PG - e200071 VI - 2 IP - 2 4099 - http://ne.neurology.org/content/2/2/e200071.short 4100 - http://ne.neurology.org/content/2/2/e200071.full SO - Neurol Edu2023 Jun 26; 2 AB - Background and Objectives Simulation bootcamps are used to onboard neurology trainees. It is not known whether these bootcamps result in competency for acute ischemic stroke (AIS).Methods For this prospective, single-center pre-post educational intervention study, the Angoff standard setting method was used to determine a Minimum Passing Score (MPS) and Mastery Score for 2 AIS simulations. Junior neurology residents completed precourse knowledge and confidence assessments and had traditional didactic teaching. A week later, each resident completed the first scored AIS simulation. Each resident then practiced stroke care in an unscored simulation. Two to 8 weeks later, each resident was evaluated in an unannounced AIS simulation (the post-test). Postgraduate year (PGY)-3 adult neurology senior residents also completed a knowledge and confidence assessment and were scored on just the AIS post-test case. Using independent and paired t tests, respectively, we compared the junior residents' retention test performance to their baseline assessment and to senior residents' performance.Results Thirteen junior residents (9 PGY-2 adult neurology residents and 4 PGY-3 child neurology residents) participated in the course. Only 3 junior residents (23%) initially achieved the MPS in the first AIS simulation. After the simulation course, 9 junior residents (69%) achieved the MPS threshold. Although none achieved mastery, junior residents' mean performance score in the simulation improved (mean score preintervention [SD] = 10.3 [2.8] vs mean score postintervention [SD] = 15.7 [2.6], p < 0.001) and their confidence increased (mean score preintervention [SD] = 3.3 [1.9] vs mean score postintervention [SD] = 4.9 [1.2], p < 0.001, d = 1.7). Eight PGY-3 adult neurology residents were scored on the AIS post-test. Five reached MPS (63%), and 1 demonstrated mastery. The simulation scores of the postcourse juniors and seniors were similar (junior resident mean score [SD] = 15.7 [2.6] vs senior resident mean score [SD] = 16.0 [2.5], p = 0.793).Discussion A brief AIS simulation course may improve junior residents' performance and confidence to a level comparable with senior residents, although not to mastery.AIS=acute ischemic stroke; CTA=CT angiography; ENLS=Emergency Neurological Life Support; ICC=intraclass correlation; ICH=intracerebral hemorrhage; MCA=middle cerebral artery; ML=mastery learning; MPS=Minimum Passing Score; MS=Mastery Score; NIHSS=NIH Stroke Scale; PGY=postgraduate year; SBML=simulation-based mastery learning; SE=status epilepticus; tPA=tissue plasminogen activator