RT Journal Article
SR Electronic
T1 Education Research: Junior Neurology Residents Achieve Competency but Not Mastery After a Brief Acute Ischemic Stroke Simulation Course
JF Neurology: Education
JO Neurol Edu
FD American Academy of Neurology
SP e200071
DO 10.1212/NE9.0000000000200071
VO 2
IS 2
A1 Catherine S.W. Albin
A1 Melissa B. Pergakis
A1 Erika J. Sigman
A1 Nirav R. Bhatt
A1 Spencer K. Hutto
A1 Sitara Koneru
A1 Ehizele M. Osehobo
A1 Joaquin A. Vizcarra
A1 Nicholas A. Morris
YR 2023
UL http://ne.neurology.org/content/2/2/e200071.abstract
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