Milligan T A, Yun A, LaFrance W C, Baslet G, Tolchin B, Szaflarski J, Wong V S S, Plioplys S, Dworetzky B A
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Rhode Island Hospital, Brown University, Providence, RI, USA.
Epilepsy Behav Rep. 2021 Dec 16;18:100517. doi: 10.1016/j.ebr.2021.100517. eCollection 2022.
We report a survey of neurology residency program directors (PDs) and recent neurology residency graduates about the education provided during residency on functional seizures (FS), a subtype of functional neurological disorder (FND). The purpose of our study was to assess the education gap for neurology residents about FS since patients with FS are frequently seen by neurologists, who typically conduct the evaluation and share the findings with the patient. A survey was sent to 93 Neurology residency program directors and 71 recent graduates. We obtained a low response rate of 17%. Results of the survey revealed that the most frequent settings for education on FS were within a clinical rotation in the Epilepsy Monitoring Unit (68.8% of PDs and 88.7% of recent graduate respondents) and via a single didactic lecture (81.3% of PDs and 80.3% of recent graduate respondents). The majority of programs did not provide a curriculum for training and feedback on best practices in communicating the diagnosis or on evidence-based treatments. Eighteen percent of neurology residents reported not learning how to communicate the diagnosis of FS to patients, while 77% responded that they were not taught about treatment. These results illustrate a curriculum gap in what neurology residents are taught about diagnosis and management of FS (and FND). We propose a standardized model that can be adapted in residencies.
我们报告了一项针对神经病学住院医师培训项目主任（PDs）和近期神经病学住院医师毕业生的调查，内容涉及住院医师培训期间关于功能性癫痫（FS）的教育，FS是功能性神经障碍（FND）的一种亚型。我们研究的目的是评估神经病学住院医师在FS方面的教育差距，因为FS患者经常由神经科医生诊治，神经科医生通常会进行评估并与患者分享结果。我们向93名神经病学住院医师培训项目主任和71名近期毕业生发送了调查问卷。我们获得了17%的低回复率。调查结果显示，FS教育最常见的途径是在癫痫监测单元的临床轮转中（68.8%的项目主任和88.7%的近期毕业生受访者）以及通过一次专题讲座（81.3%的项目主任和80.3%的近期毕业生受访者）。大多数项目没有提供关于诊断沟通最佳实践或循证治疗的培训课程和反馈。18%的神经病学住院医师报告没有学习如何向患者传达FS的诊断，而77%的人回答他们没有接受过关于治疗的教导。这些结果说明了神经病学住院医师在FS（和FND）诊断和管理方面所接受教育的课程差距。我们提出了一个可在住院医师培训中采用的标准化模式。
