Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Mult Scler Relat Disord. 2022 Jul;63:103821. doi: 10.1016/j.msard.2022.103821. Epub 2022 Apr 25.
To obtain feedback from Neurology residents and Neuroimmunology fellows about the practical training in multiple sclerosis (MS).
A survey was developed and administered electronically to Neurology residents or Neuroimmunology fellows that received training in eight large MS outpatient clinics in Brazil, from 2018 to 2021. We evaluated their beliefs on: (1) the optimal number of MS patients evaluated in a 4-hour outpatient clinic session, (2) the quality of dedicated MS medical records, (3) the training of the neurological exam in MS patients, (4) the teaching discussion with the attending neuroimmunologist and (5) the prescription of MS disease-modifying drugs (DMDs).
The response rate was 57% (43/76). We found that 4 or 5 MS patients would be optimal during a 4-hour outpatient clinic session. Optimal MS medical records were considered structured and presented in a timeline of disease activity and the history of DMDs. 18 in 43 (42%) respondents felt insecure in performing clinical scales used in MS patients. Discussion with the attending neurologist specialized in Neuroimmunology was considered adequate in only half of the respondents, suggesting a need for improvement in teaching strategies. Almost a quarter of the respondents (11/43, 26%) felt that the prescription of DMDs was complex and challenging. Some respondents suggested that readymade templates could be helpful.
The number of patients, medical records, use of MS clinical scales, discussion with attending neurologist specialized in MS care, and the prescription of DMDs present room for improvement in MS training for Neurology residents and Neuroimmunology fellows.
从神经病学住院医师和神经免疫学研究员的角度获取多发性硬化症(MS)实践培训的反馈。
我们开发了一项调查,并于 2018 年至 2021 年期间通过电子方式向在巴西 8 个大型 MS 门诊诊所接受培训的神经病学住院医师或神经免疫学研究员进行了调查。我们评估了他们对以下方面的看法:(1)在 4 小时的门诊就诊中评估 MS 患者的最佳人数,(2)专用 MS 病历的质量,(3)MS 患者神经系统检查的培训,(4)与主治神经免疫学家的教学讨论以及(5)MS 疾病修正药物(DMD)的处方。
响应率为 57%(43/76)。我们发现,在 4 小时的门诊就诊中,4 或 5 名 MS 患者将是最佳选择。最佳的 MS 病历被认为是结构化的,并以疾病活动和 DMD 病史的时间线呈现。43 名受访者中的 18 名(42%)认为在 MS 患者中进行临床量表的操作没有把握。只有一半的受访者(43 名中的 26%)认为与专门从事神经免疫学的主治神经科医生的讨论是充分的,这表明需要改进教学策略。近四分之一的受访者(43 名中的 11 名,26%)认为 DMD 的处方复杂且具有挑战性。一些受访者建议可以使用现成的模板。
MS 培训中,患者人数、病历、MS 临床量表的使用、与专门从事 MS 护理的主治神经科医生的讨论以及 DMD 的处方都有改进的空间。