Pecha Thomas, Shetty Sharonya, Kengen Abhishek, Gavvala Jay, Maheshwari Atul
From the Baylor College of Medicine (T.P., S.S., A.K., A.M.); and McGovern Medical School (J.G.), Houston, TX.
Neurol Educ. 2023 Sep 25;2(4):e200089. doi: 10.1212/NE9.0000000000200089. eCollection 2023 Dec 22.
The primary objective of this study was to assess the potential educational value of a virtual patient management conference (PMC) with the introduction of inclusive anonymous polling at a comprehensive epilepsy center. The secondary objective was to evaluate differences between faculty and trainee polling results.
Two online surveys were sent 1 year apart seeking opinions about a transition to virtual PMC and completed by virtual PMC faculty participants (including representatives from neurology, neurosurgery, and neuropsychology). One online survey was sent to trainees (medical students, residents, and fellows) to assess the educational value of the conference. Anonymous electronic polls surveying treatment options were completed by both faculty and trainees after each virtual PMC presentation but before discussing the case. The results were collected and analyzed over 16 months, including over the course of 1 academic year. The degree of consensus was determined by the maximum percentage of votes that a single choice received.
Eleven faculty and 22 trainees responded to their respective surveys. The initial faculty survey revealed that 60.0% of faculty had an "excellent" or "very good" experience with virtual PMC; 1 year later, this proportion increased to 100.0% while trainees reported 90.9%. Each virtual PMC component, including perceived standard of care, was found to be "excellent" or "very good" by most faculty and trainees, and most (91% faculty, 63.7% trainees) were equally comfortable or more comfortable expressing opinions during the virtual discussion. During virtual PMC polls, faculty members were significantly more likely to vote for vagus nerve stimulation as a treatment option, while trainees were more likely to opt for responsive neurostimulation. Linear regression over the course of the academic year showed stable consensus over time for both faculty and trainees; however, the match between faculty and trainee consensus significantly increased over the academic year.
Our results demonstrate that the virtual PMC constitutes an effective educational experience as an alternative to in-person conferences for the management of patients with drug-resistant epilepsy.
本研究的主要目的是在一家综合性癫痫中心引入包容性匿名投票的情况下，评估虚拟患者管理会议（PMC）的潜在教育价值。次要目的是评估教员和学员投票结果之间的差异。
相隔1年发送了两份在线调查问卷，征求关于向虚拟PMC过渡的意见，并由虚拟PMC教员参与者（包括神经科、神经外科和神经心理学代表）完成。向学员（医学生、住院医师和研究员）发送了一份在线调查问卷，以评估会议的教育价值。在每次虚拟PMC展示后但在讨论病例之前，教员和学员都完成了关于治疗选择的匿名电子投票。结果在16个月内进行了收集和分析，包括1个学年的时间。共识程度由单一选择获得的最高投票百分比确定。
11名教员和22名学员回复了各自的调查问卷。最初的教员调查显示，60.0%的教员对虚拟PMC有“优秀”或“非常好”的体验；1年后，这一比例增至100.0%，而学员的这一比例为90.9%。大多数教员和学员认为每个虚拟PMC组件，包括感知的护理标准，都是“优秀”或“非常好”，并且大多数人（91%的教员，63.7%的学员）在虚拟讨论中表达意见时同样自在或更自在。在虚拟PMC投票中，教员显著更倾向于将迷走神经刺激作为一种治疗选择投票，而学员更倾向于选择反应性神经刺激。在学年期间的线性回归显示，教员和学员随着时间推移的共识都保持稳定；然而，教员和学员共识之间的匹配度在学年期间显著增加。
我们的结果表明，对于耐药性癫痫患者的管理，虚拟PMC作为面对面会议的替代方式构成了一种有效的教育体验。
