Han Steve C, Stainman Rebecca S, Busis Neil A, Grossman Scott N, Thawani Sujata P, Kurzweil Arielle M
From the Department of Neurology (S.C.H., N.A.B., S.N.G., S.P.T., A.M.K.), New York University Grossman School of Medicine, New York; and Department of Neurology (R.S.S.), Johns Hopkins School of Medicine, Baltimore, MD.
Neurol Educ. 2023 Aug 3;2(3):e200084. doi: 10.1212/NE9.0000000000200084. eCollection 2023 Sep 25.
As the role of teleneurology expands, it is important to prepare trainees to perform virtual encounters proficiently.
We created a comprehensive multimodality teleneurology curriculum for residents to teach key aspects of telehealth encounters including the virtual examination and skill development across several environments.
We developed and implemented a teleneurology curriculum focused on teaching the virtual neurologic examination, measuring teleneurology competency, and providing opportunities for trainees to perform telehealth encounters in multiple settings. Residents (N = 22) were first surveyed on what methods would be most helpful to learn teleneurology. Trainees observed a faculty member conducting a teleneurology visit with another faculty member playing a patient. Residents then practiced a teleneurology encounter during a 10-minute objective structured clinical examination (OSCE) at a simulation center. After positive feedback from the fall of 2020, we adapted the OSCE to be completely remote in the spring of 2021 for senior residents. Trainees then performed teleneurology visits during their continuity clinics and subspecialty clinic rotations.
All neurology residents from adult and child neurology and neuropsychiatry programs at New York University Grossman School of Medicine participated in the curriculum. Residents identified a variety of teaching modalities that would help them learn teleneurology: didactics with slides (25%), live demonstration (25%), simulated experience (23%), starting with live patients (23%), and articles/reading material (4%). To date, 68 trainees participated in the OSCE. Trainees who completed on-site and remote simulations reported increased comfort ( < 0.05) and interest in teleneurology ( < 0.05) and requested more access to simulations during training. Sensorimotor assessment and adequate visualization of the affected limb were identified as areas for improvement.
Our multimodal 3-year teleneurology curriculum provides opportunities for residents to learn and apply teleneurology. Survey tools helped strengthen the curriculum to optimize educational potential. We implemented a teleneurology simulation with and without the use of a simulation center. We plan to expand our teleneurology clinical and simulation experiences to trainees based on our data and further developments in teleneurology and to track the progress of teleneurology skills as residents advance through training.
随着远程神经病学作用的扩大,让受训人员熟练进行虚拟会诊变得很重要。
我们为住院医师创建了一个全面的多模式远程神经病学课程,以教授远程医疗会诊的关键方面,包括虚拟检查以及在多种环境下的技能培养。
我们开发并实施了一个远程神经病学课程,重点是教授虚拟神经学检查、评估远程神经病学能力,并为受训人员提供在多种环境中进行远程医疗会诊的机会。首先对22名住院医师进行调查,了解哪种方法对学习远程神经病学最有帮助。受训人员观看了一位教员与另一位扮演患者的教员进行远程神经病学会诊的过程。然后,住院医师在模拟中心进行的10分钟客观结构化临床考试(OSCE)中练习了一次远程神经病学会诊。在收到2020年秋季的积极反馈后,我们在2021年春季将OSCE调整为完全远程模式,供高年级住院医师使用。之后,受训人员在他们的连续性门诊和专科门诊轮转期间进行远程神经病学会诊。
纽约大学格罗斯曼医学院成人及儿童神经病学与神经精神病学项目的所有神经病学住院医师都参与了该课程。住院医师们指出了多种有助于他们学习远程神经病学的教学方式:幻灯片教学(25%)、现场演示(25%)、模拟体验(23%)、从真实患者开始(23%)以及文章/阅读材料(4%)。迄今为止,68名受训人员参加了OSCE。完成现场和远程模拟的受训人员表示在远程神经病学方面的舒适度(<0.05)和兴趣有所增加(<0.05),并要求在培训期间有更多机会进行模拟。感觉运动评估和对患肢的充分可视化被确定为有待改进的方面。
我们的三年多模式远程神经病学课程为住院医师提供了学习和应用远程神经病学的机会。调查工具有助于强化课程,以优化教育潜力。我们实施了有或没有使用模拟中心的远程神经病学模拟。我们计划根据我们的数据以及远程神经病学的进一步发展,将我们的远程神经病学临床和模拟经验扩展到受训人员,并跟踪住院医师在培训过程中远程神经病学技能的进展情况。