Objective:

To describe the design, implementation, and evaluation of a nerve block training program for neurology residents.

Background:

Peripheral nerve blocks are an important tool for treating headache in the acute and outpatient settings. Formal nerve block training is not currently required in neurology residency, which limits their utilization.

Design/Methods:

We designed and implemented a structured, hands-on nerve block training program for neurology residents at an academic medical center. The program was a component of a larger educational effort including a mandatory two-year headache curriculum for PGY-2 residents and a week-long advanced elective for PGY-3/4s. Residents observed nerve blocks in clinic and then performed them under supervision. For credentialing, residents completed five supervised nerve blocks assessed by a standardized checklist, after which they could perform nerve blocks independently.

Residents completed a pre-survey prior to implementation, with five confidence questions rated using a 5-point Likert scale (1= no confidence to 5= most confidence) and five multiple-choice competence-based questions assessing knowledge of evidence-based guidelines and procedural steps. Residents will complete a post-survey after credentialing.

Results:

The headache curriculum was launched in July 2023. 19 PGY2 and 3 PGY3 residents completed the pre-survey. Residents reported low confidence in understanding indications for nerve blocks (mean(SD), 1.86(1.13)) and performing nerve blocks (1.36(1.05)). Residents also demonstrated poor knowledge, scoring on average 30% (SD 18.3%) on five competence questions. We anticipate sharing results of the post-survey in our presentation.

Conclusions:

We introduced a structured, hands-on nerve block training as part of a formal headache curriculum in an academic neurology residency program. Residents have limited knowledge of indications for nerve blocks and low confidence in performing nerve blocks. The post-survey will evaluate the implementation and educational impact of nerve block training. Lessons learned in the design and evaluation of our nerve block training and headache curriculum may help guide other neurology residency programs.