Don't PANIC: A Psychiatry And Neurology Interdepartmental Collaboration to Understand Learner Anxiety with Code Strokes.
Alexandra Morra1, Nabil Hawwa1, Shristi Sharma2, Kathleen Sheehan3, Manav Vyas4, Jeffrey Wang5
1Psychiatry, University of Toronto, 2Western University, 3Psychiatry, University Health Network, 4Neurology, St. Michael's Hospital, 5Neurology, St Michael's Hospital
Objective:
To evaluate the effectiveness of traditional code stroke orientation versus with addition of e-learning videos in reducing anxiety among non-neurology residents.
Background:
Anxiety due to “neurophobia”, and specifically relating to code strokes, could negatively impact learning outcomes of non-neurology residents during their neurology rotations. There is a paucity of evidence surrounding effective orientation modalities, though it has been suggested that e-learning videos can improve orientation. We developed a new video-based approach to code stroke orientation and evaluated its impact on resident learner anxiety.
Design/Methods:
Module Development: Self-directed e-learning videos were created using audiovisual software, with each video lasting 3-5 minutes. The videos aimed to clarify resident responsibilities and key steps during code strokes.
Assessment: A multicenter, prospective, pre/post intervention study was conducted involving non-neurology residents rotating through neurology at one of three hospitals in Toronto, Canada. Anxiety was measured using the STAI-6 (range 6-24), with structured surveys administered one week before the rotation and immediately after orientation. Data were analyzed using a difference-in-difference approach.
Results:
Seventy-six participants submitted the initial survey, with 84.21% completing both surveys (34 control vs. 30 intervention). Forty-six participants (60.53%) were in their first year of training. Baseline sociodemographic characteristics, clinical experience, and mean STAI-6 score were similar between groups.STAI-6 scores decreased post-orientation in both groups (control: mean difference 2.23, 95% CI 1.18-3.28; intervention: mean difference 3.63, 95% CI 2.48-4.77). The intervention group showed a trend towards a greater score reduction, however this difference was not statistically significant (beta coefficient -1.47, 95% CI -3.59 to 0.63).
Conclusions:
Non-neurology residents reported elevated anxiety in anticipation of managing code strokes, which was improved by traditional pre-rotation orientation. The addition of e-learning videos exhibited a trend towards lower post-orientation anxiety, although not statistically significant. These findings warrant further investigation into the use of technology-enhanced orientation to mitigate anxiety for off-service residents.
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