Objective:

To design simulated cases (SimLabs) mimicking neurologic emergencies and evaluate their impact on knowledge and confidence in junior neurology residents.

Background:

The management of neurologic emergencies, such as stroke and status epilepticus, are critically important parts of residency. Simulation is a well-established method of medical education, which is often underutilized in neurology despite its potential to enhance learning.

Design/Methods:

We designed simulated cases on ischemic stroke, intracerebral hemorrhage, and status epilepticus utilizing a standardized patient and an actor playing the role of family/informant. First-year neurology residents (PGY2) participated in the simulations early in their training (n=9). Knowledge, confidence, and value were measured using anonymized pre/post-surveys consisting of questions rated on a 5-point Likert Scale. The pre-post survey data were analyzed using paired, two-tail, t-tests.

Results:

All questions focusing on residents’ confidence in the acute management of neurologic emergencies showed a positive trend in the post-survey, including status epilepticus (0% pre- vs. 56% post-simulation) and acute stroke (56% pre- vs. 67% post-simulation). Confidence in the management of status epilepticus was statistically significant (p<0.05) as was the self-rated ability of simulation to improve confidence (p<0.05). All participants strongly-agreed or agreed that the SimLab improved both their subjective confidence and knowledge in our study topic. After the SimLab, residents felt more knowledgeable in the workup of acute deficits, running a stroke activation, thrombolytic inclusion/exclusion criteria, and management of status epilepticus (p<0.05). The largest trend was in the management of status epilepticus (p<0.001). In the post-test, all residents strongly-agreed or agreed that SimLabs are a valuable part of residency (p<0.05).

Conclusions:

We found that junior residents rate SimLabs as a valuable component of their neurology training. SimLabs enhanced residents’ confidence and perceived knowledge base, as reflected in improved self-assessment ratings. Larger studies should be performed to provide further support for the incorporation of SimLabs in neurology training.