Assessment of Educational Needs For Non-Neurologists Utilizing a Teleneurology Consultation Codel: a Mixed-Methods Study
Bruna Leles Vieira de Souza1, Marinos Sotiropoulos1, Joao Vitor Mahler1, Cynthia Whitney1, Galina Gheihman1, Tamara Kaplan1, Marcelo Matiello1
1Mass General Brigham
Background:
Due to the shortage of neurologists, many hospitals in the US are utilizing teleneurology consultations for the workup and management of patients in the Emergency Department, Intensive Care Unit (ICU) or floor. As non-neurologists are required to perform crucial components of the examination and management, there is a need for a structured, evidence-informed educational needs assessment to ensure the teleneurology model works safely and effectively.
Design/Methods:
We completed a comprehensive mixed methods needs assessment using quantitative surveys evaluating in person clinicians’ perceived neurology educational needs, focus groups and thematic analysis to investigate 14 academic teleneurology physicians’ perceptions and experiences of in-person clinician educational needs, and consultation data from 15,626 teleneurology and telestroke consults over 24 months in 37 hospitals in our institution's Teleneurology network.
Results:
48 clinicians completed the survey and indicated that diagnosis and management of acute stroke and seizure, neurologic complications of critical illness, and delirium were the most high yield learning topics for the Emergency Department, ICU and floor respectively. They ranked in-person, and on-demand recorded lectures or short videos as their preferred Continuing Medical Education modalities. Stroke (42%) and seizure (10%) were the most frequent consultation questions, similar topics were mentioned by teleneurologists in the focus groups. They identified challenges such as incomplete access to history and exam data, particularly with reflex or mental status exams, and variable resources between spoke hospitals. They felt that in-person clinicians would benefit from structured teaching on neurologic exam maneuvers, access to exam tools, and that an in-person setting would be ideal to offer that training.
Conclusions:
An effective teleneurology model relies on in-person clinicians’ knowledge and skill in identifying neurologic presentations and performing crucial exam components. A blended curriculum for non-neurologists combining in-person neurologic exam teaching and feedback with continued online learning could improve the effectiveness and efficiency of teleneurology consultations.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.