Simulation-based Brain Death Determination Training for Neurology Residents
Noelia Morales1, Cesar Escamilla Ocanas3, Gabriel Torrealba Acosta4, Catherine Garcia5, Lintu Ramachandran6, Mohammad Hirzallah2
1Neurology, Baylor College of Medicine, 2Baylor College of Medicine, 3Neurocritical care, Massachusetts General Hospital, 4Duke University Hospital Neurocritical Care Unit, 5MD Anderson Cancer Center, 6University of Florida College of Medicine – Jacksonville
Objective:
N/A
Background:
Brain death determination is an essential skill every neurologist should have. Despite the availability of clear guidelines for brain death determination, there is significant variability in practice both, within the United States and internationally. Previous studies have shown neurology residents have limited exposure to brain death examination and typically do not perform this task independently. However, they are expected to be proficient in determining brain death by the end of residency.
Design/Methods:

A simulation-based brain death determination workshop was generated for second year neurology residents, and conducted for three consecutive years from 2022 to 2024. Two questionaries (Form A and B) were generated, each with 14 premises that evaluated different educational competencies on brain death determination guidelines.

The workshop was divided in two parts. The first part consisted of a 60 minute lecture given covering the above-mentioned competencies, based on the 2023 pediatric and adult BD/DNC consensus guideline by a neurocritical care attending. followed by a questionnaire. 

Residents then teamed up in groups of 2. High fidelity mannequins were used to simulate patients in five different clinical scenarios. We asked teams to take turns leading each encounter. A debriefing session was conducted after each case to provide immediate feedback. After completing the simulations, the residents received the second questionnaire, ensuring it was a different version from the initial one. Questionnaire results had no identifiable information. 

Results:

19 neurology residents completed the brain death determination workshop. 18 out of 19 demonstrated an improvement in performance following the completion of the workshop. Mean pre-workshop score was 63.68 % ± 17.80, while the mean post-workshop score increased to 89.71 % ± 9.4 (p<0.0001).

Conclusions:

Conducting a simulation-based workshop early during neurology training might help increase the level of confidence and proficiency performing a comprehensive brain death examination prior to the completion of residency.

10.1212/WNL.0000000000212451
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.