Neurocritical Care Simulation-Based Course for Advance Practice Providers with Limited Prior Experience and Assessment of Employment Retention
Melvin Parasram1, Shamelia Loiseau1, Michael Levine3, Anika Nichlany2, Richard Shin2, Margaret Huynh1, Baxter Allen1
1Neurology, 2Emergency Medicine, New York Presbyterian-Queens, 3Emergency Medicine, The Brooklyn Hospital Center
Objective:
Would a simulation-based neurocritical care (NCC) course improve advance practice providers (APPs) knowledge with limited prior NCC experience and result in good employment retention at 1 year?
Background:
APPs with limited NCC experience may lack skills to manage NCC patients. Simulation-based training may provide a learner-centered educational approach to improve knowledge in NCC and result in APP employment retention. We implemented a simulation-based neurological emergency course for APPs with limited NCC experience and assessed APP employment retention at 1 year.
Design/Methods:
Four simulation cases were conducted. Prior to the cases, learners completed a pre-test and pre-briefing. Simulation cases utilized high fidelity manikins capable of reproducing neurological emergencies. After the cases, learners completed a debriefing, post-test, and post simulation survey on the simulation experience. Pre- and post-test averages were compared using a paired t-test analysis. APP employment retention was also measured 1 year following course completion.
Results:
Learners included 7 APPs with limited NCC experience, who participated in 4 simulation-based courses on NCC management of stroke, cardiac arrest with status epilepticus, intracerebral hemorrhage, and neuromuscular emergencies. Average pre- and post-test scores were 65% and 89% (p<0.00001), respectively. In a post-simulation survey using the Likert Scale (1=strongly disagree, 2=disagree, 3=neutral, 4=agree, 5=strongly agree), learners strongly agreed simulations compared to real-time patient management (median 5, IQR 4-5), was a valuable and effective use of time (median 5, IQR 4-5), led to new knowledge gained (median 5, IQR 4-5), and agreed that they felt prepared (median 4, IQR 4-5) and confident (median 4, IQR 4-5) in managing these neurological emergencies after the simulation course. At one year after course completion, 5 of the 7 APPs (71%) were retained.
Conclusions:
A simulation-based neurological emergency course for APPs with limited prior NCC experience resulted in significant increase in knowledge gained and good employment retention at 1 year.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.