2026 American Academy of Neurology Abstract Website

Objective:

To evaluate neurology residents’ performance across serial neuroanatomy assessments within a spiral curriculum, compare results to attending physicians, and determine whether anchored analyses adjusting for test difficulty reflect true learning gains.

Background:

Neuroanatomy is a foundational discipline in clinical neuroscience but is often perceived as difficult to learn and retain, contributing to "neurophobia" among trainees. Traditional methods like cadaveric dissection are impractical during residency, while alternative strategies—such as near-peer teaching (NPT), inquiry-based clinical cases (IBCC), and spiral curricula—may offer more effective and sustainable learning.

Design/Methods:

This prospective, single-center educational intervention involved PGY-2 to PGY-4 neurology residents who completed four multiple-choice neuroanatomy tests: baseline (Pre), immediate post-intervention stage one (Post-1), repeat of baseline after stage two (Post-2), and a final test with new content after stage two (Post-3). The curriculum was delivered through biweekly sessions incorporating NPT and case-based learning. Two attending neurologists independently reviewed all test items, and questions deemed unclear were excluded. Outcomes included percent correct scores, paired comparisons, regression analyses, tertile-based performance changes, benchmarking against attendings, and anchored analyses adjusting for test difficulty.

Results:

Seventeen residents completed the first three tests; fifteen completed the final. While raw scores remained stable (Pre: 45.3%, Post-1: 45.1%, Post-2: 49.8%, Post-3: 45.6%), regression analyses showed improved rank-ordering (R² from 0.233 to 0.636). Tertile analysis revealed that 80–83% of low-performing residents improved. Anchored analyses showed resident performance relative to attendings increased from 74% to 84–86%, with difficulty-adjusted scores rising by ~6–7 points.

Conclusions:

Despite stable raw scores, anchored analyses revealed meaningful learning gains, particularly among lower-performing residents. These findings suggest that combining near-peer teaching, case-based learning, and MCQ assessments within a spiral curriculum may be an effective strategy for teaching neuroanatomy in neurology residency programs.