Implementation and Evaluation of a Comprehensive Neurophysiology Curriculum for Neurology Residents
My Nguyen1, Katherine Fu2, Rajarshi Mazumder3, Inna Keselman2, Marc Nuwer3, Joy Chan2
1Medical School, David Geffen School of Medicine at UCLA, 2University of California, Los Angeles, 3Department of Neurology, University of California, Los Angeles
Objective:

We implemented a neurophysiology curriculum covering electroencephalography (EEG), electromyography/nerve conduction study (EMG/NCS) and less commonly taught topics like evoked potentials (EPs) and intraoperative monitoring (IOM) and evaluated learning outcomes with pre- and post-curricular assessments.  

Background:

Residency training is largely inpatient, leaving little time for structured neurophysiology education despite American Council of Graduate Medical Education (ACGME) milestones in EEG and EMG. Neurology residents have expressed decreased confidence in these two areas. Furthermore, there is minimal training in EPs and IOM. We implemented a neurophysiology curriculum to improve competency in EMG, EEG, EPs, and IOM with the goal of improving competency and engagement in the field.

Design/Methods:

During their required PGY-3 outpatient rotation, UCLA neurology residents spent two half days per week learning EMG/NCS, EEG, EP, and IOM. The curriculum combined lectures, readings, and case discussions. To determine knowledge acquisition, we designed and administered pre- and post-curricular assessments, analyzing the change in scores with a paired t-test and administered a survey for curricular evaluation.

Results:

10 residents completed the pre-assessment and 5 completed the post-assessment. There was a significant improvement in mean scores on the post-test (M = 68.3 %, SD = 18.1, p=0.013) compared to the pre-test (M = 45.4%, SD = 12.8) with improvements across all topics. The curricular evaluation demonstrated that the majority of residents felt more proficient in all topics. EP and IOM sessions were viewed as passive with comments requesting a more case-based approach. Residents expressed a desire to practice writing EEG reports.

Conclusions:

The curriculum empowered residents to learn more about neurophysiology and highlighted their preference for hands-on learning. Limitations included variable time between rotation blocks. Future iterations include incorporating EEG and EMG/NCS report writing and adjusting curricular assessments to better map to ACGME EEG and EMG milestones for Clinical Competency Committee use.

10.1212/WNL.0000000000215687
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