Christine Shrock1, Christopher Teng1, Ross Carson2, Celia Greenlaw1, David Kane1, Elizabeth Barkoudah1, Miya Bernson-Leung1
1Boston Children's Hospital, 2UPMC Children's Hospital of Pittsburgh
Objective:
To adapt a cardiology fellow curriculum for neurology residents and to assess its effect on preparedness and comfort with consultation and phone triage skills.
Background:
Consultation and phone triage involve a variety of clinical, triage, communication, and systems navigation skills that are integral to subspecialty training but often not taught. Simulation-based consult orientation has been developed in other subspecialties with positive results.
Design/Methods:
Child neurology residents (PGY3-5) at a large tertiary care hospital were surveyed on prior experiences with phone triage, level of preparedness for the consult service, and comfort level with core consultation skills prior to starting and at their current stage. An orientation curriculum was then developed for PGY3 child neurology residents before starting the night consult and phone triage role, including a lecture-based introduction and low-fidelity simulation. The simulation involved scripted consult pages for common scenarios, sent at predetermined times, to practice triaging and time management skills as well as medical decision making and systems navigation. Participants worked collaboratively to answer pages. They completed pre- and post-session surveys on preparedness and comfort.
Results:
8 (50%) PGY4 and PGY5 residents and 8 (100%) PGY3 residents completed the baseline survey. Only 31% of residents reported formal training in phone triage prior to covering the outpatient pager. 8/8 (100%) participants found the simulation content and structure helpful. Only 1/8 respondents felt prepared for the consult role prior to the orientation. Post-simulation, there was significant improvement in preparedness (p=0.020) and significantly increased comfort with multiple skills, both compared to pre-simulation and to prior years’ baseline, including triaging and managing multiple concurrent pages, providing initial consult recommendations, responding to outside hospital calls, and documenting telephone encounters.
Conclusions:
A simulation-based orientation to consult and phone triage was successfully adapted for neurology residents, demonstrating promising results in improving resident preparedness and comfort with consult and phone triage skills.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.