Create a comprehensive, multifaceted teleneurology curriculum.

Teleneurology is rapidly expanding yet there is limited research regarding effective ways to teach trainees teleneurology skills.

We implemented a teleneurology curriculum that focused on teaching key aspects of a virtual visit including the virtual neurological examination, measured teleneurology competency, and provided opportunities to implement trainees’ skills in multiple environments. Residents were first surveyed on what tools would be most helpful for learning teleneurology. Trainees observed a faculty member conduct a teleneurology visit with another faculty member who portrayed a patient in a session that was recorded and uploaded to a shared space. Residents practiced a teleneurology encounter during a 15-minute objective structured clinical examinations (OSCE) at a simulation center or remotely. Residents then performed teleneurology visits with patients during their continuity clinics and subspecialty clinic rotations.

Prior to the start of the teleneurology curriculum, residents identified a variety of modalities that would help them learn teleneurology: didactics with slides (25%), live demonstration of a virtual encounter (25%), simulated experience (23%), simply starting with live patients (23%), and articles/reading material (4%). All neurology residents rated the teleneurology OSCE highly. 88% or more of the neurology residents thought their in-person or remote OSCE should be repeated in the future. Survey results before and after the simulations showed increased levels of comfort with and interest in teleneurology (P<0.05). Faculty observers identified key areas for improvement regarding the teleneurology exam, most notably inadequate visualization of the affected limb during the exam or an incomplete sensorimotor exam.

Residents benefit from a multidisciplinary longitudinal teleneurology curriculum. Longitudinal survey tools help strengthen components of the curriculum to optimize educational potential. We will expand our teleneurology clinical/simulation experiences to trainees based on our data and track progress of teleneurology skills as residents advance in their training.