To determine the impact of longitudinal simulation-based learning on neurology trainee knowledge retention and transferability in select neurologic emergencies.

Simulation-based learning has been shown to be an effective method of knowledge improvement for neurology trainees. However, it is unknown if this leads to knowledge retention and transferability of skills learned to clinically novel, thematically similar scenarios.

Four PGY2 neurology trainees participated in a simulation-based bootcamp where they learned about four neurologic emergencies: ischemic stroke, myasthenic crisis, status epilepticus, and spinal cord compression. Initially, they took a knowledge-based quiz (QUIZ 1) before any didactic or clinical exposure. Following didactic lectures, they participated in their first simulation session, were assessed using an action-based checklist based on ACGME milestones, and received individualized feedback (SIM 1). They then retook the knowledge-based quiz (QUIZ 2). Three months later, they engaged in a second simulation session (SIM 2) and completed another knowledge-based quiz (QUIZ 3), both covering the same emergencies with different clinical scenarios to assess knowledge retention and skill transferability. Confidence levels were measured at each stage using a 5-point Likert scale. Quiz scores were analyzed using a mixed model with repeated measures, and action-based checklist score changes were estimated via paired T-tests.

Mean score of the knowledge-based quiz was statistically improved at both QUIZ 2 (81.5%) and QUIZ 3 (86.1%) when compared to QUIZ 1 (65.7%) (p=0.034, p=0.012), with no difference when comparing QUIZ 2 to QUIZ 3 (p=0.451). Paired change in all action-based checklists showed statistically significant improvement for all 4 simulations (p<0.05). At QUIZ 3, all 4 trainees strongly agreed that they felt confident being the first responder for neurologic emergencies.

These findings support the use of longitudinal simulation-based learning as an effective method to both improve trainee knowledge and promote transferability of learned skills to clinically novel, thematically similar scenarios.