Abstract Details

Title Assessment of ��ɫ��al Needs For Non-Neurologists Utilizing a Teleneurology Consultation Codel: a Mixed-Methods Study

Topic ��ɫ��, Research, and Methodology

Presentation(s) S28 - Novel Approaches to Teaching, Assessment, and Beyond in Neurology ��ɫ�� (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Objective NA

Background Due to the shortage of neurologists, many hospitals in the US are utilizing teleneurology consultations for the workup and management of patients in the Emergency Department, Intensive Care Unit (ICU) or floor. As non-neurologists are required to perform crucial components of the examination and management, there is a need for a structured, evidence-informed educational needs assessment to ensure the teleneurology model works safely and effectively.

Design/Methods We completed a comprehensive mixed methods needs assessment using quantitative surveys evaluating in person clinicians’ perceived neurology educational needs, focus groups and thematic analysis to investigate 14 academic teleneurology physicians’ perceptions and experiences of in-person clinician educational needs, and consultation data from 15,626 teleneurology and telestroke consults over 24 months in 37 hospitals in our institution's Teleneurology network.

Results 48 clinicians completed the survey and indicated that diagnosis and management of acute stroke and seizure, neurologic complications of critical illness, and delirium were the most high yield learning topics for the Emergency Department, ICU and floor respectively. They ranked in-person, and on-demand recorded lectures or short videos as their preferred Continuing Medical ��ɫ�� modalities. Stroke (42%) and seizure (10%) were the most frequent consultation questions, similar topics were mentioned by teleneurologists in the focus groups. They identified challenges such as incomplete access to history and exam data, particularly with reflex or mental status exams, and variable resources between spoke hospitals. They felt that in-person clinicians would benefit from structured teaching on neurologic exam maneuvers, access to exam tools, and that an in-person setting would be ideal to offer that training.

Conclusions An effective teleneurology model relies on in-person clinicians’ knowledge and skill in identifying neurologic presentations and performing crucial exam components. A blended curriculum for non-neurologists combining in-person neurologic exam teaching and feedback with continued online learning could improve the effectiveness and efficiency of teleneurology consultations.

Authors/Disclosures
Bruna Leles Vieira de Souza, MD PRESENTER	Miss Leles Vieira de Souza has nothing to disclose.
Marinos G. Sotiropoulos, MD (Massachusetts General Hospital)	Dr. Sotiropoulos has stock in Moderna. Dr. Sotiropoulos has stock in Ikena Oncology. Dr. Sotiropoulos has stock in Cassava Sciences. Dr. Sotiropoulos has stock in Biogen. Dr. Sotiropoulos has stock in Tiziana Life Sciences. Dr. Sotiropoulos has received publishing royalties from a publication relating to health care.
Joao Vitor Mahler, MD	Dr. Mahler has received research support from The Sumaira Foundation.
Cynthia M. Whitney, RN	Ms. Whitney has nothing to disclose.
Galina Gheihman, MD (Brigham & Women's Hospital)	Dr. Gheihman has nothing to disclose.
Tamara B. Kaplan, MD, FAAN (Brigham and Women'S Hospital)	Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono . Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech.
Marcelo Matiello, MD, FAAN (Massachusetts General Hospital, Brigham, Harvard)	Dr. Matiello has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Matiello has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion.

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