Abstract Details

Title Simulation-based Mastery Learning Improves Residents’ Identification and Management of Status Epilepticus

Topic Research Methodology, ��ɫ��, and History

Presentation(s) S44 - Research Methodology and ��ɫ�� (4:30 PM-4:42 PM)

Poster/Presentation
Number 006

Objective

To train post graduate year (PGY)-2 neurology residents to identify and manage status epilepticus (SE) using simulation-based mastery learning (SBML) and compare their skills to graduating traditionally-trained neurology residents (who did not participate in SBML).

Background SE is a medical emergency where timely management decreases morbidity and mortality. However, SE is often mismanaged due to delays in diagnosis and administration of inappropriate antiepileptic medications. Traditionally, neurology residents learn about SE through didactics and direct patient care. It is unknown if SBML results in superior SE identification and management skills compared to traditional training.

Design/Methods We developed an SBML curriculum to teach neurology residents SE identification and management. The curriculum consisted of a baseline simulation scenario pretest, deliberate practice with simulator, and a simulation scenario posttest. Testing sessions were scored using a dichotomous 26-item SE checklist developed for this curriculum. All residents were expected to meet or exceed a minimum passing score (MPS) at posttest. Those who did not meet the MPS participated in more deliberate practice and retested until they met this score. We trained PGY-2 neurology residents at our institution using the SE SBML curriculum. Subsequently, we tested the simulated SE skills of PGY-4 neurology residents (traditionally-trained) from 3 tertiary-care medical centers one month before graduation using the SE checklist. We compared PGY-2 posttest scores to PGY-4 test scores.

Results

Sixteen PGY-2 residents participated in SE SBML and met the MPS at posttest. Sixteen PGY-4 residents were tested and none met the MPS. SBML-trained PGY-2 residents had significantly better SE management skills on the simulated posttest than graduating PGY-4 residents [mean checklist scores 93.5% (SD=4.4%) vs. 59.9% (SD=11.9%) items correct; p<0.001].

Conclusions SBML improves recognition and management of SE compared to traditional neurology residency training alone. SBML ensures a high level of SE skills and may ensure residents are prepared for independent practice.

Authors/Disclosures
Yara Mikhaeil-Demo, MD (Northwestern University, Feinberg School of Medicine) PRESENTER	The institution of Dr. Mikhaeil-Demo has received research support from U.S Department of Health and Human Services.
George W. Culler IV, MD (Dartmouth-Hitchcock Medical Center)	Dr. Culler has nothing to disclose.
Jessica W. Templer, MD	Dr. Templer has nothing to disclose.
Danny Bega, MD (Northwestern University)	Dr. Bega has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GE Healthcare. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acadia Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as a Consultant for WebMD. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Acorda Therapeutics. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurocrine Biosciences. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sunovion. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACTN / ANA. The institution of Dr. Bega has received research support from Huntington Disease Society of America. The institution of Dr. Bega has received research support from Parkinson Foundation.
	No disclosure on file
Amar Bhatt, MD, FAAN (Rush University Medical Center)	No disclosure on file
Neelofer Shafi, MD	Dr. Shafi has nothing to disclose.
	No disclosure on file
Elizabeth Gerard, MD (Northwestern University)	Dr. Gerard has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon. The institution of Dr. Gerard has received research support from NIH/NINDS. The institution of Dr. Gerard has received research support from Xenon Pharmaceuticals. The institution of an immediate family member of Dr. Gerard has received research support from NIH. The institution of Dr. Gerard has received research support from Eisai, Inc. (via Stanford University). Dr. Gerard has received publishing royalties from a publication relating to health care.
	No disclosure on file

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