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Abstract Details

A Simulation-based Mastery Learning Curriculum to Assess and Ensure Competency in Brain Death/Death by Neurological Criteria Determination: Preliminary Results
好色先生, Research, and Methodology
S27 - Research and Innovations in Neurology 好色先生 (1:24 PM-1:36 PM)
003
To evaluate if simulation-based mastery learning (SBML) can achieve uniform competency among neurology trainees in brain death / death by neurological criteria (BD/DNC) determination.
The ACGME Milestones suggest that neurology trainees should be able to properly perform BD/DNC determination by graduation.  Data on physician knowledge, comfort, and competency with performing BD/DNC determinations demonstrate opportunities for improvement.  We hypothesized that SBML could close the gap between ACGME expectations and practice in BD/DNC determination. 
In August 2025, we began enrolling in an ongoing multicenter pretest-posttest study of SBML.  We randomized neurology trainees to one of three simulated cases of BD/DNC determination as a pretest, followed by didactic training (the Neurocritical Care Society online Brain Death Determination course).  We assessed participants using a different randomly selected simulated case immediately after taking the course, and again after deliberate practice.  We scored performance using a checklist derived from a Delphi process involving authors of 2023 BD/DNC Guidelines with a minimum passing score (MPS = 89%) derived from Angoff standard setting determined by members of UCNS and ACGME Neurocritical Care examination committees.  We performed repeated measures ANOVA for comparison among those that completed the curriculum.
Thirty neurology residents (5 PGY-2, 14 PGY-3, 11 PGY-4) and five neurocritical care fellows have enrolled and 18 completed the curriculum (17 in progress).  Eleven (31%) previously received training in BD/DNC determination, 24 (69%) previously observed a BD/DNC evaluation, and 14 (40%) previously performed a BD/DNC evaluation with supervision.  Among the 18 that completed the curriculum, performance improved across assessments (pretest mean (SD) 51.4% (12.9%) vs. post-online course mean (SD) 81.2% (10.2%) vs post-deliberate practice mean (SD) 97.9% (3.5%), F (2,34) = 144.01, p <  .001). All but one participant achieved the MPS. 
SBML achieved near uniform competency in BD/DNC determination skills among neurology trainees that completed the SBML curriculum.
Authors/Disclosures
Nicholas A. Morris, MD, FAAN (University of Maryland Medical Center)
PRESENTER 		The institution of Dr. Morris has received research support from National Institute of Neurological Disorders and Stroke. The institution of Dr. Morris has received research support from 好色先生. The institution of Dr. Morris has received research support from National Institute of Neurological Disorders and Stroke. Dr. Morris has received personal compensation in the range of $500-$4,999 for serving as a Webinar Speaker with Kreg Therapeutics. Dr. Morris has a non-compensated relationship as a Editorial Board Member with 好色先生 that is relevant to AAN interests or activities. Dr. Morris has a non-compensated relationship as a Editorial Board Member with Neurocritical Care Society that is relevant to AAN interests or activities.
Amjad Elmashala, MD (The University of Iowa Hospitals & Clinics) Dr. Elmashala has nothing to disclose.
Matthew B. Bevers, MD, PhD (Brigham and Women's Hospital) Dr. Bevers has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for EBSCO. An immediate family member of Dr. Bevers has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for multiple law firms. Dr. Bevers has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for multiple law firms. The institution of Dr. Bevers has received research support from NINDS. The institution of an immediate family member of Dr. Bevers has received research support from AHRQ. The institution of an immediate family member of Dr. Bevers has received research support from NIH/Kowa Industries. The institution of an immediate family member of Dr. Bevers has received research support from NIDA.
Galina Gheihman, MD (Brigham & Women's Hospital) Dr. Gheihman has nothing to disclose.
Jamie LaBuzetta, MD (UC San Diego Health) Dr. LaBuzetta has nothing to disclose.
Tracey H. Fan, DO Dr. Fan has nothing to disclose.
Shivani Ghoshal, MD (Columbia University Medical Center) Dr. Ghoshal has nothing to disclose.
Justine E. Cormier, MD Dr. Cormier has nothing to disclose.
Casey S. Albin, MD, FAAN (Emory Healthcare) Dr. Albin has received personal compensation in the range of $0-$499 for serving as a Consultant for Azurity Pharmaceutical. Dr. Albin has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum: Life Long Learning in Neurology. Dr. Albin has received research support from 好色先生. Dr. Albin has received publishing royalties from a publication relating to health care.
Brittany Lachance, MD (Chest Medicine Associates) Dr. Lachance has nothing to disclose.
Melissa B. Pergakis, MD Dr. Pergakis has nothing to disclose.
Matthew T. Hoerth, MD, FAAN (Mayo Clinic Arizona) Dr. Hoerth has a non-compensated relationship as a Epilepsy.com Editorial Board member with the Epilepsy Foundation of America that is relevant to AAN interests or activities.
Nina M. Massad, MD (University of Miami) Dr. Massad has nothing to disclose.
Jenna Ford, MD (Northwestern) Dr. Ford has nothing to disclose.
Jon Rosenberg, MD Dr. Rosenberg has nothing to disclose.
Hera A. Kamdar, MD Dr. Kamdar has nothing to disclose.
Hannah Kirsch, MD (Stanford University) An immediate family member of Dr. Kirsch has stock in Genentech.
Lauren Koffman, DO, MS (Temple University Hospital) Dr. Koffman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Law Firm. Dr. Koffman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Walters Kluwer.
Xin Zhou, MD (Temple University Hospital) An immediate family member of Dr. Zhou has received personal compensation for serving as an employee of PTC Therapeutics . An immediate family member of Dr. Zhou has or had stock in PTC Therapeutics.
Sarah Wahlster, MD Dr. Wahlster has nothing to disclose.
Sean Marinelli, MD (University of Washington) Dr. Marinelli has nothing to disclose.
Stefanie Cappucci, MD (Yale School of Medicine) Dr. Cappucci has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Aquifer .
Rachel Beekman, MD (Yale New Haven Medical Center) Dr. Beekman has nothing to disclose.
Reem El Ghawanmeh, MBBS No disclosure on file
Ariane Lewis, MD, FAAN (NYU Langone Medical Center) Dr. Lewis has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Seminars in Neurology. Dr. Lewis has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Neuroscience.
David M. Greer, MD, FAAN (Boston University School of Medicine) Dr. Greer has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Thieme, Inc. Dr. Greer has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for multiple. Dr. Greer has received publishing royalties from a publication relating to health care. Dr. Greer has received publishing royalties from a publication relating to health care. Dr. Greer has received publishing royalties from a publication relating to health care. Dr. Greer has a non-compensated relationship as a Treasurer-Elect with American Neurological Association that is relevant to AAN interests or activities. Dr. Greer has a non-compensated relationship as a President with Neurocritical Care Society that is relevant to AAN interests or activities.
William C. McGaghie, PhD Dr. McGaghie has nothing to disclose.
Daniel S. Harrison, MD (Boston Medical Center) Dr. Harrison has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Glass Health. Dr. Harrison has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Diedrich & Donohue, LLP.