519: ENHANCING NEUROCRITICAL CARE EDUCATION THROUGH MULTIDISCIPLINARY SIMULATION TRAINING

Abstract

Introduction: Early recognition and response are paramount in treatment of neurologic emergencies. Due to its complexity, neurocritical care continues to provoke unease for practitioners and trainees. A simulation environment can provider a realistic opportunity for learners to detect and make rapid-fire decisions for an acutely deteriorating neurologic patient. A multidisciplinary simulation-based learning environment may improve education and trainee confidence when caring for the neurocritical care patient population. Methods: Three 45-minute simulation lab sessions were performed with a multidisciplinary team including medical students, neurology residents, critical care medicine fellows, advanced practice providers, and a critical care pharmacist. High fidelity manikins capable of reproducing acute neurologic and physiologic emergencies were used. Prior to the simulation, participants received Emergency Neurological Life Support resources. The simulation session lasted 45 minutes with an additional 10-minute debriefing with a neurointensivist and neurocritical care APP. After the simulation, participants were asked to complete a survey utilizing Likert scale responses, containing questions regarding pre- and post-simulation comfort levels managing specific acute neurologic emergencies. Results: Three simulation lab sessions were conducted and thirteen surveys were completed. Mean learner comfort levels in managing patients improved from pre- to post-simulation in patients with coma [3.25 vs 4.25 (p=0.007)], status epilepticus [3.25 vs 4.25 (p=0.007)], and procedures such as central lines [2.2 vs 3.8, p=0.003], intubations [2 vs 3.2, p=0.004], and bronchoscopies [2 vs 3.2, p=0.004]. Consistently, learners strongly agreed that faculty were knowledgeable, and sessions were well informed and thorough. Learners commented that the simulation experiences were realistic and allowed them to identify areas for improvement. Conclusions: Simulation training can be an effective method to improve education of neurocritical care team members by increasing clinician comfort in managing neurologic emergencies and procedures as well as providing opportunities for multidisciplinary collaboration. Further evaluation of the effectiveness of simulation education in this patient care setting is warranted.