Developing a Curriculum for Functional Neurological Disorder in Neurology Training (P2-2.005)

Abstract

<h3>Objective:</h3> To put forward a case for why a functional neurological disorder (FND) curriculum is needed and to provide guidance on curricular content and teaching methods. <h3>Background:</h3> FND is commonly encountered by neurologists, with a growing body of evidence-based treatments operationalized over the past two decades. There remains a large gap in neurology education regarding FND, with little to no formal teaching over the course of medical education, and many practicing neurologists do not feel as though they have good knowledge of FND. <h3>Design/Methods:</h3> We included multidisciplinary and interdisciplinary expert consensus from FND care providers across neurology, psychiatry, social work, physical therapy, and psychology to develop a framework for the development of an FND curriculum for neurology residents. <h3>Results:</h3> Key curricular content regarding FND should include: Medical knowledge regarding pathophysiology and neuropsychological etiological factors, diagnostic criteria, approach to adjunctive diagnostic testing, and principles underlying treatment modalities (rehabilitative and psychological therapies). Clinical skills including being able to perform a psychiatric and social history, specific exam maneuvers to determine rule-in diagnostic features, and formulation of a multidisciplinary treatment and longitudinal care plan. Communication and collaboration skills including effectively conveying an FND diagnosis, educating the patient/family around diagnosis and management including addressing diagnostic doubt, and a thorough understanding of all care team member roles and ability to work together towards care optimization. Methods for teaching this curricular content should include didactic sessions, clinical exposure, and access to supplementary content resources for self-guided learning. Methods for evaluation of curricular content should be linked to Accreditation Council for Graduate Medical Education milestones and include written evaluation, direct clinical observation, and standardized skill assessment through use of standardized or simulated patients. <h3>Conclusions:</h3> A dedicated FND curriculum to appropriately train residents is needed, and should aim to provide knowledge, clinical acumen, communication skills, and effective use of team-based collaboration. <b>Disclosure:</b> Dr. Finkelstein has received personal compensation in the range of $500-$4,999 for serving as a Speaker at Annual Fall Meeting with Massachusetts Neurologic Association. Dr. O’Neal has received personal compensation for serving as an employee of Best Doctors. Dr. O’Neal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Crico malpractice company. Dr. O’Neal has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Crico malpractice company. Dr. O’Neal has received publishing royalties from a publication relating to health care. Dr. Baslet has received publishing royalties from a publication relating to health care. Dr. Dworetzky has received publishing royalties from a publication relating to health care. Ms. Godena has nothing to disclose. Mrs. Maggio has nothing to disclose. Dr. Millstein has nothing to disclose. Dr. Milligan has nothing to disclose. Dr. Perez has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley: Brain and Behavior. The institution of Dr. Perez has received research support from NIH. The institution of Dr. Perez has received research support from Sidney R. Baer Jr. Foundation. Dr. Perez has received publishing royalties from a publication relating to health care.