Feedback from neurology residents and neuroimmunology fellows about the practical training in multiple sclerosis

Abstract

ObjectiveTo obtain feedback from Neurology residents and Neuroimmunology fellows about the practical training in multiple sclerosis (MS). MethodsA survey was developed and administered electronically to Neurology residents or Neuroimmunology fellows that received training in eight large MS outpatient clinics in Brazil, from 2018 to 2021. We evaluated their beliefs on: (1) the optimal number of MS patients evaluated in a 4-hour outpatient clinic session, (2) the quality of dedicated MS medical records, (3) the training of the neurological exam in MS patients, (4) the teaching discussion with the attending neuroimmunologist and (5) the prescription of MS disease-modifying drugs (DMDs). ResultsThe response rate was 57% (43/76). We found that 4 or 5 MS patients would be optimal during a 4-hour outpatient clinic session. Optimal MS medical records were considered structured and presented in a timeline of disease activity and the history of DMDs. 18 in 43 (42%) respondents felt insecure in performing clinical scales used in MS patients. Discussion with the attending neurologist specialized in Neuroimmunology was considered adequate in only half of the respondents, suggesting a need for improvement in teaching strategies. Almost a quarter of the respondents (11/43, 26%) felt that the prescription of DMDs was complex and challenging. Some respondents suggested that readymade templates could be helpful. ConclusionThe number of patients, medical records, use of MS clinical scales, discussion with attending neurologist specialized in MS care, and the prescription of DMDs present room for improvement in MS training for Neurology residents and Neuroimmunology fellows.