Implementation and Assessment of A Pilot Workshop on Inpatient First Time Seizure History Taking and Counseling (P14-2.002)

Abstract

<h3>Objective:</h3> To implement an intervention aimed at improving neurology residents’ history-taking and counseling skills when consulted for a “first-time seizure.” This intervention comprises three interactive, practice-based workshops implemented by a chief resident and epileptologist. <h3>Background:</h3> Neurology residents at our institution are frequently consulted for “first-time seizures,” but lack structured training. A structured workshop was planned to provide instruction and real-time feedback. <h3>Design/Methods:</h3> Four interactive cases were prepared with the brief: “You are consulted by the emergency department overnight for a ‘first-time seizure.’” The chief resident and eplileptologist acted as standardized patients; participants obtained a history and formulated a preliminary diagnosis. The history-taking goals were to 1) distinguish epileptic seizures from seizure mimics; 2) distinguish unprovoked, provoked, and acute symptomatic seizures; 3) to identify underlying epilepsy. Residents then provided counseling, including 1) the diagnosis, 2) diagnostic testing, 3) treatment, 4) driving and seizure precautions, and 5) gender-specific considerations as appropriate. Residents were presented with a 5-question pre- and post-quiz to assess their knowledge and a 5-question survey to assess their subjective confidence before and after the intervention. <h3>Results:</h3> Of eight residents who participated in the workshop, seven responded to the surveys. Subjectively, 5 (71%) reporting improved confidence in history taking and 6 (86%) reporting improved confidence in counseling. However, we did not see an objective change in the quiz results (pre: 71%–100%, post: 71%–100%). <h3>Conclusions:</h3> While the residents performed well on the knowledge-based quiz, this intervention was still able to improve participants’ confidence in their history-taking and counseling skills. This finding reflects the complexity of the topic and the need for ongoing training among residents. <b>Disclosure:</b> Dr. Rehim has nothing to disclose. Dr. Zobel has nothing to disclose. Dr. Husain has a non-compensated relationship as a member, Medical Board of Directors with Epilepsy Foundation of Eastern Pennsylvania that is relevant to AAN interests or activities.