Child Neurology Residency Research Articles

Comment: Right-sizing adult neurology training for the child neurologist

Surprisingly little is mandated about adult neurology training during child neurology residency other than 12 clinical …

Comment: Child neurology training—The adult neurology program director perspective

I read with interest the opinion piece by Dr. Nina Schor.1 Adult neurology program directors approach their residents as neurology residents, not distinguishing them as child or adult neurology residents. This is a conscious approach as the foundation for our clinical platform is the same, …

Evaluating the Use of High Fidelity Simulation To Introduce and Educate Incoming Neurology Resident Learners to Common Neurologic Emergencies and Procedures (P06.026)

Background There has been no literature published on the use of high fidelity simulation in neurology training. These types of simulations have been utilized in other areas of medicine (eg. anesthesiology, emergency medicine) and have been shown to have educational value and a potential for improvement in resident learner competence, knowledge, performance and ultimately patient safety. Design/Methods: First year neurology resident learners in Virginia Commonwealth University neurology and child neurology residency programs (8 in total) completed three simulated neurologic emergencies/procedures. Two of these were high fidelity simulations (status epilepticus, acute ischemic stroke) with the use of iStan technology. The third utilized a static lumbar puncture simulator. Residents participated in a thirty minute pre-simulation briefing on each neurologic emergency/procedure and a hour post-simulation debriefing. The simulations were designed to give the resident learners some familiarity with the various scenarios, diagnoses, management options, informed consent, and the need for escalation of care when appropriate. Resident learners evaluated the simulations with a post-course questionnaire on the benefit of the simulation experience. Results: All eight resident learners felt that the high fidelity simulation exercises enabled them to have a better understanding in the procedural routine in performing tasks such as lumbar puncture. Resident learners also felt a better understanding in the diagnosis and initial management strategies in treating acute stroke and status epilepticus. The pre-course preparation with NIHSS on-line training module and post-course debriefing session were found to be useful by all resident learners and all stated that they would like the course to continue. Conclusions: The use of high fidelity simulation activities appears to be a beneficial tool in the education and initial exposure of incoming neurology residents to neurologic emergencies and procedures. Disclosure: Dr. Lehosit has nothing to disclose. Dr. Vota has nothing to disclose. Dr. Gowda has nothing to disclose.

Changing Child Neurology Training

Child neurology training must change as our understanding of the diseases of the developing nervous system increases. A proposed child neurology training path leading to certification in child neurology would eliminate all but 3 months of adult neurology training; however gaining approval for a new Accreditation Council for Graduate Medical Education (ACGME) training program would be an arduous task. I review why this change would add significant administrative and financial burdens and how this change in training could negatively affect the education of child neurology residents. I believe that modifications of the current training requirements already underway could achieve the same aims with fewer losses.

Child Neurology Residency

From limitations on residents' duty hours, to ways in which outcomes are measured, changes to graduate medical education are sweeping the nation. In this issue of the journal, Gilbert and Greenwood present thoughtful, if somewhat disparate, opinions on ways to improve the educational experience of child neurology trainees. As the Designated Institutional Officer of a large children's hospital, I have focused my commentary on "the big picture." That is, what systemwide impact can changes in child neurology trainees' education have.

Child Neurology Residency Training in Neuromuscular Disorders

The field of pediatric neuromuscular disorders provides rich training experiences in child neurology residency programs. Specific learning objectives include skills in examination and assessment, familiarity with muscle and nerve studies, and indications for biopsies. This review also specifies which neuromuscular disorders are most important to cover within the resident's scope of knowledge, as well as the relationship of this field to the core competencies of residency training. Appropriate settings for inclusion of these skills in child neurology residency programs are suggested.

Noninfectious Central Nervous System Inflammatory Disorders

Acute central nervous system (CNS) inflammation may occur as a monophasic illness or may represent the first attack of a chronic inflammatory disorder, such as multiple sclerosis, neuromyelitis optica, or CNS vasculitis. We review essential components of the initial assessment, diagnostic workup, acute and chronic management strategies, and research issues pertaining to children with CNS inflammatory diseases and suggest methods for these competencies to be attained during the course of child neurology residency training.

The Academic Half-Day in Canadian Neurology Residency Programs

The academic half-day (AHD) appears to have become widespread in Canadian neurology residency programs, but there is little published information about the structure, content, or impact of the AHD. A written questionnaire was sent to the directors of all active Canadian adult and child neurology residency programs. All 21 program directors responded. An AHD was operating in 15/15 adult and 5/6 child neurology programs. The AHD typically lasts three hours, and occurs weekly, 10 months per year. Most of the weekly sessions are lectures or seminars, usually led by clinicians, with about 90% resident attendance. Course-like features (required textbook, examinations) are present in many AHDs. There is a wide range of topics, from disease pathophysiology to practice management, with considerable variation between programs. Almost all Canadian neurology programs now have an AHD. Academic half-days are broadly similar in content and format across the country, and residents now spend a substantial portion of their training attending the AHD. The impact of the AHD on how residency programs are organized, and on the learning, clinical work, and professional development of residents merits further study.

The future of child neurology: a profile of child neurology residents.

Current workforce projections estimate that there is a shortage of child neurologists. We surveyed child neurology residents to learn more about the entry point for a career in child neurology: what attracts current residents to the field of child neurology and what the future career plans of child neurology residents are. Most respondents (52%) were exposed to child neurology for the first time in their third or fourth year of medical school, with 41% reporting that they chose the specialty at that time. US medical graduates identified having a mentor as one of the most influential exposures in their career choice. Respondents predict that they will spend less time on patient care and more time on research than current practicing child neurologists report. When asked about what could improve the attractiveness of the field, residents responded that medical students should get increased and earlier exposure to child neurology. Given the declining number of individuals pursuing a career in child neurology and that current residents predict that they will spend less time seeing patients than their predecessors do, understanding how to attract more candidates to child neurology will be essential to alleviate future shortages in child neurology.