Half Day Research Articles

Adult learning principles in the development of an academic half day session

<abstract> <p>Post-graduate trainees serve a dual role as learner and practitioner, and their clinical education must be supported by an academic curriculum that meets the objectives of their training program. Principles of adult learning that encourage critical thinking and collaboration can enhance the effectiveness of academic sessions for adult learners. This paper will review the practical use of adult learning in the context of an academic half day session for residents in Pediatrics. The specific focus on a single topic models adult learning techniques that can be broadly applied across different branches of medicine and different levels of learners.</p> </abstract>

Impact of a peer-support programme to improve loneliness and social isolation due to COVID-19: does adding a secure, user friendly video-conference solution work better than telephone support alone? Protocol for a three-arm randomised clinical trial

IntroductionThe COVID-19 pandemic has forced the implementation of physical distancing and self-isolation strategies worldwide. However, these measures have significant potential to increase social isolation and loneliness. Among older people, loneliness...

Early Clinical Experience: A Way for Preparing Students for Clinical Setting

Background: Various methods are used to improve the quality and usefulness of basic sciences taught to medical students before beginning of the clinical course and practice in higher grades. One method which is evaluated in the present study is early clinical experience. Methods and Materials: In this descriptive study, all medical freshmen were participated in a half day workshop for familiarity with hospital clinical environment. The attitude of the students towards early clinical exposure, profession, and medical education was investigated using a 30- item questionnaire before and after this workshop. Results: Totally, 207 students participated in the present study. Overall, scoring of the program was good to excellent on a five-point Likert scale (93.75%). Most students (89.6%, score =4.25) believed that the program’s content and management was appropriate for them. Conclusions: It was concluded that early clinical experience parallel with theoretical courses can provide a framework for the beneficial and successful integration of the teaching and learning of basic sciences for medical students.[GMJ. 2012;1(2):42-47]

The Impact of Asking Medical Students What They Want to Learn on Student Participation in Lectures.

The General Internal Medicine Acting Internship (GIM AI) at our school is a compulsory, one-month-long experience. Morning report-style case-based discussions were conducted on a weekly basis as part of the acting internship and were poorly attended. We sought to redesign our academic half day didactic curriculum and increase voluntary student attendance by allowing students to actively participate in determining the content of the acting internship academic half day. Prior to the beginning of the acting internship, students were sent an email survey listing seven inpatient topics to rank on a scale of 1-5 (1=not at all interested, 5=very interested). Based on student feedback, one additional topic was added: antibiotic use for common inpatient diagnoses. Topics that received the highest score were selected for topic-based sessions.A total of 32 teaching sessions were conducted over eight months. Twenty-four of these sessions were topic-based and the remainder were case-based. Student attendance at these sessions was voluntary. Case-based discussions had the lowest preference ranking (n=94, mean=2.9), while cross-cover-based discussions (n=94, mean=4.3, p=0.001) and antibiotic use (n=52, mean=4.3, p=0.001) received the highest scores. Thirty-four percent (41/120) of possible learners attended case-based discussions, while 78% (281/360) of possible learners attended topic-based sessions (p<0.001). Learners reported a statistically significant improvement in comfort level in recognizing and managing 73% of sub-topics (29 out of 41) covered in topic-based sessions. A learner-centered approach to curriculum design led to robust student engagement in our acting internship academic half day. Fourth-year students prefer specific topic-based teaching sessions over case-based, morning report-style sessions.

The ‘role’ of improvisational theater in learning family therapy

Mastering family therapy is a core competence in the Brown child and adolescent psychiatry fellowship program. To acuminate our skills, in addition to working doing a half day per week of family therapy for the duration of our training, we have weekly family therapy seminars led by Dr. Michelle Rickerby. Most of the time, we spend the hour discussing one or two challenging cases among our class, and if there is time, allot the last 5 to 10 minutes of class to play out a particularly arduous interaction. However, once or twice a year, Dr. Rickerby invites improvisational “improv” actors from a local theater for an extended workshop on family therapy. I was fortunate that my case was chosen as a prompt for this year's workshop.

Training nursing home social workers in the Pre‐loss Group Support intervention

AbstractBackgroundPre‐loss Group Support (PLGS) is a 10‐session multi‐modal, psychotherapy group intervention administered by nursing home social workers (NH‐SWs) for dementia family care partners (CPs) whose PLWD resides in a nursing home.1 While the overarching purpose of this project is to determine if telehealth‐delivered PLGS reduces risk of poor bereavement outcome in family CPs of PLWD when delivered by NH‐SWs, in this presentation we describe developing and applying the PLGS clinical training for NH‐SWs in this phase of our NIH‐Stage 52 implementation and dissemination study.MethodUsing professional actors, we created a simulated PLGS 10‐session group as a series of training videos. Training utilized our Stage‐3 PLGS Facilitator manual.3 We developed a training curriculum incorporating these video vignettes, didactic content, interactive case examples and pragmatic application concepts of PLGS for telehealth delivery to CPs by NH‐SWs. The full training is deliverable in one full day or two half day sessions and is provided on an interactive distance platform. Training was delivered to two cohorts of NH‐SWs in a stepped‐wedge design.ResultWe are evaluating this implementation study using the RE‐AIM measures.4 In this training phase, we have successfully achieved Reach—defined as buy‐in and training of NH SWs, Adoption—defined as uptake by NHs and SWs, and the first phase of Implementation—Defined as training completion. Trained NH‐SWs were assessed for satisfaction with the training. On a 7‐item satisfaction scale with a range of 3‐21, satisfaction rate was 95% (highly valuable), with 100% indicating they would recommend training to SWs in other facilities. In this session, we will share PLGS training content and procedures.ConclusionNursing home SWs are the last clinicians with opportunity to support CPs as they approach the death of their PLWD in the facility. NH‐SWs have clinical expertise to learn and implement PLGS, allowing us to simultaneously evaluate telehealth SW training acceptability, telehealth delivered PLGS outcomes. Carefully tailoring PLGS training content and delivery for NH‐SWs to equip them for telehealth implementation, engagement to recruit and retain enthusiastic SWs, and available consultation have contributed to the success of this phase in the project.

Centre‐based early education interventions for improving school readiness: A systematic review

Centre‐based early education interventions for improving school readiness: A systematic review

Improving Access to Comprehensive Care for Pediatric Sickle Cell Patients through the Creation of Multispecialty Clinics

There are many barriers to health care for those in underserved populations such as the pediatric sickle cell population. Due to limitations of transportation, clinical availability, and lack of care coordination, pediatric sickle cell patients are at an increased risk of not receiving the extensive multi-subspecialty health care recommended to prevent potential sickle cell related complications that affect every organ system. To improve access to this multidisciplinary care, UPMC Children's Hospital of Pittsburgh (CHP) pediatric sickle cell program developed a multi-subspecialty collaborative clinic model to offer coordinated sickle cell and pulmonary care, which is critical for sickle cell patients due to the increased risk of pulmonary complications associated with sickle cell disease. By considering health care barriers experienced by our pediatric sickle cell population, we proposed that this coordinated subspecialty clinic model will increase compliance by offering patients and families the opportunity to receive synchronized care from two essential subspecialty groups in just one medical center trip. This increased access to preventative health care for the pediatric sickle cell population should contribute to decreased acute medical events that require critical care and other extensive resources within the health care system. Methods: Two adjacent clinic appointments within the sickle cell and pulmonology clinics were designated for sickle cell patients also requiring preventative pulmonary care to be seen consecutively by both clinical teams during the same half day (one in sickle cell clinic and one in pulmonary clinic). The effect of improving completed referrals using this multi-specialty clinic model was assessed by retrospective electronic medical record review comparing the number of pulmonology referrals made by SCD team and pulmonary visits completed pre- and post- coordinated multi-subspecialty clinic initiative. The studied time period prior to the multispecialty clinic creation was chosen to be calendar year 2019 in order to eliminate the variable of the COVID-19 pandemic affecting outpatient clinic participation. Post-intervention data were collected during calendar year 2022 soon after the creation of this multi-subspecialty initiative. Prior to the creation of this multi-subspecialty clinic model, coordinating CHP sickle cell and pulmonology care, only 24% of pediatric sickle cell patients referred for outpatient pulmonology consultation completed the clinical evaluation. Our program referred 53 of 168 total families during calendar year 2019, with only 17 patients completing their visit. Since beginning this multi-subspecialty clinic initiative, pulmonology evaluations completed by referred sickle cell patients increased to 55%. Thus, CHP's multispecialty clinic offering coordinated sickle cell and pulmonology care increased completed pulmonology referrals by 129%. Using Pearson's chi-square test to compare the relationship between the two categorical variables of prior- and post- multispecialty clinic formation with a null hypothesis of multispecialty clinics will not increase completed referrals, we found a value of 10.76, which is greater than the applied critical value of 9.21 (p=0.01). Therefore, these results are significant, and the null hypothesis was rejected. In summary, by establishing this multi-subspecialty coordinated care at CHP for our pediatric sickle cell population, our goal of improving compliance with critical preventive care was achieved. We hope that this type of intervention will enhance the quality of life for children with sickle cell disease currently, as well as contribute to better health in the patients' futures. We also predict that this improved preventive care will also contribute to decreased emergency care and extensive treatments required for patients cared by CHP. This multi-subspecialty care model also has the potential to benefit other pediatric patients with chronic diseases from underserved populations who experience similar barriers, both in CHP's Western Pennsylvania region as well as underserved populations and health care organizations beyond our region. By applying an approach to care focused on reducing health care barriers to underserved populations, impactful improvements may be seen not only in the pediatric sickle cell population, but in the health care system at large.

A Survey of Internal Medicine Residents Comparing Virtual Academic Half Day to Traditional Academic Half Day Model

A Survey of Internal Medicine Residents Comparing Virtual Academic Half Day to Traditional Academic Half Day Model

Social networking service messages improve novice trainees' motivation and performance of skills.

We examined the usefulness of positive social networking service (SNS) messages to improve motivation and performance during off-the-job training. Subjects were sixth-year medical students who completed a 4-week clinical clerkship in our department involving two separate tasks. Time taken to perform the tasks was recorded on Days 1, 14, and 28. All trainees voluntarily practiced the task until Day 14. The trainees were classified into two groups according to the results of their time measurements on Day 14. The slow time group was intervened with SNS messages (SNS group) and the fast time group was not intervened (non SNS group, nSNS). The SNS group received messages from the moderator daily or every other day. The time to complete the skills practiced in the first (Days 1-14) and second half (Days 15-28) were recorded for each group. On Day 14, the time for both tasks of the nSNS group was significantly faster than the SNS group. However, there was no significant time difference on Day 28. During Days 15-28, the SNS group had significantly more practice days than the nSNS group (5.3 vs. 3.8 days, p = .023). On questionnaire, all SNS group participants indicated that the messages increased their motivation to practice. SNS messages using smartphones might have increased motivation for task training and improved the performance of tasks in off-the-job training for novice trainees.

Bio-friendly long-term subcellular dynamic recording by self-supervised image enhancement microscopy

Fluorescence microscopy has become an indispensable tool for revealing the dynamic regulation of cells and organelles. However, stochastic noise inherently restricts optical interrogation quality and exacerbates observation fidelity when balancing the joint demands of high frame rate, long-term recording and low phototoxicity. Here we propose DeepSeMi, a self-supervised-learning-based denoising framework capable of increasing signal-to-noise ratio by over 12 dB across various conditions. With the introduction of newly designed eccentric blind-spot convolution filters, DeepSeMi effectively denoises images with no loss of spatiotemporal resolution. In combination with confocal microscopy, DeepSeMi allows for recording organelle interactions in four colors at high frame rates across tens of thousands of frames, monitoring migrasomes and retractosomes over a half day, and imaging ultra-phototoxicity-sensitive Dictyostelium cells over thousands of frames. Through comprehensive validations across various samples and instruments, we prove DeepSeMi to be a versatile and biocompatible tool for breaking the shot-noise limit.

Abstract 17950: Atrial Fibrillation Impacts Mortality, Length of Stay, Resources Utilization and Need for Endotracheal Intubation in Patients Who Were Submitted to C-section or Natural Delivery: A Nationwide Analysis 2016-2020

Background: Atrial fibrillation (AF) is rare during pregnancy but the data on its impact during delivery is scaring. In this study, we aim to analyze the impact of AF in patients who underwent delivery via Cesarean section (CS), natural spontaneous delivery (NSD) or instrumental delivery (ID). Methods: We obtained the data from the National Inpatient Sample from 2016-2020. Our primary outcome was in-hospital mortality. Secondary outcomes included length of stay, total hospital charges and respiratory failure requiring intubation. Primary and secondary outcomes were adjusted to variables that had a p-value&lt;0.2 for that outcome. Results were considered statistically significant if p-value &lt;0.05. Results: There were 17,785,980 deliveries who underwent CS, NSD or ID. Of this, 6,000 patients had the secondary diagnosis of atrial fibrillation. The population had a mean age of 29.13 years. (See table 1) Patient with AF had almost twenty times more change of dying compared to those without AF odds ratio (OR) 19.12, 95% Confidence interval (CI) 4.33 - 84.45, p&lt;0.001. Furthermore, AF cohort stayed for one and a half day longer Coefficient 1.55, CI 1.16 - 1.94, p&lt;0.001, had a higher hospital charge Coefficient 19294.05, CI 14658.17 - 23929.93 and had a higher rate of respiratory complications requiring intubation OR 15.86, CI 7.83 - 32.15, p&lt;0.001. (See table 2) Conclusion: Atrial fibrillation has a substantial negative impact in inpatient outcomes on pregnant patients during delivery. Further research is needed to explore these disparities in maternal care.

Amino acid supplementation during the adaptation period did not affect the standardized ileal digestibility of amino acids in corn and soybean meal fed to pigs.

The objective was to determine the influence of amino acid (AA) supplementation during the adaptation period on the ileal digestibility of crude protein and AA in corn and soybean meal (SBM) fed to pigs. Six barrows with an initial body weight of 30.9±2.6 kg fitted with a T-cannula at the distal ileum were assigned to a 6×6 Latin square design with 6 dietary treatments and 6 periods. Two experimental diets contained corn or SBM as the sole AA source and an N-free diet was additionally prepared. For AA supplementation groups, an AA mixture consisted of Gly, Lys, Met, Thr, Trp, Ile, Val, His, and Phe was added to the corn diet and the N-free diet at the expense of cornstarch, and an AA mixture of Lys, Met, and Thr was added to the SBM diet. All diets contained 0.5% of chromic oxide. The 6 experimental diets were fed to the pigs for four and half days, and the 3 diets containing an AA mixture were switched to the respective diets without AA mixture during the following two and half days. Ileal digesta were collected on days 6 and 7. The addition of an AA mixture during the adaptation period increased apparent ileal digestibility of Arg and Trp in corn (p<0.05) but did not affect that in SBM. The addition of an AA mixture during the adaptation period increased apparent ileal digestibility of Pro and Gly regardless of feed ingredient (p<0.05) but did not affect that of other AA. All AA except Pro in corn and SBM were unaffected by the addition of the AA mixture during the adaptation period. The addition of amino acids to a low-protein diet during the adaptation period does not affect the standardized ileal digestibility of indispensable amino acids in pigs.

A107Mental Health Simulation for Foundation Doctors: Bridging the gap of placement variation

There is significant variation of foundation programme tracks across the United Kingdom, giving a range of clinical exposure to newly qualified doctors [1]. Common themes in tracks can be identified to include acute/emergency, community, general medicine, surgery and psychiatry components. In the deanery, many Foundation Trainees (FTs) on psychiatry will have up to 3 additional simulation days devoted to psychiatry themes and this is felt to be an especially effective way to supplement education on psychiatry consultation skills [2]. FTs who do not have psychiatry posts will not have the opportunity to attend this training. Typically, mandatory foundation simulation training focuses on human factors related to acute medical and surgical problems [3]. Our education department has developed a pilot programme to support simulation training on key mental health consultations to support well rounded training of FTs. Half day sessions have been delivered to small groups of FTs who do not have psychiatry posts. Faculty has included experienced simulation faculty and psychiatry doctors and the scenarios conducted in a small group format with professional actors playing patients for increased realism of scenarios. The participants rotated between 3 key scenarios covering essential themes of mental state examination, psychiatry team liaison, patient risk assessment and explaining mental health presentations. 2 sessions have been delivered for a total of 18 FTs. FTs showed insight to a number of challenges related to mental health presentations they had experienced outside of psychiatric settings and this formed the outline of the learning objectives for the session. The participants further reflected on discussions in their feedback from the session and portfolio. The sessions were well received, with improvement in confidence in managing these consultations demonstrated in pre and post course survey comparison from the majority of participants. Given the initial success of the session, the team is building a database of local faculty for continuity of the course and looking to secure relevant funding from HEE to provide further sessions for the FTs in the next academic year. This simulation pilot has shown promise to be a useful addition to supplement the education of FTs for mental health consultations applicable in all areas of their clinical practice. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

THU293 Enhancement Of Best Practices In Diabetic Ketoacidosis Management Using Standardized Order-sets vs Individual Practitioner Orders

Abstract Disclosure: C. Yim: None. Q. Li: None. T.G. Arnason: None. Diabetic ketoacidosis (DKA) is a hyperglycemic emergency occurring in diabetics due to insulin deficiency. This results in urinary losses of water and electrolytes (sodium, potassium, chloride) and ultimately extracellular fluid volume depletion. Hallmark features of DKA include ketoacidosis, arterial pH &amp;lt; 7.3, bicarbonate &amp;lt;15 mmol/L and an anion gap of &amp;gt;12 mmol/L. The 2018 Diabetes Canada (DC) guidelines outline the key steps of DKA management including fluid resuscitation, resolution of ketoacidosis, correction of electrolytes and management of precipitating factors. Its detailed algorithm identifies three pillars to DKA treatment: IV fluids, serum potassium and acidosis. A 2016 DKA outcome audit at the Royal University Hospital (RUH) in Saskatoon identified that practitioners diverged considerably from (2013) Canadian Diabetes Association guidelines. Subsequently, two standardized preprinted DKA order sets were developed incorporating the 2018 DC recommendations for i) INITIAL and ii) MAINTENANCE DKA management. Their rollout overlapped with annual academic half day sessions on DKA management for postgraduate year 1 residents in internal medicine. These order-sets were initially implemented at RUH in November 2018 and subsequently adopted by some practitioners at St. Paul’s Hospital (SPH). To ensure the order-sets were promoting improved outcomes and adhering to best practices, a retrospective chart review was conducted of all adult DKA admissions at RUH and SPH from Nov. 13, 2018 to December 31, 2020. In total, 279 hospital admissions were reviewed: 99 used practitioners’ own orders, 115 used both initial and maintenance order-sets, 26 used only the initial order-set and 38 used only the maintenance order-set. Use of the INITIAL order set significantly improved compliance (p &amp;lt; 0.0001) with DC 2018 guidelines for recommended insulin dose and timing, fluid resuscitation as well as potassium, sodium and dextrose replacement. Use of the MAINTENANCE order set consistently enhanced outcomes for intravenous fluid selection, subcutaneous insulin overlap, and ensuring a closed anion gap at transition (p &amp;lt; 0.0001). Additionally, the chart review revealed that there were hospital differences for uptake of order sets and compliance to DC 2018 guidelines. There was a significant uptake of order sets at RUH versus SPH (p &amp;lt; 0.0001). RUH consistently met outcomes for appropriate insulin dosing, potassium and dextrose replacement (p &amp;lt; 0.0001). RUH also consistently overlapped IV and SC insulin and ensured a closed insulin gap. The anion gap remained consistently closed post-transition at RUH versus SPH (p = 0.035). These results suggest that utilization of a DKA order set does significantly promote adherence to key best practices outlined in the DC 2018 guidelines. Presentation: Thursday, June 15, 2023

The Judiciary's Position in Encouraging Gender Equality

We have addressed and discussed the topic of Gender and the Law in all aspects over the past one and a half days, including gender-based violence, gender and judging, human rights of victims and perpetrators of violence, equality in property division, gender equality and international treaties, as well as gender in the workplace, masculinity and violence, sentencing, and access to justice.

TINGKAT STRESS PADA SISWA DALAM MENGIKUTI FULL DAY SCHOOL

Full day school system in Indonesia had actually been running before the existence of a policy from the Ministry of Education and Culture, namely in private schools, international schools and religious-based schools such as Islamic boarding schools. The full day system allows children to lose some of their playing time due to the long study time at school. Children with a full day school system have a higher stress level than children with a half day school system. This is because children study at school until 15.30. Long study time results in reduced playing time for children so that children get bored easily. Adequate play time for children will have a good impact on children, they will tend not to feel a burden on themselves .Objective to determine the description of the level of stress on students in attending full day school SMA Batik 2 Surakarta. Methods This type of research is quantitative with a descriptive approach. Sampling of 96 respondents. The research instrument used the Perceived Stress Scale (PSS) questionnaire. Data analysis using Univariate test. The results showed that the majority of student categories based on gender were female as many as 47 (52.2%) and the description of the level stress on students attending full day school was the majority of respondents with severe stress levels of 52 students or 57.8% and minority respondents were mild stress level with a total of 7 students or 7.8% . Conclusion the description of the level of stress on students in attending full day school at SMA Batik 2 Surakarta is relatively high with the results being the majority of 52 people (57.8%) in the severe stress category.

275 The Declining Elective Workload of a Consultant Surgeon

Abstract Aim The elective workload of a consultant surgeon has changed considerably over time. We aimed to describe these changes and explore possible reasons behind them. Method All elective procedures performed by a single consultant vascular and general surgeon at a district general hospital were identified for the years 2000 and 2019. Cases were classified by complexity (major, moderate or minor) and specialty (general, vascular, colorectal, upper GI, plastics, endocrine, breast, urology or other). Results In 2000 there were 41 full and 50 half day theatre lists compared to 24 full and 47 half day lists in 2019. The total number of procedures fell by 39.25% (400 in 2000 versus 243 in 2019). The mean number of procedures per full and half day list was 5.46 and 3.50 in 2000 compared to 4.67 and 2.80 in 2019. There were 51 major (12.75%), 189 moderate (47.25%) and 160 minor (40%) procedures compared to 8 major (3.29%), 99 moderate (40.74%) and 137 minor (56.37%) in 2019. Most cases were general or vascular (82.5% in 2000, 97.53% in 2019) but the breadth was greater in 2000 (9 versus 4 specialties). Conclusions The number of lists, total procedures performed and mean cases per list are lower despite increasing demand. The breadth and complexity of cases has also decreased. The reasons for this are likely multi-factorial but may include the use of varying anaesthetic and scrub teams, the introduction of checklists, changes to consent procedures, centralisation of services, the presence of a trainee in theatre and changes to specialty training.

998 Distal Radius Fractures – Assessing Time to Surgery

Abstract Background The British Orthopaedic Association Standards for Trauma (BOAST guidelines) recommend that intra-articular distal radius fractures should be operated within 3 days and extra-articular fractures within 7 days of a decision to operate (1). Aim The objectives of this audit were to assess compliance with BOAST guidelines for operative management of distal radius fractures within a local trauma unit. Method Three audit cycles were completed between 2018 and 2021 over 3 -4-month periods. The second and third cycles were completed after elective orthopaedic cases were moved to an elective orthopaedic centre, and commencement of a weekly half day dedicated hand trauma list. All skeletally mature patients with acute distal radius fractures were included. Results Despite the addition of a dedicated hand trauma list and elective services moving to a dedicated site, compliance with BOAST guidelines remained almost unchanged. Compliance was at 100% for extra-articular fractures. However, for intra-articular fractures, compliance only slightly improved from 50 % to 53.3%. The average time to surgery improved from 4.25 days to 3.66 days for intra-articular fractures. Average time to surgery for extra-articular fractures was 3 days. Proposed reasons for delay included lack of trauma theatre time, prioritisation of other urgent cases such as femur fractures and lack of appropriate surgeon. Conclusions No distinction was being made to prioritise intra-articular distal radius fractures over extra-articular fractures for surgery. Trauma and Orthopaedic (T&amp;O) staff have been educated and changes made to the T&amp;O department’s trauma database to resolve this.

Current state of headache training within Canadian Neurology Residency program: a national survey

BackgroundHeadache disorders are the most common neurological disorders worldwide. Despite their widespread prevalence and importance, the topic of headache is inconsistently taught at both the undergraduate and postgraduate levels. The goal of this study is to establish a better picture of the current state of Headache Medicine (HM) training in Neurology postgraduate programs in Canada and describe the impact of the current pandemic on training in this domain.MethodsOnline surveys were sent to senior residents of adult Neurology programs in Canada. We also conducted telephone interviews with Neurology Program Directors. Descriptive statistics were analyzed, and thematic analysis was used to review free text.ResultsA total of 36 residents, and 3 Program Directors participated in the study. Most of the teaching in HM is done by headache specialists and general neurology faculty. Formal teaching is mainly given during academic half day. Most of the programs expose their residents to Onabotulinum toxin A injections and peripheral nerve blocks, but they don’t offer much formal teaching regarding these procedures. Residents consider HM teaching important and they would like to have more. They don’t feel comfortable performing interventional headache treatments, despite feeling this should be part of the skillset of a general neurologist.ConclusionOur study is the first to establish the current state of headache teaching in post-graduate neurology programs as perceived by trainees and program directors in Canada. The current educational offerings leave residents feeling poorly prepared to manage headaches, including procedural interventions. There is a need to diversify the source of teaching, so the educational burden doesn’t lie mostly upon Headache specialists who are already in short supply. Neurology Residency programs need to adapt their curriculum to face the current need in HM.