ABSTRACT #13

DEVELOPMENT OF A “BOOTCAMP” ORIENTATION PROGRAM FOR NEW NEUROLOGY RESIDENTS

Adam M. Karp, Kate Kerpen, Saritha Kosarussavadi, Leslie Higuita, Laura Stein, Michelle Fabian

PURPOSE AND GOALS: The start of training is a difficult period of transition for new residents. This is particularly true for Neurology residents who have completed a year of general medicine training with limited exposure to the specialty. Orientation programs have been successful in easing the transition to residency training. We developed a novel bootcamp orientation curriculum for incoming PGY2 neurology residents at Mount Sinai Hospital.

METHODS: We developed the bootcamp curriculum in response to feedback received from current residents of useful topics to cover as well as in discussion with program leadership. PGY2 residents were relieved of clinical duties for one day to allow full class participation. The program ran over one full didactic day led by the Neurology Chief Residents in rotating small groups of 2-3 PGY2s. Topics covered included the detailed neurologic exam, management of common neuro-emergencies (including acute stroke, seizure, status epilepticus, intracranial hemorrhage, and herniation), as well as icebreakers and team building exercises.

EVALUATION PLAN: Pre- and post- orientation surveys were completed to assess resident comfort with the neurologic exam, readiness to treat neuro-emergencies and begin training in Neurology, and the quality of the experience.

SUMMARY OF RESULTS: 10 learners participated in the program. 10 completed the pre-orientation survey and 8 completed the post-orientation survey. Learners rated their average comfort with the neurologic exam prior to orientation as 5.4 (on a likert scale of 0-10) and 7 out of 10 after orientation. Learners rated confidence in identifying acute stroke and running a stroke code was 1.7 prior and 5.25 out of 10 afterwards. Confidence initiating a stroke workup prior was 3.3 prior and 6.125 out of 10 afterwards. Confidence identifying patients with increased intracranial pressure (ICP) prior was 2 prior and 6.125 out of 10 afterwards. Confidence initiating ICP management was 2.7 prior and 5.75 out of 10 afterwards. Confidence identifying seizure/status epilepticus 2.8 prior and 6.25 out of 10 afterwards. Confidence initiating treatment for status epilepticus 2.8 prior and 7.25 out of 10 afterwards. Learners additionally rated the experience as high quality and incredibly helpful for starting PGY2 year. One learner attested that they “could not imagine starting PGY2 year without it”.

REFLECTIVE CRITIQUE: Early experience with our neurology residency “bootcamp” orientation curriculum suggests benefit in comfort with the neurologic exam, readiness to treat neuro-emergencies, and readiness to begin training in Neurology.