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Education Research: Utilization of Simulation in Residency Programs: A Survey of Adult Neurology Residency Program
Shivani Ghoshal1, Catherine S W Albin1, Nisha A Malhotra1
1From the Department of Neurology (S.G., I.A., J.B., M.B., I.K.), Columbia University Vagelos College of Physicians and Surgeons, New York, NY; Department of Neurology (C.S.W.A.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (N.A. Malhotra, A.K.), NYU Grossman School of Medicine, New York; Department of Neurology (R.S.), Johns Hopkins School of Medicine, Baltimore, MD; Department of Neurology (J.F., Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Neurology (N.M.), University of Miami Leonard M. Miller School of Medicine, FL; Department of Neurology (B.W.), University of Florida College of Medicine, Gainesville; Department of Neurology (Z.T.), F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD; and Department of Neurology (N.A. Morris), University of Maryland School of Medicine, Baltimore.
Background And Objectives:
Previous research has demonstrated that simulation-based medical education (SBME) can improve neurology trainees' confidence, knowledge, and competence. However, a general needs assessment and review of current SBME used within neurology are needed to guide SBME curriculum development. The objective of this study was to describe the current use of SBME in resident education and to assess perceived barriers to expanding SBME interventions.
Methods:
We surveyed adult neurology residency program directors (PDs) listed in the Accreditation Council for Graduate Medical Education directory using a Qualtrics-based survey platform. Survey questions addressed current utilization of SBME and barriers to SBME growth.
Results:
Seventy-five PDs of 171 contactable PDs responded to our survey (response rate 44%). Of the respondents, 84% (64/75) report using SBME in their adult neurology residencies. Of those using SBME, 87% (55/64) programs create their own cases. Most programs use simulation to teach neurocritical care topics (63%) and vascular neurology (78%); few use simulation to teach outpatient topics and teleneurology. Among programs that use SBME, there was variability in the frequency of the SBME interventions and in the target trainee cohort. Among responding programs, most expressed interest in expanding SBME in their curriculum (69%, 52/64), but frequently cited lack of faculty protected time (55%), funding (35%), and resident availability (32%) as barriers to doing so.
Discussion:
Most responding programs use SBME. However, the frequency and target learner for SBME interventions varied between programs. Many programs wish to expand SBME at their institutions but are constrained by limited protected time and institutional financial support. We discuss potential solutions to the perceived barriers to SBME, including intra-institutional collaboration to advance SBME use and case diversity for learners and help innovate neurology medical education.
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