Education Research: Feasibility and Impact of Academic Half-Day at a Large Academic Neurology Residency Program

The aim of this study was to assess the limitations of a traditional twice-daily lecture format and evaluate the feasibility and impact of implementing an academic half-day (AHD) for neurology residents at a multisite academic institution. AHD has the potential to improve attendance, satisfaction, and clinical competency compared with traditional didactics in graduate medical education. However, its feasibility and impact within neurology residency programs remain underexplored, with few adopting this model to date. Coverage logistics, faculty availability, and neurologic emergencies continue to pose challenges, particularly in large, multisite institutions.

A needs assessment survey was administered to 36 neurology residents (postgraduate year [PGY]2-PGY4) in spring 2024 to evaluate attendance, satisfaction, and suggestions for improvement. Attendance was recorded over 1 month (August 2024). Based on survey feedback, a new 3.5-hour AHD curriculum was developed collaboratively by residents and faculty, held Tuesday mornings every week with varied lecture formats. One resident per class covered urgent clinical duties at each of 3 sites, while faculty and advanced practice providers (APPs) independently conducted rounds. Attendance was recorded for one month after implementation (September 2024), and surveys were distributed to assess satisfaction with both the curriculum and the coverage model. Residency In-Training Examination (RITE) scores were compared between the 2022 and 2024 cohorts (before AHD) and the 2025 cohort (after AHD implementation).

The needs assessment (n = 27) identified major barriers, including prerounding (78%), urgent clinical situations (37%), and Epic messaging during lectures (30%). Pre-AHD attendance averaged 35% (n = 36), which improved to 79% after AHD (p = 0.006). Residents reported greater engagement, concentration, retention, and camaraderie. Average RITE scores improved for the 2025 cohort compared with previous years (71% vs 65%, p = 0.0013). Faculty and APPs reported positive or neutral effects on workflow (82.6% and 100%, respectively) and patient safety (95.6% and 100%, respectively).

Implementation of AHD across a large, multisite neurology residency program was feasible and associated with higher attendance, improved resident satisfaction, and enhanced RITE performance, without adverse effects on workflow or patient safety. Key factors for success included resident involvement, a targeted needs assessment, and strong coverage support from faculty and APPs.