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Rachel Gottlieb-Smith¹, Joshua Adams¹, Miya E Bernson-Leung²

¹Department of Pediatrics, University of Michigan, Ann Arbor.

Neurology. Education

|July 1, 2026

Summary

This summary is machine-generated.

Child neurology residents often lack preparedness for independent practice. Analyzing electronic health records revealed that over half of the American Board of Psychiatry and Neurology content areas were underrepresented in clinical exposure compared to the certification exam.

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Area of Science:

Medical Education
Neurology
Health Informatics

Background:

Recent child neurology graduates frequently exhibit gaps in preparedness for independent practice.
The breadth and variability of clinical exposure during residency are not well-characterized.
Understanding resident clinical experiences is crucial for developing effective residency curricula and precision medical education (PME).

Purpose of the Study:

To catalog child neurology resident clinical experiences using electronic health record (EHR) data.
To link diagnostic codes from EHR data to educational benchmarks set by the American Board of Psychiatry and Neurology (ABPN).
To inform curricular development and PME by characterizing resident exposure to various medical conditions.

Main Methods:

A retrospective cohort study of 11 child neurology residents over an 11-month period.
Utilized an algorithm to identify meaningful patient encounters based on EHR interaction.
Extracted International Classification of Disease (ICD)-10 codes and mapped them to ABPN content areas.

Main Results:

Over 7,000 meaningful inpatient and outpatient encounters were analyzed.
A crosswalk was developed mapping 385 ICD-10 categories to ABPN content areas, achieving high capture rates for encounters.
Key conditions like epilepsy and migraine were frequent, but over half of ABPN content areas were underrepresented in resident exposure compared to the certification exam.

Conclusions:

A novel crosswalk between ICD-10 codes and ABPN content areas transforms EHR data into educational insights.
Characterizing resident experiences via EHR data can guide rational curricular design and PME.
Data can optimize rotations and address learning gaps, enhancing resident preparedness for autonomous practice.