Multimodal Teleneurology Curriculum Helps Residents Learn, Apply Techniques

A multimodal, comprehensive, 3-year teleneurology curriculum better prepared neurology residents for the clinical application of teleneurology, considering varying student needs and preferences for learning. These are the findings of a study published in the journal Neurology: Education.

The COVID-19 pandemic necessitated virtual assessment of student competence as well as expedited the need for telemedicine across neurology practices.

Researchers at New York University Grossman School of Medicine and Johns Hopkins University School of Medicine developed and implemented a 3-year, comprehensive, multimodal, teleneurology curriculum to instruct neurology residents in key aspects of telehealth encounters, such as virtual examination and skill development.

To determine the teaching methods that would best help students to learn teleneurology, the educators surveyed 22 neurology residents who identified the following teaching methods:

• Didactics with slides (25%)
• Live demonstrations (25%)
• Simulated experience (23%)
• Starting with live patients (23%)
• Articles/reading material (4%)

Most students preferred active over passive teleneurology training, according to this needs assessment. The researchers developed a multimodal teleneurology curriculum that incorporated all of these teaching methods across various environments over a 3-year period.

As part of the teleneurology program, residents watched a teleneurology visit with 1 faculty member playing the part of the patient and another faculty member conducting the examination. They then reinforced what they observed in this session by practicing a teleneurology encounter during a 10-minute objective structured clinical examination (OSCE) at a simulation center where they were the examining provider.

After the first year of the program, the researchers received positive feedback, motivating them to make the OSCE fully remote by the spring of 2021 for senior neurology residents. To date, a total of 68 neurology residents have completed the teleneurology curriculum — both on-site and remote training — across both institutions.

The researchers evaluated the efficacy of the teleneurology curriculum by having residents complete postcurriculum qualitative evaluations using a 5-point Likert scale. They discovered that residents gained confidence and felt more comfortable upon completion of the on-site and remote training simulations in the teleneurology curriculum (P <.05). Residents also became more interested in teleneurology (P <.05), requesting access to extra teleneurology simulations. The teleneurology curriculum required improvement in sensorimotor assessment and adequate visualization of the affected limb.

“We believe that teleneurology will be a commonly accepted and widespread modality of patient care in the future. Robust teleneurology education should become an essential part of residency training to prepare residents to provide high-quality virtual patient care after training,” the researchers concluded.

This study did not represent the wide range of patient technologic literacy, addressing only a small subset of potential technical challenges. The faculty observer assessment for the first cohort of learners was not standardized; however, the plan is to ensure uniformity so that learners are assessed using the same metrics and checklists.