Despite advances in neurologic diagnosis and therapy, there has been little change in practice characteristics of US neurologists.

(NRRC) of the Accreditation Council for Graduate Medical Education (ACGME) required neurology residents to enter patient encounters into a Web-based data entry system. This system was meant to document actual resident experience for informational purposes 1 (Robert Pascuzzi, MD, personal communication) as the ACGME believed the current institutional databases were inadequate and a national Web-based system was needed.2 To assess the burden from and compliance with the case log system, the Graduate Education Subcommittee (GES) of the American Academy of Neurology (AAN) created an anonymous resident survey. The preliminary results of this survey were made available to the NRRC in May 2005. Citing inefficiencies in the current system, the NRRC made entry of the data voluntary on June 1, 2005.3 Here we present the full results of the survey.METHODS Members of the GES and the Consortium of Neurology Residents and Fellows created survey questions aimed at assessing compliance with the case log system, time spent entering the cases, use of a personal digital assistant, and perceived educational and patient care benefits of the system. Questions were tested by members of the GES. An e-mail notification to participate was sent to all US AAN member neurology residents and fellows based on AAN databases. Two percent (n ϭ 29) of residents had already received three AAN surveys in 3 years and were excluded from the survey, per AAN policy. This resulted in 1,629 eligible survey participants. Participants were identified by their AAN identification code only. Five e-mail reminders and two postal letters were sent to those who had not responded. Finally, neurology residency program directors were asked to encourage responses. One percent (21) of the survey participants indicated they did not use the case log system, and did not complete the survey. Respondents' and nonrespondents' demographic data were obtained from the AAN membership databases. For the demographic data, age means were compared with a two-tailed t test analysis and proportions with a 2 analysis. p Values Ͻ 0.05 were considered significant. RESULTSThe final response rate was 50% (810/ 1,629). There were no significant differences between responders and non-responders in age, gender, geographic location, or year in residency. Key results are presented in the table. The remainder of the results are available in table E-A-1, table E-A-2, and appendix E-1. Fourteen percent of residents entered every patient encounter into the case log. A majority of residents could not find the correct International Classification of Diseases (ICD) code (54% found the code less than 50% of the time). Sixty-one percent took 2 minutes or more to enter a single patient encounter, and 59% said it took 10 minutes or more to enter their daily encounters. Fifty-three percent agreed or strongly agreed that the case log interfered with their education vs 23% who disagreed or strongly disagreed. Similarly, 40% agreed or strongly agreed that the case log interfered with patient care vs 29% wh...