An online curriculum in movement disorders for neurology housestaff

Abstract

Introduction In many neurology residency programs, outpatient neurology subspecialties are underrepresented. Trainee exposure to these subspecialties, including movement disorders, is limited by paucity and variability of clinical experiences. We designed a structured educational tool to address this variability and allow for standardization of elements of movement disorders teaching. Methods We designed and implemented a web-based curriculum in movement disorders for neurology housestaff, in order to improve participant knowledge. The curriculum includes an introduction with a structured framework for the description of abnormal movements and 10 interactive modules focusing on common movement disorders. The curriculum was piloted with nine neurology housestaff at Yale-New Haven Hospital. Evaluation of the curriculum was performed using pre- and post-tests, a survey, and semi-structured interviews. Results The mean pre-test score was 0.7 (±0.19), and the mean post-test score was 0.95 (±0.05) ( t = 3.27). Surveys demonstrated mean Likert values >4/5 for all questions in all categories (knowledge acquisition, quantity, enthusiasm and technical). Semi-structured interviews revealed the following themes: 1) the modules increased participant comfort with the topic, 2) the format was engaging, and 3) the curriculum accommodated different learning styles. All participants remarked that the structured framework was a particular strength. Conclusion We have created, implemented, and evaluated a foundational curriculum in movement disorders for neurology trainees, using readily-available technology. Housestaff responded positively to the curriculum, both in terms of content and format. This curriculum can be implemented in a variety of educational settings, as a central component of a standardized approach to movement disorders teaching.

Multi-Residency Implementation of an Online Movement Disorders Curriculum Based on Real Patient Videos

“…Members of 12 neurology residency programs in North America were recruited on a voluntary basis through an email sent to neurology residency program directors, totaling 233 adult neurology and 10 child neurology residents ( Figure 2 ). Data from subjects from the pilot study at the Yale Neurology Residency Program were included with the intervention group; three PGY-5 fellows were part of this cohort [ 10 ], and two additional PGY-5 neurology fellows participated in the study from other sites at the discretion of their program directors. All study elements were available through Qualtrics Survey Platform through Yale University, and on a centralized website ( http://movementmodules.yale.edu ).…”

“…Ten movement disorders modules were designed using online formats to create an interactive, patient video-based curriculum in movement disorders for neurology residents. Further details of the design of this curriculum have previously been published [ 10 ]. The 12 original programs were randomized by SMS via random number generation to assign six control and six intervention programs.…”

“…Many of the sessions consist of traditional hour-long recorded lectures with slides, which are disadvantaged by their lack of interactivity and their length [ 7 ]. Studies have shown that medical learner attention spans may be as short as 15 or even six minutes [ 8 9 ], and busy neurology residents prefer “bite-sized” learning resources [ 10 ]. Some of the newer additions to the MDS Education Roadmap do provide interactive components that likely appeal well to the millennial learner.…”

“…The trainee is tasked with deciding whether abrupt, rapid, and brief are different from one another, how a movement can be unsustained but also continual, and how to compare and contrast one phenomenology from another. While movement disorders experts may perform well without a structured framework underpinning their phenomenological determinations, new learners have been shown to benefit from a structured approach when met with new concepts [ 10 12 ].…”

“…To address the challenges in formal movement disorders education, we studied the implementation of an online, interactive curriculum in movement disorders across several neurology residency programs. The curriculum begins with an introductory video that proposes a structured framework for phenomenological determination, starting with a core set of descriptors and building from the descriptors to the phenomenology in order to inform the diagnosis [ 10 ] ( Figure 1 ). The remaining curriculum utilizes the framework as a starting point within each module, focusing on individual elements of real patient examinations so that trainees can understand what they should look for in an examination of an undifferentiated movement disorders patient.…”