Neurohospitalists: Perceived Need and Training Requirements in Academic Neurology

Probasco, John C.; George, Benjamin P.; Dorsey, E. Ray; Venkatesan, Arun

doi:10.1177/1941874413495880

Cited by 13 publications

(14 citation statements)

References 20 publications

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“…9 These current academic leaders perceive both advantages and disadvantages to such a program with regard to educating neurology residents. Regardless of expectations, neurohospitalists appear likely to play an increasingly prominent role in neurology residency training.…”

Section: Discussionmentioning

confidence: 99%

“…9 With the majority of responding academic neurology departments expected to have a neurohospitalist program within the next 5 years, it is highly likely neurohospitalists will play a prominent role as mentors and educators for future neurologists. In general, leaders in academic neurology anticipate this to improve resident education, and better understanding of this new care delivery model should allow neurology departments to take advantage of its strengths and mitigate its weaknesses to benefit resident education.…”

Section: Discussionmentioning

confidence: 99%

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Defining the Role of the Academic Neurohospitalist in Residency Education

Velez‐Ruiz

Khan

Greene

2014

The Neurohospitalist

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Objective: We sought to better understand the potential impact of the burgeoning neurohospitalist model of inpatient care on education of neurology residents and to better define possible roles for ''neurohospitalists'' in residency education. Method: We designed a brief qualitative open-ended survey directed toward academic leaders in neurology and distributed it by e-mail to every academic neurology department in the United States and Canada. Results: Of 83 respondents, 36 (43%) had an active neurohospitalist program and only 10% felt certain they would not have 1 within the next 5 years. All respondents expected to have residents continue to be involved with inpatient care. The main perceived advantage for resident education associated with neurohospitalists was inpatient care expertise, and the main expected disadvantage was decreased exposure to subspecialty attendings. The majority anticipated positive impact on all Accreditation Council for Graduate Medical Education core competencies predominantly based on neurohospitalists' expertise in the inpatient setting. Conclusion: The majority of academic neurology departments are expected to have a neurohospitalist program within the next 5 years. There are several perceived advantages and disadvantages to such a program for education of neurology residents. In general, the impact of these programs is expected to improve resident education. Regardless of expectations, neurohospitalists will likely play a prominent role in the education of the next generation of neurologists.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Defining the Role of the Academic Neurohospitalist in Residency Education

Velez‐Ruiz

Khan

Greene

2014

The Neurohospitalist

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“…In fact, the knowledge of the particularities of patients in each department represents an excellent opportunity for residents to learn and build expertise. 10 Evaluations were mostly carried out between 24 to 48 hours, which seems to be an appropriate response, suggesting the high quality standard of this work.…”

Section: Discussionmentioning

confidence: 99%

A Neurologist’s Hard Day’s Work: Impact of Inpatient Neurology Consultation in a Tertiary Hospital

et al. 2016

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Introduction: Consultation of hospitalized patients under the responsibility of other specialties is a very demanding work. However, it is often under-recognized and poorly documented. The aim of the present study was to assess the burden of the inpatient neurology consultation in a Portuguese hospital and to evaluate the performance of our Neurology department regarding this issue. Material and Methods: A retrospective study was conducted during 2013, reviewing clinical and demographic data. Results: Over one year, the neurologists of our department evaluated 632 inpatients. The commonest reasons for consultation were altered mental state/behavior, focal neurological deficit and seizures. Requests came mainly from medical departments but also from Intermediate and Intensive Care Units. Neurologists suggested further investigation in almost one half of patients and management changes in a similar proportion of patients. A new diagnosis could be established in 63% of cases and the most frequent diagnosis were neurological manifestations of systemic disorders, epilepsy and cerebrovascular disease. Our intervention had impact on the care of 68% of patients. Discussion and Conclusion: Different studies in the literature support our findings and highlight the economic and patient care benefits of this activity. Our results suggest that neurological inpatient observation generates useful interventions for the clinical management of these patients.

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“…The survey was conducted simultaneously with queries regarding neurohospitalist training, the results of which have been published separately. 7 Respondents were asked to choose from a multiple-choice list for many of the questions, some of which could accommodate multiple answers. Several questions utilized either a 4-point scale (never, occasionally, frequently, and always) or a 5-point Likert-type scale.…”

Section: Survey Instrumentmentioning

confidence: 99%

Impact of 2011 Resident Duty Hour Requirements on Neurology Residency Programs and Departments

George

Probasco

Dorsey

et al. 2014

The Neurohospitalist

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Objective: In 2011, the Accreditation Council on Graduate Medical Education (ACGME) redefined resident duty hour requirements by reducing in-hospital duty hour requirements for residents in an effort to improve patient care, resident wellbeing, and resident education. We sought to determine the cost of adoption based on changes made by neurology residency programs and departments due to these requirements. Methods: We surveyed department chairs or residency program directors at 123 ACGME-accredited US adult neurology training programs on programmatic changes and resident expansion, hiring practices, and development of new computer-based resources in direct response to the 2011 ACGME duty hour requirements. Using data from publicly available resources, we estimated respondents' financial cost of adoption. Results: In all, 63 responded (51% response rate); 76% were program directors. The most common changes implemented by programs were adding night float systems (n ¼ 31; 49%) and increasing faculty responsibility (n ¼ 26; 41%). In direct response to the requirements, 21 programs applied to ACGME for 40 additional residents, 29 of which were fully covered by institutional funds. In direct response to the requirements, nearly half of the departments (n ¼ 26) hired individuals for a total of 80 hires (or 64 full-time equivalents), most commonly mid-level practitioners. The total estimated cost to responding departments was US $12.7 million or US $201,000 per department annually. When projecting expenses of planned changes for the following year, costs increased to US $360,000 per department, with 5-year costs exceeding US $1 million. Conclusions: The most recent restriction on resident duty hours comes at substantial cost to neurology departments and residency programs.

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Neurohospitalists: Perceived Need and Training Requirements in Academic Neurology

Cited by 13 publications

References 20 publications

Defining the Role of the Academic Neurohospitalist in Residency Education

Defining the Role of the Academic Neurohospitalist in Residency Education

A Neurologist’s Hard Day’s Work: Impact of Inpatient Neurology Consultation in a Tertiary Hospital

Impact of 2011 Resident Duty Hour Requirements on Neurology Residency Programs and Departments

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