Abstracts

Rationale: Neurology Residents are expected to achieve milestones in Epilepsy and Electroencephalography (EEG) by graduation, 2 ACGME core competencies. The beginning of neurology residency training often includes heavy inpatient services, with frequent management or consultation of patients suffering from seizures. At Stanford, neurology residents rotate for one month on the epilepsy service, which includes care of patients on the epilepsy monitoring service, seeing patients in epilepsy clinic and learning the basics of EEG.The duration of epilepsy/EEG rotations during residency across the country often varies from 1-3 months. Stanford residents have < 50% rotation time when compared to many other residency programs in US.  Methods: A teaching pilot study was performed from 7/2018-5/2019 with PGY-2 neurology residents rotating with the Stanford epilepsy service. Based on ABPN and ACGME recommended knowledge base in epilepsy, a curriculum was designed with 16 concise talks including basic knowledge, EEG reading, anti-seizure medication (ASD) pharmacology and surgical management. Each lecture included a 10-15 minutes PowerPoint presentation, and were sequentially given four days a week during each rotation. A 12-question survey with 5-point Likert scale was given to each resident before and after the curriculum, with questions addressing resident comfort with the consensus topics and their feedback. Data was analyzed using Mann-Whitney U test with SPSS 23 software. P values of <0.05 were considered significant.  Results: Survey response was 100%, however, one resident was excluded for post-survey analysis as they were unable to finish the rotation during the time frame due to scheduling issues. The residents uniformly felt more comfortable with the consensus topics after the fellow-driven curriculum was taught including: interviewing epilepsy patients, managing status epilepticus patients, managing ASDs, comfort of discussing various epilepsy treatments (e.g. meds, VNS, RNS, DBS) with patients, identifying normal and seizure patterns of EEG, and interpreting EEG reports (p<0.05).  Conclusions: Epilepsy fellows are in a unique position to supplement neurology resident teaching. Fellow-driven, near-peer teaching in a standardized fashion may help residents gain competence in clinical epilepsy prior to graduating from residency. In addition, neurology residents would benefit from increased rotation time on epilepsy/EEG.  Funding: No funding