Disclosures: Peter C. Yeh, MD: Nothing to disclose

Objective: We studied the effect of faculty-led neurological exam workshops on junior PM&R residents’ exam skills using Neurological Assessment Competency Evaluation System (NACES) to provide future guidance for residency training.

Design: Two-year prospective case-control.

Setting: Outpatient clinic.

Participants: 12 junior residents (PGY-2) each year.

Interventions: Brain injury (BI) and spinal cord injury (SCI) attendings led hands-on neurological exam workshops with emphasis on junior residents practicing the skills on co-residents under direct guidance.

Main Outcome Measures: Pre-intervention data were collected 6 weeks after the start of the academic year using NACES where junior residents rotated through seven stations of various topics and were given a clinical scenario to perform appropriate neurologic exam on a model patient while being assessed by a grader. Examinees provided written responses to posed questions for two additional stations. BI and SCI faculty trained the graders and standardized the grading system prior to the NACES. Following neurological exam workshops, post-intervention NACES was conducted in the same manner, 6 months after the pre-intervention NACES. The following academic year, NACES was repeated at the same timeline without the neurological exam workshops, to serve as “controls” to study the effect of natural course of residency training on junior residents’ neurological examination skills.

Results: Intervention group showed significant improvement in altered mental status (AMS), concussion, stroke, falls, ASIA motor, and spasticity categories. Control group had significant improvement in AMS, falls, and brachial plexus categories. There was statistically significant improvement with the intervention group compared to the control group in the concussion (P=.026) and spasticity (P=.005) categories. However, scores in dementia, stroke, falls, ASIA sensory, ASIA Motor, and brachial plexus categories were not significantly different.

Conclusions: Emphasizing attending-guided hands-on educational session on neurologic physical examination skills can serve as an educational enhancement tool to improve trainee core competencies in several categories. NACES itself may also improve residents’ exam skills through feedback system.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-effects-of-neurologic-exam-workshops-on-junior-pmr-residents-exam-skills-assessed-by-neurological-assessment-competency-evaluation-system/