Development of an Educational Curriculum for Implanting and Managing Vagus Nerve Stimulators for Epilepsy

Background: Vagus nerve stimulation (VNS) devices are commonly used for extracranial neuromodulation of drug-resistant epilepsy. These devices are implanted by multiple surgical subspecialties and managed by practitioners with varying levels of epilepsy-specific expertise. The North American Neuromodulation Society (NANS) education committee presents a curriculum defining level-dependent recommendations within the six-core competency rubric for the implantation and management of VNS devices. Material and Methods: A multidisciplinary (anesthesiology, neurology, neurosurgery, and physiatrists) and diverse (advanced practice providers, physicians, and surgeons) subcommittee of the NANS education committee met virtually over a year to develop a curriculum following the Accreditation Council for Graduate Medical Education (ACGME) core competencies. The subcommittee used a consensus approach, evidence-based development strategy; once completed, the VNS curriculum was approved by the NANS board. Results: The subcommittee developed a VNS curriculum as a standard to be used for implanting surgeons, managing physicians, and advanced practice providers. The vertical orientation of the curriculum uses the ACGME educational core competencies framework; within this paradigm is a horizontal progression of skills with distinct competency groups for implanting surgeons and/or managing physicians. The horizontal progression defines the expected competence for early learner, advanced learner, and independent practitioner. Conclusion: A NANS education subcommittee iteratively developed a VNS curriculum for defining progressive competence of myriad care providers, including clinicians and advanced practice providers, within the ACGME six core competencies.