TY - JOUR
T1 - Education Research
T2 - Variation in priorities for neurocritical care education expressed across role groups
AU - Cohen, Abigail S.
AU - Izzy, Saef
AU - Kumar, Monisha A.
AU - Joyce, Cara J.
AU - Figueroa, Stephen A.
AU - Maas, Matthew B.
AU - Hall, Christiana E.
AU - McDonagh, David L.
AU - Lerner, David P.
AU - Vespa, Paul M.
AU - Shutter, Lori A.
AU - Rosenthal, Eric S.
N1 - Funding Information:
Upon review and approval by the Neurocritical Care Society (NCS), the survey was posted on the NCS website and disseminated to its physician and nursing members in multiple NCS announcements. In addition, the survey was comprehensively disseminated by Accreditation Council for Graduate Medical Education (ACGME) neurology residency program directors and UCNS NCC fellowship program directors to trainees, physicians, and nurses based on program registration information from the UCNS Fellowship Training Program directory2 and the ACGME directory of neurology residency programs.4 Program directors were asked to send the survey to their residents and fellows and to distribute to nurse leaders at their institutions. In total, program directors at over 90 institutions in 37 states were contacted.
Publisher Copyright:
© 2018 American Academy of Neurology.
PY - 2018/6/12
Y1 - 2018/6/12
N2 - Objective To define expectations for neurocritical care (NCC) core competencies vs competencies considered within the domain of other subspecialists. Methods An electronic survey was disseminated nationally to NCC nurses, physicians, fellows, and neurology residents through Accreditation Council for Graduate Medical Education neurology residency program directors, United Council for Neurologic Subspecialties neurocritical care fellowship program directors, and members of the Neurocritical Care Society. Results A total of 268 neurocritical care providers and neurology residents from 30 institutions responded. Overall, >90% supported NCC graduates independently interpreting and managing systemic and cerebral hemodynamic data, or performing brain death determination, neurovascular ultrasound, vascular access, and airway management. Over 75% endorsed that NCC graduates should independently interpret EEG and perform bronchoscopies. Fewer but substantial respondents supported graduates being independent performing intracranial bolt (45.8%), ventriculostomy (39.0%), tracheostomy (39.8%), or gastrostomy (19.1%) procedures. Trainees differed from physicians and program directors, respectively, by advocating independence in EEG interpretation (92.8%, 61.8%, and 65.3%) and PEG placement (29.3%, 9.1%, and 8.5%). Conclusions Broad support exists across NCC role groups for wide-ranging NCC competencies including skills often performed by other neurology and non-neurology subspecialties. Variations highlight natural divergences in expectations among trainee, physician, and nurse role groups. These results establish expectations for core competencies within NCC and initiate dialogue across subspecialties about best practice standards for the spectrum of critically ill patients requiring neurologic care.
AB - Objective To define expectations for neurocritical care (NCC) core competencies vs competencies considered within the domain of other subspecialists. Methods An electronic survey was disseminated nationally to NCC nurses, physicians, fellows, and neurology residents through Accreditation Council for Graduate Medical Education neurology residency program directors, United Council for Neurologic Subspecialties neurocritical care fellowship program directors, and members of the Neurocritical Care Society. Results A total of 268 neurocritical care providers and neurology residents from 30 institutions responded. Overall, >90% supported NCC graduates independently interpreting and managing systemic and cerebral hemodynamic data, or performing brain death determination, neurovascular ultrasound, vascular access, and airway management. Over 75% endorsed that NCC graduates should independently interpret EEG and perform bronchoscopies. Fewer but substantial respondents supported graduates being independent performing intracranial bolt (45.8%), ventriculostomy (39.0%), tracheostomy (39.8%), or gastrostomy (19.1%) procedures. Trainees differed from physicians and program directors, respectively, by advocating independence in EEG interpretation (92.8%, 61.8%, and 65.3%) and PEG placement (29.3%, 9.1%, and 8.5%). Conclusions Broad support exists across NCC role groups for wide-ranging NCC competencies including skills often performed by other neurology and non-neurology subspecialties. Variations highlight natural divergences in expectations among trainee, physician, and nurse role groups. These results establish expectations for core competencies within NCC and initiate dialogue across subspecialties about best practice standards for the spectrum of critically ill patients requiring neurologic care.
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U2 - 10.1212/WNL.0000000000005682
DO - 10.1212/WNL.0000000000005682
M3 - Article
C2 - 29891575
AN - SCOPUS:85053920998
SN - 0028-3878
VL - 90
SP - 1113
EP - 1115
JO - Neurology
JF - Neurology
IS - 24
ER -