Resident Education

Academic Half Day

We have transitioned into an Academic ½ Day (AHD) for our Neurology residents and away from the standard noon conference format of the past. It is held in-person only, on Tuesdays between 12:30 and 4:30 PM. The curriculum has been carefully designed to ensure it is (1) clinically relevant (2) multi-directional and interactive. Faculty will serve as facilitators for each academic ½ day, rather than sole presenters. As such, please try your best to keep the environment engaging and interactive and encourage all trainees to actively participate in the learning experience.
We expect faculty facilitators to be participate in the entire academic ½ day. For neurology faculty, clinical responsibilities will be held during this time. Residents also will be free from any clinical duties, ensuring active engagement on all fronts.

Agenda

The agenda is standardized as below. The only session that will vary week to week will the 3:15-4:15 flex block. Please review descriptions of each session below as you prepare your half day!

OneDrive Shared Folder

You have been granted access to a shared folder in OneDrive titled “AHD_OneDrive_2024-2025”. In it, you will find the AHD Guidelines Document PDF (this document), and, a dedicated sub-folder for your specific AHD, to be used for:\

• Access to the relevant Continuum article(s) for your respective AHD
• A brief “txt” or “doc” file that describes your flex block and any other notes specific to your AHD

You will upload all files needing printing in this folder as well, specifically:

• Pre & Post Test
• Continuum of Care Questions
• PPT slides for your 15 Slides session
• Any materials for the flex block

Storage of these files in this sub-folder will also allow for future reference by residents and/or faculty.

Afternoon Report

Akin to "morning report”, this session serves as a presentation and discussion on an educational and/or challenging clinical case selected by one of the residents. It serves as a platform for learning through case presentations, differential diagnoses, and evidence-based discussions to enhance clinical knowledge and decision-making skills. Although this is resident-run, your participation ensures that your expertise is shared with the learners.

Pre-Test / Post-Test

Pre-tests and post-tests serve as valuable assessment tools in medical education, especially in evaluating the effectiveness of a learning intervention or instructional strategy e.g., the academic half day. It provides a baseline assessment (for the learner), helps identify knowledge gaps, creates accountability, and tangibly measures learning. Post-tests motivates your learner by demonstrating the progress they’ve made over the course of instruction.

Think about 5 key points/ideas/facts that you absolutely want the residents to learn by the end of the half day. Develop 5 multiple choice questions (mcq) based off this. At the start of the ½ day, you will distribute the questions (pre-test) and ask them to work independently (without resources), and collect the handouts after 15 minutes. You will hand a second copy (post-test) of the questions at 4:15, prior to the end of the half day. They will complete it and turn it in. Furthermore, the Pre-Test will contain the prior week’s 5 mcq’s as well, to gauge longer-term retention. The residency program coordinator will facilitate printing of both the pre-test and post-test.

• Pre-Test --> Prior week’s 5 mcq’s + Current week’s 5 mcq’s
• Post-Test --> Current week’s 5 mcq’s only

Note: BOTH the pre and post-test handouts MUST be collected and handed to Krystal at the end of the ½ day. This will serve as attendance for both time-points (i.e., start and end).

15 Slides

This is your opportunity to showcase, using PowerPoint slides, anything you would like as it pertains to the topic using visuals/graphics/images/diagrams/charts. This is intended to be an exciting intro to the topic to set the tone for the remainder of the half day. Consider showcasing any of the following:

• Intro to the topic to bring all learners onto the same page
• Key objectives/points you feel are critical to the topic (i.e., “takeaways”)
• A graphical overview of the clinical topic/question of the day
• Landmark studies related to the topic
• Your own research in this field
• Other Graphs/Diagrams/Teaching images

This should be in MS Powerpoint / Slideshow format, and should be limited to no more than 15 slides. The idea is not to cover the topic comprehensively, but rather, showcase key learning points using curated slides. The subsequent Continuum of Care session will allow for a more detailed discussion on the topic.

Continuum of Care

The goal of this session is to provide a learner-driven review of the respective topic, utilizing articles from Continuum Lifelong Learning in Neurology. Residents will be required to listen to an audio podcast of the article (author of article discusses key points with an interviewer) in the week leading up to the session. This will help prepare residents for a deeper dive into the topic/article.

The review should revolve around a clinical case. Each continuum article generally has 2 clinical cases. If it has more than 2, choose any two cases you prefer. And, in rare cases, two articles may be assigned for one AHD (for the sake of topic coverage); feel free to use cases from either of the 2 articles. You, the facilitator, will develop 5 challenging questions beforehand that pertain to each of these cases, and provide printed handouts of these questions with space for written answers. The questions should be specific and challenging and should require the resident sift through the article to find answers. You may even consider asking that they provide a reference article to support their answer; they would have to sift the article to find the answer, then search the reference in the “REFERENCES” section at the end.

This process of active learning should help the learner solidify their understanding of the topic and hopefully identify knowledge gaps.

Format

• 1:45 - 2:05 - Resident works individually, sifts through the article and writes down responses
• 2:05 – 2:30* - Residents review their answers in pre-determined small groups of 4
• 2:30 – 3:00 – Interactive discussion on the questions; facilitator should call on groups/individuals to engage

* Note: To ensure an engaging small group discussion, please NUMBER off residents in random fashion, to allow for varying educational levels to be represented in each small group (e.g., students, PGY levels, etc.,). Group sizes should be no more than 4.

Sample Clinical Case & Questions

Based off Continuum 2020: “Update on Treatment of Acute Ischemic Stroke” 2020;26 (CEREBROVASCULAR DISEASE)

“A 62-year-old man presented with the sudden onset of right-sided weakness and dysarthria. The patient promptly arrived by ambulance to the emergency department 25 minutes after symptom onset. His National Institutes of Health Stroke Scale (NIHSS) score was 8. Noncontrast brain CT showed no hemorrhage, acute ischemic changes, or hyperdense vessel sign. He had no contraindications for IV thrombolysis. IV recombinant tissue plasminogen activator (rtPA) was started 46 minutes after symptom onset. CT angiography was performed after initiation of IV rtPA and showed no evidence of large artery occlusion. The patient improved rapidly within the following 3 hours, and by the following day, he had no residual symptoms.”

1. What three main goals of acute stroke care are highlighted in this clinical case? Describe how each of these principles was achieved.
2. Should this patient’s bed position have been placed flat, or HOB 30 degrees? Why? What clinical trial(s) evaluated this question?
3. What questions were reviewed (with this patient, their chart, their family) prior to deciding on administering IV rTPA?
4. Describe three benefits of Tenecteplase over Alteplase? What famous clinical trial compared the safety and efficacy of Tenecteplase over Alteplase and in which journal was it published?
5. Should CT perfusion have been performed in this patient? Why or Why not?

Flex Blocks

This 60 minute window will be used as “flex” time. This time will allow you, the facilitator, the option of introducing your own unique approach to teaching an assigned topic. Additionally, this time may be used to incorporate sessions required as a part of our longitudinal curriculum (and may not directly require your preparation).
We will work closely with you in developing this. Below are ideas of how flex blocks can be used, with some occurring at a more regular cadence than others:

Flex Blocks Options:

• Journal Club: This occurs once monthly, and is led by a resident who prepares the topic and presents it to the group in an engaging manner. Your expertise here (both in selecting the article and facilitating a deep discussion into it) is critical.
• Neuropathology/Neuroradiology Rounds: Occurring once every 4-8 AHD’s, we invite one of our neuropathologists or neuroradiologists to review cases in a show-and-tell fashion.
• Gamification: This is a resident-favorite; consider Kahoot, jeopardy, or other clever competitive ways of teaching your topic. Winning players/teams can be treated for coffee at Papa Joe’s (Residency Program Coordinator can facilitate this).
• Cost-Conscious Care: A lesson on the ever-important topic of providing cost-conscious care. Resources from the AAN may be used to assist.
• SIM Center: Reserve the SIM center for an interactive teaching session, ideal for procedural training, code-simulation algorithms, and the like.
• Medicolegal: An opportunity for residents to understand the landscape of clinical practice and the potential medicolegal implications, using legal cases.
• Medical Ethics: Utilizing resources from our health system, experts
• Patient Education Activity: An interactive session in which residents design patient education material (e.g., brochure, short videos), a practical in simplifying concepts and learning to teach our patients.
• Video Rounds: Teaching through educational videos demonstrating neurological exam findings (e.g., seizure semiology, movement disorders) or a joint viewing from an expert lecturer (e.g., AAN On Demand)
• Debate: Engage residents in a competitive yet entertaining fashion by encouraging them to broaden their thinking and perspective on clinical scenarios

EPIC Optimization Training
AAN On Demand Video
Business of Medicine
DEIJ/Wellness Curriculum
QI (Quality Improvement)

Resident Attendance & Participation

Active resident attendance and participation are expected at each academic half day. All residents (save night float residents and residents on approved PTO) are exempted from clinical duties and should be present for the entirety of the half day. As is standard with clinical duties, any exceptions (e.g., meetings, interviews) to this will require prior approval by the program director.
Attendance will be taken and tracked through pre-test and post-test submissions. Additionally, if a trainee is absent for portions of the half day, please notify the program director and program coordinator of this. Any unexcused absences (partial or full) from the half day will require completion of a 1500 word essay summary of the topic for the day.