Building Your Neurology Acumen’: A Flipped Classroom Approach to Strengthen Internal Medicine Residents’ Neurological Skills

Abstract

Abstract Background/Purpose: Rotating internal medicine (IM) residents often do not feel knowledgeable about neurology, or adequately prepared to approach patients presenting with neurologic clinical issues. Limited pre-clinical exposure, uncertainty when facing neurological complaints, inadequate clinical teaching, and perceived complexity of the field contribute to this perception. We conducted a needs assessment to determine the feasibility of a novel neurology flipped classroom (FC) curriculum for internal medicine residents. Methods: We utilized a multiple methods design and recruited participants through a combination of purposive and convenience sampling. We conducted interviews with internal medicine residents (n=12), a focus group with neurology residents, and a focus group with neurology staff. Additionally, internal medicine residents completed an entry and post-call survey while on their neurology rotation. Results: We implemented a deductive method of analysis by organizing themes according to Kern’s framework for curriculum development.

Problem Identification: Discomfort and perception of under-preparedness amongst IM trainees Targeted Needs Assessment: What the learners (stakeholders) think they need to know vs. what their teachers want them to know vs external requirements (Royal College) Goals and objectives: What content is relevant for clinical requirements vs assessments? Are they mutually exclusive? Methods and setting: Didactic vs. bedside vs. on-demand Implementation of the curriculum: AHD vs. Rotation Evaluation and feedback: Curriculum could be evaluated with surveys, performance on rotation, and board examination result

Conclusion: Our findings illustrate the need to re-examine the way in which neurology is being taught to off-service residents.