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      Curriculum Innovations: A Novel Neurology Clinician-Educator Program

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          Abstract

          Background and Objectives

          Neurology residents serve as frontline teachers for junior trainees but often lack formal training in medical education. We developed a novel longitudinal curriculum to enhance the teaching skills and educational leadership of residents interested in pursuing careers as clinician-educators.

          Methods and Curriculum Description

          We developed and piloted a Neurology Clinician-Educator Program (NCEP) with the following goals: (1) improve resident satisfaction with opportunities to develop teaching skills, (2) improve resident satisfaction with opportunities to transition into a clinician-educator role after training, and (3) enhance resident teaching skills using evidence-based strategies. The NCEP was implemented on an optional basis for senior neurology residents at a single academic institution and applied through a thematic framework centered around experiential learning theory. The program involved 2 immersive 3-week experiences including both didactic and application formats. These sessions were integrated through the implementation of capstone education projects, facilitating the translation of theoretical knowledge acquired from the NCEP into real-world practice. Satisfaction with opportunities to develop clinician-educator skills was measured through preimplementation and postimplementation surveys distributed to the entire residency cohort while participant progression of educator skills was measured through faculty-guided self-assessment of the Accreditation Council for Graduate Medical Education (ACGME) Clinician Educator Milestones framework.

          Results and Assessment Data

          Eight residents completed the 2-year NCEP in its initial iteration. Residents throughout the entire residency program (response rate 24/27 before implementation and 25/27 after implementation) reported significantly higher satisfaction with opportunities to develop teaching skills (64% after implementation vs 33% before implementation, p = 0.032) and with opportunities to transition into a clinician-educator role following training (68% after implementation vs 29% before implementation, p = 0.007) after implementation of the NCEP. Among the 8 residents who completed the NCEP, faculty-guided self-assessment improved significantly ( p < 0.05) in 14 of 20 ACGME Clinician Educator Milestone domains.

          Discussion and Lessons Learned

          This study demonstrates the successful implementation of a novel curriculum for neurology residents interested in becoming clinician-educators. The NCEP was well received by participants, resulted in improved satisfaction with opportunities to develop clinician-educator skills, increased learning of education concepts and skills, and resulted in behavioral change reflected in various capstone education projects.

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          Most cited references21

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          Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda

          An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of “implementation outcomes” distinct from service system and clinical treatment outcomes. This paper proposes a heuristic, working “taxonomy” of eight conceptually distinct implementation outcomes—acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability—along with their nominal definitions. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.
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            Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes?

            Although physicians report spending a considerable amount of time in continuing medical education (CME) activities, studies have shown a sizable difference between real and ideal performance, suggesting a lack of effect of formal CME. To review, collate, and interpret the effect of formal CME interventions on physician performance and health care outcomes. Sources included searches of the complete Research and Development Resource Base in Continuing Medical Education and the Specialised Register of the Cochrane Effective Practice and Organisation of Care Group, supplemented by searches of MEDLINE from 1993 to January 1999. Studies were included in the analyses if they were randomized controlled trials of formal didactic and/or interactive CME interventions (conferences, courses, rounds, meetings, symposia, lectures, and other formats) in which at least 50% of the participants were practicing physicians. Fourteen of 64 studies identified met these criteria and were included in the analyses. Articles were reviewed independently by 3 of the authors. Determinations were made about the nature of the CME intervention (didactic, interactive, or mixed), its occurrence as a 1-time or sequenced event, and other information about its educational content and format. Two of 3 reviewers independently applied all inclusion/exclusion criteria. Data were then subjected to meta-analytic techniques. The 14 studies generated 17 interventions fitting our criteria. Nine generated positive changes in professional practice, and 3 of 4 interventions altered health care outcomes in 1 or more measures. In 7 studies, sufficient data were available for effect sizes to be calculated; overall, no significant effect of these educational methods was detected (standardized effect size, 0.34; 95% confidence interval [CI], -0.22 to 0.97). However, interactive and mixed educational sessions were associated with a significant effect on practice (standardized effect size, 0.67; 95% CI, 0.01-1.45). Our data show some evidence that interactive CME sessions that enhance participant activity and provide the opportunity to practice skills can effect change in professional practice and, on occasion, health care outcomes. Based on a small number of well-conducted trials, didactic sessions do not appear to be effective in changing physician performance.
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              How can physicians' learning styles drive educational planning?

              As changes in health care delivery systems and in the global burden of disease call for a reassessment of how tomorrow's physicians should be educated--indeed, for a reconsideration of the diversity of roles the physician should play--there is an immediate need to produce continuing medical education (CME) programs with real impact. Curriculum planners are questioning both the content of medical education and the methods of instruction and training. The product, or content, and the mechanism for its delivery have been defined and discussed, but a significant body of literature has shown that new knowledge does not necessarily lead to new behavior. Ample evidence exists in the CME literature to support the implementation of more active and self-directed learning strategies to promote the desired change in behaviors. The question, then, that is the focus of this article is how educational planning might be better guided by an understanding of how physicians learn within the continuing medical education domain. Revisiting the principles of David Kolb's Learning Styles Inventory, the authors propose applying his experiential learning model to overall curriculum design work. The authors argue that promoting the application of all learning styles in sequence in an educational encounter is a most desirable approach, and that this approach to learning could extend far beyond individual learners to influence how every component of medical education is designed, from the individual lecture or class activity to entire courses or programs.
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                Author and article information

                Journal
                Neurol Educ
                Neurol Educ
                NXE
                Neurology: Education
                Lippincott Williams & Wilkins (Hagerstown, MD )
                2771-9979
                December 2024
                27 November 2024
                27 November 2024
                : 3
                : 4
                : e200175
                Affiliations
                From the Department of Neurology, Mayo Clinic, Rochester, MN.
                Author notes
                Correspondence Dr. Mustafa mustafa.rafid@ 123456mayo.edu

                Go to Neurology.org/NE for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

                Submitted and externally peer reviewed. The handling editor was Roy E. Strowd III, MD, MEd, MS.

                Author information
                https://orcid.org/0000-0003-2827-0507
                https://orcid.org/0000-0001-6257-1464
                https://orcid.org/0000-0002-5689-4424
                https://orcid.org/0000-0001-9763-1025
                https://orcid.org/0000-0002-6661-2910
                https://orcid.org/0000-0003-2770-0691
                https://orcid.org/0000-0002-7768-0994
                https://orcid.org/0000-0002-7784-504X
                https://orcid.org/0000-0002-5851-8705
                https://orcid.org/0000-0003-1206-0222
                Article
                NE9-2024-100121
                10.1212/NE9.0000000000200175
                11694801
                39748890
                2097b9c2-8504-422c-9efc-9c2619cb389d
                © 2024 American Academy of Neurology

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 July 2024
                : 14 October 2024
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