Development and Initiation of a Neurocritical Care Curriculum for Toronto Adult Critical Care Medicine Fellowship Program in Canada
CCCF ePoster library. Goffi A. Oct 27, 2015; 114774; P92
Dr. Alberto Goffi
Dr. Alberto Goffi
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Abstract
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P92


Topic: Education Science


Development and Initiation of a Neurocritical Care Curriculum for Toronto Adult Critical Care Medicine Fellowship Program in Canada



Alberto Goffi, V. McCredie, A. Manoel, J. Singh, M. Chapman, S. Schweikert, S. Abrahamson

Interdepartmental Division of Critical Care Medicine & Department of Medicine, Division of Respirology (Critical Care Medicine), University of Toronto & University Health Network - Toronto Western Hospital, Toronto, Canada | Interdepartmental Division of Critical Care Medicine & Department of Critical Care, University of Toronto & Sunnybrook Health Sciences Centre, Toronto, Canada | Department of Critical Care Medicine, St Michael’s Hospital, Toronto, Canada | Interdepartmental Division of Critical Care Medicine & Department of Medicine, Division or Respirology (Critical Care Medicine), University of Toronto & University Health  Network - Toronto Western Hospital, Toronto, Canada | Interdepartmental Division of Critical Care Medicine &  Department of Critical Care Medicine, University of Toronto &  Sunnybrook Health Sciences Centre, Toronto, Canada | Department of Intensive Care, Royal Perth Hospital, Perth, Australia | Interdepartmental Division of Critical Care Medicine, Department of Anesthesia & Department of Critical Care Medicine, University of Toronto & St. Michael's Hospital, Toronto, Canada

Introduction:

With the increasing burden of neurocritical illness and the advent of new effective treatments for severely brain injured patients, there is a strong need for practical education in clinical neurocritical care. In Canada there are neither formally accredited neurocritical care training programs nor subspecialty neurocritcal care examinations. Subspecialty training in neurocritical care usually requires training abroad, and certification through the UCNS Neurocritical Care examination. The lack of an accredited curriculum in the management of neurological emergencies represents a potential gap in Canadian acute care education.



Objectives: We describe the implementation of the first Emergency Neurological Life Support (ENLS) course held in Canada within the emerging neurocritical care curriculum of the University of Toronto Critical Care Medicine (CCM) Program.

Methods:

A tailored half-day ENLS course was introduced for the adult CCM trainees at the University of Toronto to complement our evolving neurophysiology, neuroimaging and neurosimulation education program. We included pre-session preparation and the option for on-line certification examination. In addition, surveys and knowledge assessment questionnaires were administered to evaluate and tailor ongoing curriculum development.



Results:

36 fellows at the University of Toronto anonymously evaluated the ENLS course. Attendees included fellows from various backgrounds including anesthesiology (42%), internal medicine (31%), general surgery (8%), emergency medicine (6%) and other (13%). Qualitative feedback regarding the ENLS course was positive with increased confidence in managing neurocritically ill patients during the first hour of their emergency. The main concern with the course was the large number of topics covered within the half-day. Multimodal neuromonitoring, determination of death by neurological criteria and neuroimaging sessions were suggested as possible future additional topics. Anonymous online pre- and post-course testing had only seven responses.



Conclusion: We are successfully implementing a tailored curriculum in neurocritical care at Canada’s largest critical care training program using ENLS as a part of this framework. We intend to formally reevaluate knowledge retention and trainee confidence. We will also refine and expand the curriculum as well as provide the ENLS course at a variety of venues to reach a broader acute care community

References: 1. http://enlsprotocols.org (accessed on July 1st, 2015)
2. Smith, W. S., & Weingart, S. (2012). Emergency Neurological Life Support (ENLS): what to do in the first hour of a neurological emergency. Neurocritical Care, 17 Suppl 1(S1), S1–3. http://doi.org/10.1007/s12028-012-9741-x
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