Competency-Based Curricula in DBS and ITB Therapies for Movement Disorders (P06.022)

Objective: To improve clinician education in the use of deep brain stimulation and intrathecal baclofen device therapy for movement disorders through the systematic development of competency-based curricula as part of an overarching competency-based neuromodulation curriculum. Background Although competency-based curricula are effective in developing continuing competence in clinical practice, the process of identifying competencies is often cumbersome. To streamline the process, a short-term, modified Nominal Group Technique (NGT) was tested as a means of more efficiently validating and stratifying clinical competencies. Design/Methods: Educational planners used evidence-based methodologies to review existing course content and derive competencies for FDA-approved uses of DBS and ITB device implantation. The content covered DBS for Parkinson9s disease, tremor, and dystonia, and ITB for spasticity in disorders such as cerebral palsy, multiple sclerosis, deep brain injury, and stroke. In three rounds of NGT, therapy-specific physician and midlevel provider panels reviewed the competencies to validate their accuracy, reliability, and relevance; to identify whether they are core or therapy specific; to assess their appropriate learner level (novice, intermediate-to-advanced, or master); and to specify their sequence within clinical practice (preoperative, operative, postoperative, and postoperative with complications). Educational planners revised the competencies based on the panelists9 feedback and assisted panelists in coming to consensus. Results: Panelists validated and delineated relevance, type, learner level, and sequencing for 220 ITB-specific competencies for physicians/fellows and 232 for midlevel providers; and 121 DBS-specific competencies for physicians/fellows and 98 for midlevels. The process took ten weeks. The validated competencies were then used in developing a competency-based curriculum to train clinicians in patient identification, stimulation and implantation, programming, pharmacological action and safety profile, and postoperative management. Conclusions: The NGT method was successful in streamlining the process of identifying competencies, learner levels, and prerequisites for use in developing comprehensive, competency-based curricula for training in DBS and ITB therapies. Supported by: Medtronic, Inc. Disclosure: Dr. Bellande has nothing to disclose. Dr. Winicur has nothing to disclose. Dr. Gallo has received personal compensation for activities with Medtronic, St Jude Medical, Teva Neuroscience, Boeringher Ingelheim Pharmaceuticals and Novartis as a consultant. Dr. Gallo has received research support from St. Jude Medical. Dr. Turner has received personal compensation for activities with Medtronic as consultant, speaker and a participant on an advisory board. Dr. Turner has received research support from Medtoronic. Dr. Saulino has received personal compensation for activities with Einstein Physician Practice Incorporated and Albert Einstein Healthcare Network. Dr. Saulino has received research support from Albert Einstein Healthcare Network. Dr. Heath has received personal compensation for activities with Medtronic as a speaker. Dr. Bennett has nothing to disclose. Dr. Nelson has received personal compensation for activities with Medtronic, Inc. Ms. Reese has received personal compensation for activities with Medtronic as an employee. Ms. Larson has received personal compensation for activities with Medtronic, Inc. as an employee. Ms. Dawidowicz has received personal compensation for activities with Medtronic as an employee. Dr. Boche has received personal compensation for activities with Medtronic, Inc as an employee. Dr. Cox has nothing to disclose.