Simulation-based Mastery Learning Improves Residents’ Identification and Management of Status Epilepticus (819)

Objective: To train post graduate year (PGY)-2 neurology residents to identify and manage status epilepticus (SE) using simulation-based mastery learning (SBML) and compare their skills to graduating traditionally-trained neurology residents (who did not participate in SBML). Background: SE is a medical emergency where timely management decreases morbidity and mortality. However, SE is often mismanaged due to delays in diagnosis and administration of inappropriate antiepileptic medications. Traditionally, neurology residents learn about SE through didactics and direct patient care. It is unknown if SBML results in superior SE identification and management skills compared to traditional training. Design/Methods: We developed an SBML curriculum to teach neurology residents SE identification and management. The curriculum consisted of a baseline simulation scenario pretest, deliberate practice with simulator, and a simulation scenario posttest. Testing sessions were scored using a dichotomous 26-item SE checklist developed for this curriculum. All residents were expected to meet or exceed a minimum passing score (MPS) at posttest. Those who did not meet the MPS participated in more deliberate practice and retested until they met this score. We trained PGY-2 neurology residents at our institution using the SE SBML curriculum. Subsequently, we tested the simulated SE skills of PGY-4 neurology residents (traditionally-trained) from 3 tertiary-care medical centers one month before graduation using the SE checklist. We compared PGY-2 posttest scores to PGY-4 test scores. Results: Sixteen PGY-2 residents participated in SE SBML and met the MPS at posttest. Sixteen PGY-4 residents were tested and none met the MPS. SBML-trained PGY-2 residents had significantly better SE management skills on the simulated posttest than graduating PGY-4 residents [mean checklist scores 93.5% (SD=4.4%) vs. 59.9% (SD=11.9%) items correct; p Conclusions: SBML improves recognition and management of SE compared to traditional neurology residency training alone. SBML ensures a high level of SE skills and may ensure residents are prepared for independent practice. Disclosure: Dr. Mikhaeil-Demo has nothing to disclose. Dr. Culler has nothing to disclose. Dr. Templer has nothing to disclose. Dr. Bega has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Speaker: Teva Pharmaceuticals, Acorda Therapeutics, Neurocrine Biosciences, Adamas Pharmaceuticals Consulting: Biogen Pharmaceuticals, Amgen Pharmaceuticals, Acadia Pharmaceuticals, Genentech, Inc, GE Healthcare, Gerson Lehrman Group, Guidepoint, L.E.K. C. Dr. Bega has received personal compensation in an editorial capacity for Editor: Annals of Clinical & Translational Neurology. Dr. Salzman has nothing to disclose. Dr. Bhatt has nothing to disclose. Dr. Shafi has nothing to disclose. Dr. Cohen has nothing to disclose. Dr. Gerard has received research support from Sunovion Phramaceuticals.Dr. Barsuk has nothing to disclose.