Galina Gheihman, Mass General Brigham & Harvard Medical School
Prashanth Rajarajan, Mass General Brigham
Marinos Sotiropoulos, Mass General Brigham
Sarah Conway, Mass General Brigham
Purpose
Patients with neurological symptoms are often first assessed by general medical providers. However, many internal medicine residencies lack formal neurology education and internal medicine (IM) residents endorse low confidence in evaluating neurological patients. To address this gap, we designed, implemented, and evaluated the BRAINs Program, a neurology trainee-led inpatient bedside rounding initiative that aims to improve IM residents’ confidence in assessing neurological patients. The program is also an opportunity for neurology trainees to develop as near-peer educators.
Methods
The BRAINs program pairs neurology trainees (residents and fellows) with teams of 4-5 IM residents for a 45-minute structured bedside teaching session bimonthly. Neurology instructors demonstrate a focused history and examination at the bedside for a patient admitted with a neurological complaint. IM residents then practice a hands-on exam and receive real-time feedback from the educator. We evaluated the program using a post-session survey. IM residents rated to what extent the session achieved its objectives, their confidence with the neurological history and exam, and provided feedback on program improvement.
Results
40 IM residents participated and completed the survey (31 PGY-1, 6 PGY-2, 3 PGY-3) since implementation in 2022. Participants agreed BRAINs met the learning objectives of developing an approach to a neurological history (31/40, 77.5%) and performing an exam (38/40, 95%). IM residents felt more confident in taking a history (34/40, 85%) and performing an exam (39/40, 97.5%) after the session. 95% (38/40) thought bedside teaching was more effective than traditional didactics.
Conclusions
The BRAINs program offers a scalable and adaptable structured bedside teaching session that accommodates learners at various levels and promotes near-peer teaching in the clinical setting. The program can be scaled to different specialties, populations of learners, and hospitals. The BRAINS program supports cross-departmental camaraderie, empowers near-peer teachers, and equips IM residents with increased confidence in neurological knowledge and skills.