Perhaps the most important teaching residents receive is through interactions with faculty during direct patient care in both inpatient and outpatient settings. Residents rotate regularly in all the various sub-specialty clinics, where they are exposed to a wide variety of complex patients and participate in the most up-to-date care in the field. We are now starting this exposure earlier during the pediatrics years for most residents to allow ample time to experience the outpatient side of sub-specialties prior to considering fellowship opportunities.
On inpatient services, residents and faculty complete bedside rounds together, allowing detailed discussions of each patient and how they represent principles of neurologic disease and management. Most importantly, all our faculty have open-door policies and are more than happy to discuss any patient with the residents at any time. This policy gives each resident the chance to take advantage of the breadth and depth of expertise that exists within the division.
Our residents enjoy daily noon conferences that are provided by faculty from our division and several other related specialties. From July through August, these are focused on the foundations of pediatric neurology, as well as potential emergencies and on-call preparedness. This sets newer residents up for success with the graduated responsibilities that come with the start of the new academic year and provides experienced residents with a review of key topics. Throughout the remainder of the year, noon conferences cover a wide range of categories:
- Child neuro core curriculum: Topical lectures from child neurology faculty experts on disorders within our many neurology sections including: epilepsy, movement disorders, neuroimmunology, neuromuscle, neonatal neurology, neurocritical care, neurodevelopmental disorders, neuro-oncology, neurogenetics, general neurology, neuropsychology and sleep neurology.
- Clinical neurosciences (CNS) conference: Weekly topical lectures presented to both adult and pediatric neurology residents as a joint conference.
- Journal club: About twice per month, one resident will present a recent journal article to the division. Residents choose a faculty advisor to help with interpretation and context of the article. Sessions are well-attended by faculty and often generate excellent discussions on evidence-based care for our patients.
- Resident report: Approximately monthly, residents present recent difficult or interesting patient cases for discussion. Faculty and residents discuss patient presentation, workup, differential, and results if known.
- Diversity, equity and inclusion curriculum: Dedicated engagement and training sessions are held by Wash-U HR employees. In addition, during all core curriculum lectures, faculty dedicate at least one to two slides to DEI in the context of their topical presentation.
- Wellness conferences: About twice per month we hold conferences dedicated to wellness, including resident townhalls, wellness “check-in” sessions and mindfulness sessions.
- Ancillary curriculum: Dedicated lectures on topics such as business of medicine, billing and documentation, and career-planning.
- Neurogenetics conference: On a near monthly basis, we have a shared conference with the Department of Genetics in which one to two residents present interesting neurogenetic cases and generate discussion amongst colleagues.
- Morbidity and mortality conference: Each resident is assigned one M&M conference session in the PGY4 year. With faculty support, a patient-safety related issue is identified and discussed with a multidisciplinary audience. Faculty and staff from other departments are invited to join when the issue relates to their work.
- Quality improvement conference: Residents are given the opportunity to present their quality improvement projects to the division. We also have QI workshop sessions with pediatrics faculty with expertise in this area to help our residents develop successful projects.
- Neuroscience grand rounds and clinical research conferences: Local and invited faculty present clinically relevant research to the division.
- Advocacy curriculum: In the spring, we have several lectures dedicated to advocacy from a variety of perspectives including legal, parental and clinical.
Other conferences that occur outside the noon hour include: epilepsy conference (every Monday afternoon), neuro-radiology conference (every Thursday morning) and neurocritical care journal club (monthly on a Thursday afternoon). Residents are invited to attend all these sessions.
We are always adding and expanding our conferences based on resident interest and learning needs. For example, this year we are expanding our conferences to include dedicated lectures from neuroradiology, pediatric neuro-ophthalmology, and expanding genetics lectures. Last year’s initiative was to develop a series on communication skills and delivering bad news which was an excellent educational experience and will become part of our regular curriculum.
Pediatric neurology resident teaching to pediatric neurology residents and faculty
One of the most important reasons we expanded the number of residents in our program was to foster the development of a community of learners. Residents have many opportunities to teach each other and the faculty. Two of our favorite conferences are journal club and resident report. During journal club, a resident presents an article from the literature and leads a discussion among the entire division with support from a faculty advisor. Resident report is led by a senior resident facilitating discussion of an interesting case on the wards with input from faculty. Perhaps the most important peer-to-peer teaching occurs during the spontaneous case discussions between residents and faculty, which happen on a daily basis.
Pediatric neurology resident teaching to others
Pediatric neurology lies at the intersection of many disciplines. Thus, our residents play an integral role in the education of trainees in many other areas. The pediatric neurology residents supervise and teach an entire inpatient team of pediatric residents and medical students during their inpatient service. We have teaching sessions with the pediatrics interns twice weekly when they are on neurology inpatient service about core topics in neurology with case base chalk talks. The pediatric neurology residents also supervise and teach adult neurology residents, pediatric residents and medical students as they rotate on our consult services and through outpatient clinics.
We have dedicated Residents as Teachers conferences through the neurology department that are designed to develop the skills to be a successful resident educator. There is also an elective that pediatric neurology residents can choose to do called the teach elective. They use this time to engage with medical students and residents and learn about educational design, delivery, and assessment. We are currently working to build in an education track that will be offered within the neurology residencies. Our residents are regularly invited to give presentations during the Department of Pediatrics noon clinical conference and at other conferences within other departments in the hospital. In fact, in the 2021-22 academic year, one of our pediatric neurology residents received the outstanding fellow teaching award from the pediatrics residents.