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Ferreira VR, Brayne C, Ragonese P, Ketzoian C, Piccioli M, Tinti L, Casali C, di Lorenzo C, Ramos C, Azevedo J, Gomes A, Stewart R, Haas H, Hoppenbrouwer S, Metting E, Gallo V. A Delphi consensus to identify the key screening tests/questions for a digital neurological examination for epidemiological research. J Neurol 2024; 271:2694-2703. [PMID: 38378908 PMCID: PMC11055750 DOI: 10.1007/s00415-024-12254-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Most neurological diseases have no curative treatment; therefore, focusing on prevention is key. Continuous research to uncover the protective and risk factors associated with different neurological diseases is crucial to successfully inform prevention strategies. eHealth has been showing promising advantages in healthcare and public health and may therefore be relevant to facilitate epidemiological studies. OBJECTIVE In this study, we performed a Delphi consensus exercise to identify the key screening tests to inform the development of a digital neurological examination tool for epidemiological research. METHODS Twelve panellists (six experts in neurological examination, five experts in data collection-two were also experts in the neurological examination, and three experts in participant experience) of different nationalities joined the Delphi exercise. Experts in the neurological examination provided a selection of items that allow ruling out neurological impairment and can be performed by trained health workers. The items were then rated by them and other experts in terms of their feasibility and acceptability. RESULTS Ten tests and seven anamnestic questions were included in the final set of screening items for the digital neurological examination. Three tests and five anamnestic questions were excluded from the final selection due to their low ratings on feasibility. CONCLUSION This work identifies the key feasible and acceptable screening tests and anamnestic questions to build an electronic tool for performing the neurological examination, in the absence of a neurologist.
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Affiliation(s)
- Vasco Ribeiro Ferreira
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands.
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Paolo Ragonese
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| | - Carlos Ketzoian
- Institute of Neurology, School of Medicine, Neuroepidemiology Section, University of the Republic, Montevideo, Uruguay
| | - Marta Piccioli
- UOC of Neurology, PO San Filippo Neri, ASL Roma 1, Rome, Italy
| | - Lorenzo Tinti
- Laboratory of Neurology, Mario Negri Institute for Pharmacological Research (IRCCS), Milan, Italy
| | - Carlo Casali
- Department of Medico-Surgical Sciences and Biotechnologies (SBMC), University Rome Sapienza, Rome, Italy
| | - Cherubino di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies (SBMC), University Rome Sapienza, Rome, Italy
| | - Claudia Ramos
- Grupo de Neurociencias de Antioquia (GNA), Faculty of Medicine, University of Antioquia, Medellín, Colombia
- Grupo de Neuropsicología y Conducta (GRUNECO), Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - João Azevedo
- Agrupamento de Centros de Saúde de Gaia, Unidade de Saúde Familiar Nova Salus, Vila Nova de Gaia, Portugal
| | | | | | - Hein Haas
- Parkinson Vereniging, Bunnik, The Netherlands
| | | | - Esther Metting
- University Medical Center Groningen, Groningen, The Netherlands
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Valentina Gallo
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
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Kang EYN, Chi KY, Liao F, Liu CC, Lin CP, Chen TL, Tanaka P, Chen CY. Indigenizing and co-producing the ACGME anesthesiology milestone in Taiwan: a Delphi study and subgroup analysis. BMC MEDICAL EDUCATION 2024; 24:154. [PMID: 38374112 PMCID: PMC10875863 DOI: 10.1186/s12909-024-05081-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 01/22/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND To implement the ACGME Anesthesiology Milestone Project in a non-North American context, a process of indigenization is essential. In this study, we aim to explore the differences in perspective toward the anesthesiology competencies among residents and junior and senior visiting staff members and co-produce a preliminary framework for the following nation-wide survey in Taiwan. METHODS The expert committee translation and Delphi technique were adopted to co-construct an indigenized draft of milestones. Descriptive analysis, chi-square testing, Pearson correlation testing, and repeated-measures analysis of variance in the general linear model were employed to calculate the F values and mean differences (MDs). RESULTS The translation committee included three experts and the consensus panel recruited 37 participants from four hospitals in Taiwan: 9 residents, 13 junior visiting staff members (JVSs), and 15 senior visiting staff members (SVSs). The consensus on the content of the 285 milestones was achieved after 271 minor and 6 major modifications in 3 rounds of the Delphi survey. Moreover, JVSs were more concerned regarding patient care than were both residents (MD = - 0.095, P < 0.001) and SVSs (MD = 0.075, P < 0.001). Residents were more concerned regarding practice-based learning improvement than were JVSs (MD = 0.081; P < 0.01); they also acknowledged professionalism more than JVSs (MD = 0.072; P < 0.05) and SVSs (MD = 0.12; P < 0.01). Finally, SVSs graded interpersonal and communication skills lower than both residents (MD = 0.068; P < 0.05) and JVSs (MD = 0.065; P < 0.05) did. CONCLUSIONS Most ACGME anesthesiology milestones are applicable and feasible in Taiwan. Incorporating residents' perspectives may bring insight and facilitate shared understanding to a new educational implementation. This study helped Taiwan generate a well-informed and indigenized draft of a competency-based framework for the following nation-wide Delphi survey.
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Affiliation(s)
- Enoch Yi-No Kang
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yu Chi
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Faith Liao
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Education, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chih-Chung Liu
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chih-Peng Lin
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Pedro Tanaka
- Department of Anesthesia, Stanford University Medical School, Palo Alto, CA, USA
| | - Chien-Yu Chen
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Education, Taipei Medical University Hospital, Taipei, Taiwan.
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Zeidan S, Baltaze S, Garcin B, de Liège A, Doridam J, Josse L, Degos B. The "Neurospeed" game: a fun tool to learn the neurological semiology. BMC MEDICAL EDUCATION 2022; 22:224. [PMID: 35361216 PMCID: PMC8970646 DOI: 10.1186/s12909-022-03316-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Neurological semiology is often considered by medical students as particularly difficult to learn. Finding alternative teaching methods may improve students' motivation and understanding of this field. METHODS We developed the "Neurospeed", a game to learn neurological syndromes. We assessed its efficiency on short-term learning of neurological syndromes in third-year medical students, through Multiple Choice Questions (MCQs) before and after the game session. Students' satisfaction was evaluated by a satisfaction survey. RESULTS Out of the 199 third-year medical students of the Faculty of Medicine Sorbonne Paris Nord, 180 attended the Neurospeed in December 2020, and 148 answered 20 Multiple Choice Questions before and after the game, with significant improvement of their score (p < 0.001). Most of the participants agreed that the game was playful, stimulating, and helpful to learn neurological semiology. CONCLUSIONS Overall, our results show that the Neurospeed game is an interesting tool as a complement to traditional lectures. Further studies are necessary to compare the efficacy of different types of serious games on short-term and long-term learning of neurological semiology.
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Affiliation(s)
- Sinead Zeidan
- Neurology Department, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Solenne Baltaze
- Medicine Department, UFR SMBH, Sorbonne Paris Nord, Bobigny, France
| | - Béatrice Garcin
- Neurology Department, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Astrid de Liège
- Neurology Department, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Jennifer Doridam
- Neurology Department, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Laure Josse
- Healthcare Simulation Center, UFR SMBH, Sorbonne Paris Nord, Bobigny, France
| | - Bertrand Degos
- Neurology Department, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France.
- Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, Université PSL, Paris, France.
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Venkatesan A, Chow FC, Aksamit A, Bartt R, Bleck TP, Jay C, Pastula DM, Roos KL, Rumbaugh J, Saylor D, Cho TA. Building a neuroinfectious disease consensus curriculum. Neurology 2019; 93:208-216. [PMID: 31253643 DOI: 10.1212/wnl.0000000000007872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/03/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To delineate a comprehensive curriculum for fellowship training in neuroinfectious diseases, we conducted a modified Delphi approach to reach consensus among 11 experts in the field. METHODS The authors invited a diverse range of experts from the American Academy of Neurology Neuro-Infectious Diseases (AAN Neuro-ID) Section to participate in a consensus process using a modified Delphi technique. RESULTS A comprehensive list of topics was generated with 101 initial items. Through 3 rounds of voting and discussion, a curriculum with 83 items reached consensus. CONCLUSIONS The modified Delphi technique provides an efficient and rigorous means to reach consensus on topics requiring expert opinion. The AAN Neuro-ID section provided the pool of diverse experts, the infrastructure, and the community through which to accomplish the consensus project successfully. This process could be applied to other subspecialties and sections at the AAN.
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Affiliation(s)
- Arun Venkatesan
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Felicia C Chow
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Allen Aksamit
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Russell Bartt
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Thomas P Bleck
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Cheryl Jay
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Daniel M Pastula
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Karen L Roos
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Jeffrey Rumbaugh
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Deanna Saylor
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City
| | - Tracey A Cho
- From the Neuro-Infectious Diseases Section (A.V., F.C.C., A.A., R.B., T.P.B., C.J., D.M.P., K.L.R., J.R., D.S., T.A.C.), American Academy of Neurology, Minneapolis, MN; Johns Hopkins University (A.V., D.S.), Baltimore, MD; University of California (F.C.C., C.J.), San Francisco; Mayo Clinic (A.A.), Rochester, MN; Blue Sky Neurology (R.B.), Englewood, CO; Rush Medical College (T.P.B.), Chicago; University of Colorado and Colorado School of Public Health (D.M.P.), Aurora; Indiana University (K.R.), Indianapolis; Remyelix Neurology & Multiple Sclerosis Institute (J.R.), Tampa, FL; University of Iowa (T.A.C.), Iowa City.
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