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Training in Neurology: Objective Structured Clinical Examination Case to Teach and Model Feedback Skills in Neurology Residency

LaRocque, Joshua J; Grossman, Scott; Kurzweil, Arielle M; Lewis, Ariane; Zabar, Sondra; Balcer, Laura; Galetta, Steven L; Zhang, Cen
We describe an educational intervention for neurology residents aimed at developing feedback skills. An objective structured clinical examination case was designed to simulate the provision of feedback to a medical student. After the simulated case session, residents received structured, individualized feedback on their performance and then participated in a group discussion about feedback methods. Survey data were collected from the standardized medical student regarding residents' performance and from residents for assessments of their performance and of the OSCE case. This manuscript aims to describe this educational intervention and to demonstrate the feasibility of this approach for feedback skills development.
PMID: 35169006
ISSN: 1526-632x
CID: 5163442

The MICK (Mobile integrated cognitive kit) app: Digital rapid automatized naming for visual assessment across the spectrum of neurological disorders

Park, George; Balcer, Marc J; Hasanaj, Lisena; Joseph, Binu; Kenney, Rachel; Hudson, Todd; Rizzo, John-Ross; Rucker, Janet C; Galetta, Steven L; Balcer, Laura J; Grossman, Scott N
OBJECTIVE:Rapid automatized naming (RAN) tasks have been utilized for decades to evaluate neurological conditions. Time scores for the Mobile Universal Lexicon Evaluation System (MULES, rapid picture naming) and Staggered Uneven Number (SUN, rapid number naming) are prolonged (worse) with concussion, mild cognitive impairment, multiple sclerosis and Parkinson's disease. The purpose of this investigation was to compare paper/pencil versions of MULES and SUN with a new digitized format, the MICK app. METHODS:Participants (healthy office-based volunteers, professional women's hockey players), completed two trials of the MULES and SUN tests on both platforms (tablet, paper/pencil). The order of presentation of the testing platforms was randomized. Between-platform variability was calculated using the two-way random-effects intraclass correlation coefficient (ICC). RESULTS:Among 59 participants (median age 32, range 22-83), no significant differences were observed for comparisons of mean best scores for the paper/pencil versus MICK app platforms, counterbalanced for order of administration (P = 0.45 for MULES, P = 0.50 for SUN, linear regression). ICCs for agreement between the MICK and paper/pencil tests were 0.92 (95% CI 0.86, 0.95) for MULES and 0.94 (95% CI 0.89, 0.96) for SUN, representing excellent levels of agreement. Inter-platform differences did not vary systematically across the range of average best time score for either test. CONCLUSION/CONCLUSIONS:The MICK app for digital administration of MULES and SUN demonstrates excellent agreement of time scores with paper/pencil testing. The computerized app allows for greater accessibility and scalability in neurological diseases, inclusive of remote monitoring. Sideline testing for sports-related concussion may also benefit from this technology.
PMID: 35038658
ISSN: 1878-5883
CID: 5131412

Proceedings of the 2020 Epilepsy Foundation Pipeline Conference: Emerging Drugs and Devices

Boada, Christina M; Grossman, Scott N; Grzeskowiak, Caitlin L; Dumanis, Sonya; French, Jacqueline A
From August 27-28, 2020 the Epilepsy Foundation hosted the Pipeline Conference, exploring emerging issues related to antiepileptic drug and device development. The conference featured epilepsy therapeutic companies and academic laboratories developing drugs for focal epilepsies, innovations for rare and ultra-rare diseases, and devices both in clinical trials and approved for use. In this paper, we outline the virtual presentations by the authors, including novel data from their development pipeline.
PMID: 34731723
ISSN: 1525-5069
CID: 5038172

HIV-Associated Rapidly Progressive Lymphoma of the Cavernous Sinus

Kvernland, Alexandra; Grossman, Scott N; Levitan, Valeriya; Gold, Doria; Galetta, Steven L
PMID: 33870944
ISSN: 1536-5166
CID: 4846742

Clinical Reasoning: A 29-Year-Old Man With Fevers and Rapidly Progressive Cranial Neuropathies

Dessy, Alexa; Berger, Stephen; Kumar, Arooshi; Grossman, Scott; Cardiel, Myrna; Galetta, Steven
PMID: 33893206
ISSN: 1526-632x
CID: 4858812

Resident and Fellow Training in a Pandemic

Grossman, Scott N; Galetta, Steven L; Lee, Andrew G; Biousse, Valerie; Ishida, Koto
PMID: 33587533
ISSN: 1536-5166
CID: 4786502

Practical Approach to the Tele-Neuro-Ophthalmology and Neuro-Otology Visits: Instructional Videos

Calix, Rachel; Grossman, Scott N; Rasool, Nailyn; Small, Leslie; Cho, Catherine; Galetta, Steven L; Balcer, Laura J; Rucker, Janet C
ABSTRACT/UNASSIGNED:A collection of instructional videos that illustrate a step by step approach to tele-neuro-ophthalmology and neuro-otology visits. These videos provide instruction for patient preparation for their video visit, patient and provider interface with an electronic medical record associated video platform, digital applications to assist with vision testing, and practical advice for detailed remote neuro-ophthalmologic and neuro-otologic examinations.
PMID: 33587534
ISSN: 1536-5166
CID: 4786512

Neuro-Ophthalmology in the Era of COVID-19: Future Implications of a Public Health Crisis [Editorial]

Grossman, Scott N; Calix, Rachel; Tow, Sharon; Odel, Jeffrey G; Sun, Linus; Balcer, Laura J; Galetta, Steven L; Rucker, Janet C
PMCID:7204645
PMID: 32387481
ISSN: 1549-4713
CID: 4430792

Rapid implementation of virtual neurology in response to the COVID-19 pandemic

Grossman, Scott N; Han, Steven C; Balcer, Laura J; Kurzweil, Arielle; Weinberg, Harold; Galetta, Steven L; Busis, Neil A
The COVID-19 pandemic is causing world-wide social dislocation, operational and economic dysfunction, and high rates of morbidity and mortality. Medical practices are responding by developing, disseminating and implementing unprecedented changes in health care delivery. Telemedicine has rapidly moved to the frontline of clinical practice due to the need for prevention and mitigation strategies; these have been encouraged, facilitated, and enabled by changes in government rules and regulations and payer-driven reimbursement policies.We describe our neurology department's situational transformation from in-person outpatient visits to a largely virtual neurology practice in response to the COVID-19 pandemic. Two key factors enabled our rapid deployment of virtual encounters in neurology and its subspecialties. The first was a well-established robust information technology infrastructure supporting virtual urgent care services at our institution; this connected physicians directly to patients using both the physician's and the patient's own mobile devices. The second is the concept of one patient, one chart, facilitated by a suite of interconnected electronic medical record (EMR) applications on several different device types.We present our experience with conducting general teleneurology encounters using secure synchronous audio and video connections integrated with an EMR. This report also details how we perform virtual neurological examinations that are clinically meaningful, and how we document, code and bill for these virtual services. Many of these processes can be used by other neurology providers, regardless of their specific practice model. We then discuss potential roles for teleneurology after the COVID-19 global pandemic has been contained.
PMID: 32358217
ISSN: 1526-632x
CID: 4424412

The Accuracy of Clinician Detection of Saccadic Slowing: A Corroboration with Eye Movement Recordings [Meeting Abstract]

Grossman, Scott; Calix, Rachel; Balcer, Laura; Galetta, Steven; Frucht, Steven; Rizzo, John Ross; Hudson, Todd; Rucker, Janet
ISI:000536058000120
ISSN: 0028-3878
CID: 4561012