Background and objectives: As the prevalence of the neurohospitalist (NH) practice model grows, understanding its effect on trainee education is imperative. We sought to determine the impact of an academic NH program on neurology resident evaluations of faculty teaching.

Methods: We performed a retrospective study of faculty teaching evaluations before and after the implementation of a full-time NH service. Primary outcomes were neurology resident evaluations of faculty teaching, which were compared in the pre-NH period (August 2010-July 2014) vs the post-NH period (August 2016-July 2018). In a secondary analysis, we used the difference-in-difference approach to analyze the effect of introducing the NH service on resident evaluation of faculty teaching compared with stroke and neurocritical care faculty controls. We performed an additional descriptive analysis of medical student evaluation of faculty teaching and described Residency In-service Training Exam scores and Accreditation Council for Graduate Medical Education (ACGME) resident survey data before and after the intervention.

Results: There were 368 resident and 360 medical student evaluations of faculty teaching during the study period. Compared to the pre-NH period, the post-NH period had significantly higher resident evaluations of faculty teaching in 19 of 27 questions of faculty teaching, across 5 of the 6 ACGME core competencies. Within the competencies of patient care, practice-based learning and improvement, and systems-based practice, the NH teaching faculty were rated significantly higher across all questions. In the difference-in-difference model, resident evaluations of faculty teaching following the implementation of the NH service remained significantly improved compared with controls in teaching evidence-based medicine, teaching diagnostic algorithms, and explaining rationale for clinical decisions. Medical student ratings of faculty teaching were unchanged in the pre-NH and the post-NH period.

Discussion: Neurology residents may benefit from the clinical expertise of NHs and their ability to teach evidence-based practice and role model systems-based practice. Given the central role NHs may play in trainee education, additional focus on both the local and national levels should be dedicated to further developing the teaching skills of NHs.

© 2024 American Academy of Neurology.

背景和目的： 随着神经医院专家（NH）实践模式的普及，了解其对住院医生教育的影响至关重要。我们旨在确定一个全职NH项目的学术影响，以评估它如何改变神经病学住院医师对教师教学评价的结果。

方法： 我们进行了一项回顾性研究，在实施全职NH服务前后对比了教师教学的评分情况。主要结果是神经病学住院医生对教师教学的评价，这些评价在NH服务前（2010年8月至2014年7月）和NH服务后（2016年8月至2018年7月）进行了对比。在次要分析中，我们使用了差分差异方法来分析引入NH服务对住院医生教师教学评价的影响，并将其与卒中和神经重症护理的教师控制组进行比较。此外，我们还进行了一项描述性分析，评估医学学生对教师教学评价的情况，并描述了Residency In-service Training Exam分数及美国毕业后医学教育委员会（ACGME）住院医师调查数据在干预前后的变化。

结果： 研究期间共收集到368名住院医生和360名医学生的教师教学评价。与NH服务前相比，NH服务后有19个问题中的27项（包括ACGME核心能力的5个方面）的居民对教师的教学评价显著提高。在患者的护理、基于实践的学习和改进以及系统性的实践中，NH教师被所有问题中都评为更高分。差分差异模型显示，在实施NH服务后，住院医生对教学循证医学、诊断算法和临床决策理由解释等方面的评分比对照组显著提高。而在NH服务前后，医学生对教师的教学评价没有变化。

讨论： 神经病学住院医师可能从NH的临床专业知识及其教授循证实践的能力以及展示系统性实践榜样中受益。鉴于NH在培训教育中的重要角色，应在地方和国家层面进一步关注并提高NH的教学技能。