Workshop on Education & Training- Child Neurology Training across the globe

Administrator: Archana Patel

ICNC 2024: Education and Training in Child Neurology Workshop
This workshop is targeted for child neurologists with expanding/developing child neurology programs,particularly in resource constrained regions or participating in global health partnerships to expand access to pediatric neurology training. As noted by the recently published ICNA survey of Pediatric Neurology
Training worldwide (Wilmshurst, JM, et al, Neurology July 2023), there is an average of only 0.39 child neurologists per 100,000 population, with low-income countries having the largest gaps. In recent years, dedicated efforts to expand access to appropriate training programs has been made, with variability in
training models from the creation of regional and local training programs to partnerships with higher resourced regions and centers. This has resulted in an encouraging increase in interest for child neurology training and potential availability of programs. However, best practices on training and minimum
education standards for child neurologists can vary from program to program, and access to quality training remains limited for many regions of the world. Moreover, the responsibility for training others in countries with emerging training programs often falls to one or two newly trained child neurologists, with
limited support and resources. This workshop will discuss strategies to overcome some of these challenges as child neurology training expands globally and highlight the roles that global partnerships and virtual
education can play to support young training programs.

Target audience:
Child neurologists with expanding/developing child neurology training programs- particularly in resourceconstrained regions or those with global health partnerships

Objectives:
1. Understand the current status of child neurology training across regions and agreed upon minimum standards required
2. Understand and learn approaches to breakdown ‘neurophobia’ amongst general pediatricians and medical trainees
3. Develop best teaching practices for child neurology, including expanding learning through global partnerships and virtual learning
4. Review approaches for building training in regions with limited resources and specialists
5. Discuss the future of child neurology across the globe and how to help expand and grow the field

Sessions:
Introduction and overview of workshop - Jo Wilmshurst. (10 min)

Panel Discussion- Child Neurology Training Across the Globe: Variations in trainings and minimal standards, the role of technology and partnerships to enhance training in resource-constrained regions, and career opportunities and the future of child neurology (35 min)
(Moderators: Archana Patel, Jo Wilmshurst)

Panelists:
o Jasna Orazem Mrak (Slovenia)
o Juhi Gupta (India)
o Esra Serdaroglu (Turkey)
o Jitanghi Wanigasinghe (Sri Lanka)
o Edward Kija (Tanzania)
o Jorge Vidaurre (USA)
o Asif Doja (Canada)
o Arushi Ghalot Saini (India)

Guiding questions for discussion:
1. What do you define (regionally and personally as an educator) as the minimal requirements of training required for child neurologists?
2. How can you meet these requirements in regions with few to no current subspecialists?
3. For child neurologists in resource-rich regions: what are opportunities and challenges for child neurologists in your region to assist training for those in RPCs
4. What level of pediatrics should a child neurologist retain, and how does this vary regionally?
5. Subspecializing in child neurology is becoming very common (i.e., epilepsy, neuromuscular, movement disorders, etc). How does this translate to lower resourced regions with few child neurologists, and how can global partnerships help support?
6. What career opportunities exist for child neurologists in your region?
7. How do you think we can best attract young physicians to the field? Expand on the fears around neurology and misconceptions that it is a field with little hope/nothing that can be done for patients…
8. What do you see as the future of child neurology?
9. How can we improve mentorship and growth in child neurology across regions?

Breaking down ‘neurophobia’ and how to overcome it amongst trainees and general pediatric colleagues to improve care for children with neurologic conditions. (15min)

Speaker: Jaime Carrizosa (Colombia)
Neurophobia can be defined as a fear of neuroscience and clinical neurology that results from the inability of students, residents, and physicians to apply their knowledge of the basic sciences to clinical situations. This generates little attraction to study the areas of neurology, but also subsequently generates an attitude of rejection or aversion to care for neurological patients.

Three types of neurophobia have been classified:
a. Fear of basic neurological sciences (neuroanatomy, neurophysiology and neuropharmacology)
b. Fear of clinical neurology
c. Fear of both considering the integration of basic neurosciences and clinical neurology.

Many studies propose solutions towards neurophobia in order to improve training for better care in neurology. Use of the following strategies can help break down neurophobia: Greater exposure in number of patients and practice time, Assertive integration of basic sciences to the clinic; Discussion of cases among colleagues; Use of digital tools in neurology such as E-learning - among many others - reducing the traditional teaching of slide presentations, Demonstration of interesting logical reasoning as an intellectual challenge;
Good and inspiring models as teachers training with residents who have a teaching role.; Perspective of a good quality of life and independent practice without many paraclinical resources, Team Based Learning; and problem-based/multi-modal methods of learning.

How to teach effectively in child neurology across resource levels

Speaker: Charuta Joshi (USA) (15min)
Best practices of teaching: understanding the psychology of learners in medicine, Outcomes, Activity, Summary (OAS) methods of planning and learning will be discussed. Tips on why “less is more” and how to
avoid “death by PowerPoint” will be highlighted. Finally parallels between how being an effective teacher can also help patient care in the child neurology setting will be explored.

Speaker: Dara Albert (USA) (20min)
Role of simulated patient encounters in teaching effective communication: Child neurologists are often called to hold difficult conversations with patients and families in the hospital and outpatient settings. How medical information is conveyed to patients and families can significantly impact their ability to comprehend and cope with neurological disorders. Communication is a skill that is best learned through deliberate practice facilitated by feedback from experts. By using simulated patient encounters, child neurology trainees can practice difficult conversations in a controlled setting and received structured feedback on communication skills. We will present an example of using clinical simulation with standardized patients to promote clinical skill development in child neurology residents.

Building and sustaining a child neuro program in countries with few, and predominantly newly trained, specialists (30min)
Speakers: Samson Gwer (Kenya), Charles Hammond (Ghana),
Robert Sebunya (Uganda)
Interactive discussion on how to build a training program in resource-constrained regions. Specific aspects to cover will include the following:
- Model examples from Kenya and Uganda- how to build a training program while simultaneously building capacity in diagnostics and ancillary services
- The importance of community buy-in and advocacy
- Role of international organizations and global partnerships to help support training and subspecialty skills; including the role of virtual learning (e.g.,BPNA teaching resources, ICNTN, etc)
- The importance of a research components in child neurology programs and elements needed for success in
RPCs