A Self-Study Curriculum in Electromyography and Nerve Conduction Studies for Residents and Fellows

Publication ID Published Volume
10581 May 10, 2017 13

Download the Educational Summary Report

Abstract

Introduction: To our knowledge, there are no freely available curricula for a focused resident or fellow rotation in electromyography and nerve conduction studies that address the Accreditation Council for Graduate Medical Education (ACGME) milestones for neurology, physical medicine and rehabilitation, clinical neurophysiology, or neuromuscular medicine. Thus, we created this curriculum to help trainees develop a basic understanding of clinical electrodiagnostic studies. The program objectives map to many of the relevant ACGME milestones, primarily those pertaining to medical knowledge, patient care, and practice-based learning and improvement. Methods: The curricular materials include an interactive, hyperlink-driven slide show with 19 educational modules, subdivided further into basic and advanced topics. We also created a 50-question multiple-choice test, paired each question with key concepts, and provided instructions on using the test results to develop a trainee-specific learning plan. Results:Residents and fellows have been using this curriculum at the University of Michigan since 2007. The mean and median scores of 80 trainees who took the 50-item test between 2007 and 2016 were 80% and 82%, respectively, with a standard deviation of 10%. In annual surveys of neurology residents, this electromyography rotation has consistently had the highest mean approval rating of all clinical rotations in the training program. Discussion: This curriculum is a complete, self-contained learning resource that may be used alone or to supplement a supervised apprenticeship for trainees who want to learn to perform electrodiagnostic studies independently. The content ensures that trainees demonstrate mastery of many of the ACGME milestones for their field.

Citation

London ZN, Gallagher GW, Ebright MJ. A self-study curriculum in electromyography and nerve conduction studies for residents and fellows. MedEdPORTAL Publications. 2017;13:10581. https://doi.org/10.15766/mep_2374-8265.10581

Educational Objectives

By the end of this session, learners should be able to:

  1. Summarize the measurable features of the sensory nerve action potential, compound muscle action potential, F-response, H-reflex, and repetitive stimulation.
  2. Identify and interpret normal and abnormal electromyographic patterns of resting muscle and voluntary motor activity.
  3. Describe the nerve, nerve root, and plexus innervations of the commonly tested upper and lower extremity muscles.
  4. Compare the clinical and electrodiagnostic features of common polyneuropathies, mononeuropathies, radiculopathies, plexopathies, and myopathies.
  5. Develop an appropriate learning plan based on identified knowledge gaps.
  6. Achieve the appropriate Accreditation Council for Graduate Medical Education milestones for neurology residency, physical medicine and rehabilitation residency, neuromuscular medicine fellowship, and clinical neurophysiology fellowship.

Keywords

  • Electromyography, Nerve Conduction Studies, Electrophysiology, Neurophysiology, Neurology, Neuromuscular, Physical Medicine and Rehabilitation

Prior Scholarly Dissemination

Between 2009 and 2013, the outline of this curriculum (without the actual self-study tool or assessment tool) was available to program directors on the American Academy of Neurology website.

References

  1. American Association of Neuromuscular & Electrodiagnostic Medicine educational guidelines for electrodiagnostic training programs. American Association of Neuromuscular & Electrodiagnostic Medicine Web site. https://www.aanem.org/getmedia/cc9bcf1f-16de-4928-aa76-42ae77e2189a/ED-guideline-training-programs-2012.pdf. Updated October 2012.

  2. Bernard RM, Abrami PC, Lou Y, et al. How does distance education compare with classroom instruction? A meta-analysis of the empirical literature. Rev Educ Res. 2004;74(3):379-439. https://doi.org/10.3102/00346543074003379

  3. Bockenek WL, Massagli TL, Swing SR, Fischer C; for the PMR Milestone Working Group. The development of the Physical Medicine and Rehabilitation Milestones. J Grad Med Educ. 2014;6(1)(suppl 1):204-206. https://doi.org/10.4300/JGME-06-01s1-23

  4. Chumley-Jones HS, Dobbie A, Alford CL. Web-based learning: sound educational method or hype? A review of the evaluation literature. Acad Med. 2002;77(10)(suppl):S86-S93. https://doi.org/10.1097/00001888-200210001-00028

  5. Clark D. Psychological myths in e-learning. Med Teach. 2002;24(6):598-604. https://doi.org/10.1080/0142159021000063916

  6. The Clinical Neurophysiology Milestone Project: a joint initiative of the Accreditation Council for Graduate Medical Education and the American Board of Psychiatry and Neurology. Accreditation Council for Graduate Medical Education Web site. https://www.acgme.org/Portals/0/PDFs/Milestones/ClinicalNeurophysiologyMilestones.pdf. Published July 2015.

  7. Goodman JC, Juul D, Westmoreland B, Burns R. RITE performance predicts outcome on the ABPN Part I examination. Neurology. 2002;58(8):1144-1146. https://doi.org/10.1212/WNL.58.8.1144

  8. Juul D, Flynn FG, Gutmann L, et al. Association between performance on Neurology In-Training and Certification Examinations. Neurology. 2013;80(2):206-209. https://doi.org/10.1212/WNL.0b013e31827b92a3

  9. Lewis SL, Józefowicz RF, Kilgore S, Dhand A, Edgar L; for the Neurology Milestone Working Group. Introducing the Neurology Milestones. J Grad Med Educ. 2014;6(1)(suppl 1):102-104. https://doi.org/10.4300/JGME-06-01s1-34

  10. Liu M, Hase K, Tsuji T, et al. Clinical electromyography and electrodiagnosis course at Keio University Hospital—a 7-year experience.Keio J Med. 2005;54(4):193-196. https://doi.org/10.2302/kjm.54.193

  11. Maloney E, Hippe DS, Paladin A, Chew FS, Ha AS. Musculoskeletal ultrasound training for radiology residents: lecture versus interactive learning module. Acad Radiol. 2016;23(7):789-796. https://doi.org/10.1016/j.acra.2015.11.018

  12. Morgulis Y, Kumar RK, Lindeman R, Velan GM. Impact on learning of an e-learning module on leukaemia: a randomised controlled trial. BMC Med Educ. 2012;12:36. https://doi.org/10.1186/1472-6920-12-36

  13. The Neurology Milestone Project: a joint initiative of the Accreditation Council for Graduate Medical Education and the American Board of Psychiatry and Neurology. Accreditation Council for Graduate Medical Education Web site. https://www.acgme.org/Portals/0/PDFs/Milestones/NeurologyMilestones.pdf. Published July 2015.

  14. The Neuromuscular Medicine Milestone Project: a joint initiative of the Accreditation Council for Graduate Medical Education, the American Board of Physical Medicine and Rehabilitation, the American Board of Psychiatry and Neurology. Accreditation Council for Graduate Medical Education Web site. https://www.acgme.org//Portals/0/PDFs/Milestones/NeuromuscularMedicineMilestones.pdf. Published July 2015.

  15. The Physical Medicine and Rehabilitation Milestone Project: a joint initiative of the Accreditation Council for Graduate Medical Education and the American Board of Physical Medicine and Rehabilitation. Accreditation Council for Graduate Medical Education Web site. http://www.acgme.org/portals/0/pdfs/milestones/pmrmilestones.pdf. Published July 2015.

  16. Willoughby J, Nguyen V, Bockenek WL. Assessing competency in physical medicine and rehabilitation residency: the ACGME Milestones Initiative. AMA J Ethics. 2015;17(6):515-520. https://doi.org/10.1001/journalofethics.2015.17.6.medu1-1506

Material Access

Please sign in to access this material.

Please register for an AAMC account if you do not have one.

Register

  • Contact Us

Subscribe to Our Quarterly Newsletter

Receive featured content & announcements!

ISSN 2374-8265