Original Publication
Open Access

Neuroinfectious Disease OSCE Station

Published: December 1, 2014 | 10.15766/mep_2374-8265.9965

Included in this publication:

  • Instructor's Guide.docx
  • Neuroinfectious Disease Presentation.ppt
  • Examiner Marking Sheet.docx
  • Resident Instructions.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

Introduction: It has been stated that a headache is the most common neurological symptom. Identification of secondary headache syndromes is a critical skill for neurologists and neurology residents, especially in the emergency room setting; early recognition of encephalitis, especially herpes encephalitis, is crucial. Delayed diagnosis of herpes encephalitis with delayed treatment with acyclovir leads to increased morbidity and mortality. Due to this clinical importance, and in alignment with national training objectives, we created this station as part of a seven-station OSCE delivered to adult and pediatric neurology residents. Methods: This is a one-station, performance-based assessment of resident competence in assessing headache, identifying secondary headache presentation, diagnosing and managing herpes simplex encephalitis through interpretation of a lab and imaging, with complication recognition, through a case presentation. Resident OSCE station instructions, examiner marking sheet, a PowerPoint presentation, and instructors' guide are included. This is primarily a summative assessment tool. Results: Twenty-four senior neurology residents (PGY 3 to 5) were examined. Using a pass threshold of 70%, all residents passed the station. Resident scores ranged from 70.6% to 96.1% with a mean of 83.1% (SD 8.20%). Discussion: Residents generally did well on recognizing secondary headache presentation. Residents recognized worrisome features on CSF findings and initiated prompt treatment. Knowledge of herpes encephalitis, prognosis, and possible complications was overall solid. Residents had the most difficulty interpreting imaging findings, especially MRI diffusion weighted and ADC map. Overall, residents recognized the neuro-critical situation with impending brain herniation and managed the complication successfully.


Educational Objectives

By using this OSCE, facilitators will be able to:

  1. Assess resident identification of secondary headache.
  2. Assess resident knowledge in identifying and managing encephalitis in clinical presentation, lab and imaging.
  3. Assess resident recognition and management of possible complications from herpes encephalitis.

Author Information

  • Penelope Smyth, MD, FRCPC: University of Alberta Faculty of Medicine & Dentistry
  • Jeffrey Jirsch, MD, MSc: University of Alberta Faculty of Medicine & Dentistry

Disclosures
None to report.

Funding/Support
None to report.



Citation

Smyth P, Jirsch J. Neuroinfectious disease OSCE station. MedEdPORTAL. 2014;10:9965. https://doi.org/10.15766/mep_2374-8265.9965