Education

Message from the Program Director

Michael Leffler-Mccabe

It is my privilege to welcome you to the University of Minnesota Department of Neurology. Thank you for your interest in our program.

The University of Minnesota has a long and storied tradition of neurological education dating back to the creation of the independent department of Psychiatry and Neurology in 1946 under the direction of renowned educator A.B. Baker, who served as the first president of the AAN in 1948. We have a proud history of a robust department, and our residency program has grown and responded to the advancements both in the field and in pedagogical approaches. Today our residency program is designed to balance formal didactics and practice-based learning. Our program is unique in being resident-led and faculty-guided. We focus on empowering our residents to become leaders of their own residency in preparation for leadership throughout their careers.

Our program covers four hospitals: the University of Minnesota Medical Center, Fairview (UMMC); Hennepin County Medical Center (HCMC); the Minneapolis Veterans Administration Hospital (VAMC); and Regions Medical Center (Regions). These facilities provide opportunities to care for patients in the urban center, academic tertiary care and the opportunity to care for patients from the entire state and beyond within the federal system. This provides not only a diversity of patient populations but also a diversity of practice environments.

A singular strength is our interdisciplinary programs with colleagues in the Departments of Neurosurgery, Psychiatry, Radiology/Neuroradiology, ENT, Physical Medicine and Rehabilitation, Biomedical Engineering and Neuroscience. We also collaborate with colleagues in the Center for Magnetic Resonance Research (CMRR), the Institute of Human Genetics, the Division of Epidemiology and Community Health (School of Public Health), the Brain Sciences Center and Geriatric Research and Education Clinical Center (GRECC) at the Minneapolis VA Medical Center, and the National Center for Interprofessional Practice and Education, a public-private partnership at the UMN created to accelerate teamwork and collaboration among health professionals to incubate ideas, define the field and guide program development and research in five core domains: leadership development; collaborative practice and health system transformation; education and training; research and scholarship; and innovative models for public outreach and education.

We are an engaged and dedicated team of faculty, and as you decide where to continue your medical training, strongly consider our residency program. We are excited about our future and hope you join us for the journey.

As a graduate myself of the University of Minnesota Neurology Residency (2010), I am honored to be taking over leadership of the residency program. I am enthusiastic about and proud of the opportunities our residents have to grow in fields of education, research and patient care, and I am eager to meet candidates for residency who are ready to learn more about our exciting program.

Michael Leffler-McCabe, MD, Program Director

Neurology Grand Rounds

Streaming video of Neurology Grand Rounds can be accessed on Fridays at noon through the link below; recordings of previous rounds are also archived on this page.

http://mediasite.ahc.umn.edu/Mediasite/Catalog/Full/8ecd29468f604ff7b70f71324840e63f21/?state=p1VaUB9uasHbzu7dLVqx

Education Meetings

Resident Participation in the Program
We believe that resident participation in our program is crucial for continuous improvement of the learning experience and trainee satisfaction. There are various venues that allow our trainees to bring up problems or concerns in an environment that provides respect, honesty and transparency.

Residency Education Meetings
This group meets quarterly on Fridays as part of Friday School, and includes all residents in the program (G1-G4), the administrative chief residents, the residency program director, and the residency program coordinator. Residents can bring up any issues or concerns that have arisen, and topics are discussed with the goal of being resolved or improved. Site directors and other key faculty are invited as needed based on the agenda. All residents are encouraged to turn in agenda items.

Nine Ground Rules for education meetings:

  • Everyone participates.
  • Different opinions are welcome.
  • Disagree in private, unite in public.
  • Silence is agreement.
  • No finger pointing.
  • Limit side conversations.
  • Start on time, end on time.
  • Follow through on action plans.
  • Everyone is responsible for success.

Chief Chat
Closed door meeting between the Chief Residents and all trainees are held quarterly during Friday School. Chief Chat helps to foster an open environment without faculty present to ensure that residents are able to talk freely about issues and/or concerns.

Chair Chat
Informal meeting with the Chair of the Department are held quarterly after the quarterly faculty meetings to allow trainees to bring up any residency concerns directly to the departmental leadership. This also provides an opportunity to get updates about the department from the Chair and to obtain career advice and insider perspective directly from Dr. Vitek.

Resident Work Group (RWG)
Elected representatives from each class including Chief Residents meet approximately once per month to identify areas of improvement in the residency program and to help create solutions and new policies to address any issues or concerns. The meetings take place immediately after Friday School. The RWG reports back to the education meeting with updates.

Protected Time for Learning: Friday School, Research and Scholarship

One of the flagships of our educational programs and the main didactic component of the residency is Friday School. It refers to a four hour time block on Friday afternoons that is dedicated to resident learning.

During a faculty meeting on April 5, 2012 our faculty passed a motion to protect this didactic time from clinical work to allow for a balance of service and education. Faculty members and fellows take over all service pagers and continue to provide patient care while residents are free to focus on learning. Since its implementation on July 1st, 2012 protected time during Friday School has been very well received and is considered a great success by our trainees.

Friday School has three components: The first hour is Departmental Grand Rounds followed by an hour of rotating sessions (described below) and a two-hour core didactic component.

  • 12:00-13:00 timeslot. Grand Rounds (including a quarterly M&M conference)
  • 13:00-14:00 timeslot. Friday School Rotating Sessions:
  • Professor Rounds (Clinical reasoning with master clinicians such as Dr. Parry or Dr. Anderson)
  • Journal club or case conference (alternating every block)
  • Administrative meetings (education meeting, Chief Resident Chat, Chair Chat or Leadership Training)
  • Board/RITE review (one Friday of each block)
  • 14:00-16:00 timeslot. Friday School Core Didactics (faculty driven, recurring two-year curriculum)

Evidence Based Medicine: A Librarian on Rounds. As part of a unique collaboration with the Health Sciences Library a dedicated librarian accompanies the inpatient team once a week on rounds at the University of Minnesota Medical Center (UMMC).

Librarian Jonathan Koffel (pictured in the center holding a tablet computer) has been part of this initiative since September of 2011 and has brought his expertise in evidence-based practice, emerging technology and its application to patient care and research as well as literature searching to the table. He demonstrates how to find relevant literature at the point of care and helps the neurology team provide the highest quality of evidence-based patient care. Jonathan has been a great resource to our trainees in other venues as well and has also worked with our residents in creating e-books and survival guides.

AAN EBM Training Course
The headquarters of the American Academy of Neurology (AAN) are located in very close proximity to our program. We take advantage of this fact by participating in the AAN Training Course (former EBM toolkit) every fall. The residents who attend bring back their knowledge and conduct EBM sessions for their peers during Friday school.

Innovation in Neurological Education: Simulation Days
Our residency collaborates with the Hennepin County Medical Center Interdisciplinary Simulation and Education Center (ISEC) to provide a guided, safe environment for our trainees to experience real-life medical situations and practice procedures. In a session in June, 2013 our trainees had access to four stations to learn about and practice acute stroke care. Two of the stations included high-fidelity simulations: one case required the administration of tPA, and tPA was contraindicated in another and a different management plan was needed. Residents practiced administering the NIH stroke scale in different settings under faculty and fellow supervision (pictured). Other stations we developed, a brain death exam and LP/line placement, are going to be used this fall.

Annual Objective Structured Clinical Examination (OSCE)
The University of Minnesota has an Interprofessional Education and Resource Center (IERC) that provides the venue for our annual OSCE. Each year our trainees participate in this assessment method, which helps to develop skills and behaviors rather than medical knowledge. The focus is on the core competencies of professionalism and communication skills, and the sessions are designed to provide feedback to our trainees. Stations in the past two years have included various patient hand-off scenarios, delivery of bad news, and the disclosure of medical error. The sessions are observed and assessed in real time by faculty (see picture of Dr. Guliani viewing the error disclosure station), and residents have the opportunity to watch and self-assess a video tape of their own encounters.

Skills Workshops
Our program has developed and conducted skills workshops for chemodenervation and EMG as part of our didactic curriculum. The workshops complement the lectures and didactics

Teaching Track for Residents
Residents have the option to enhance their educator role and skills by engaging in a longitudinal teaching elective track. The goal of the elective is to create competent physicians that will be able to function as medical educators. The rotation provides residents with the opportunity to engage in a variety of different teaching environments over the course of one year. Residents will learn ways to become effective teachers on clinical rotations, participate as an educator in a variety of medical school courses, and complete formal coursework such as the Evidence Based Medicine toolkit offered by the American Academy of Neurology.

Leadership Development and Quality Improvement
As residents are immersed in training for becoming skilled physicians, leadership skills and quality improvement may be overlooked or not formally taught. Our program has created a dedicated block at the end of the G1 year to teach these very important skills. Components of the block include communication training, team training (TeamSTEPPS) and an Insights Assessment. The capstone project for the month is a quality improvement project facilitated through a professional LEAN team. In addition, the block includes a bootcamp on neurologic emergencies to prepare for the transition into the G2 year.

Mentored Research and Scholarship
In order to practice evidence-based medicine physicians must be able to evaluate clinical and translational research literature. To do so effectively they must understand basic principles of research. Residents in Neurology will receive classroom training in research methods and statistical analysis, based on the American Academy of Neurology’s Evidence-Based Medicine toolkit. They will then learn to apply this knowledge by participating in a group Quality Improvement project during Year 1 and conducting original research during Years 2-4 under the guidance of a faculty mentor. Projects may comprise basic science, translational, clinical or educational research. Residents are expected to take leadership roles in their individual projects and to disseminate their findings. At the completion of this training, residents should be able to critically evaluate new research findings, to explain research news to patients, and to apply advances in knowledge to the care of their patients.