Priority Setting with Multi-Stakeholder Engagement Improves Neurology Residency Didactic Curriculum

Background: The didactic curriculum constitutes a central component of resident education. Surveying residents, teaching faculty, and alumni views of the didactic curriculum may offer valuable insights into how they assess its strengths and areas for improvement. We aimed to understand their different perspectives to prioritize new educational initiatives, and monitor their impact. Methods: We designed three overlapping online surveys targeting residents, teaching faculty, and alumni of the adult neurology residency program at our institution. After the initial surveys were completed, the didactic curriculum was restructured based on the respondent feedback. Follow-up surveys were administered to the three stakeholder groups during the following academic year. Fisher’s exact test and descriptive statistics were used to analyze the survey responses. Results: Initial and follow-up response rates respectively were 84% (37/44) and 67% (31/46) for current residents, 29% (28/98) and 42% (41/98) for teaching faculty, 6.5% (25/384) and 8.5% (33/386) for alumni. At baseline, most residents (62%) felt the primary goal of didactics should be to review foundational knowledge but most faculty (54%) felt it should be application of concepts to clinical neurology. The majority of residents (61%) reported satisfaction with the didactic curriculum delivery, although the proportion was lower than the faculty self-rating of effectiveness (75%). Residents and faculty agreed that the cerebrovascular was a top area of didactic strength and this aligned with the alumni report of cerebrovascular being among the most important areas for their career. Residents and faculty agreed that neuro-ophthalmology and EMG were relative areas of weaknesses. Most other responses were unique to stakeholder groups. Dedicated interventions based on initial survey results included a faculty retreat on interactive teaching as well as new neuro-ophthalmology and EMG blocks. The follow-up surveys demonstrated that EMG and neuro-ophthalmology were no longer among relative weaknesses of the curriculum according the residents and faculty. A significantly higher proportion of residents reported satisfaction with didactic curriculum delivery (90%, p = 0.02). Conclusion: Multi-stakeholder feedback and priority setting in our neurology residency didactic curriculum allowed us to bridge gaps between teachers and learners, and better ensure that our residents graduate well-prepared for contemporary clinical practice in a variety of settings and locations.