Lumbar Puncture Teaching Skills Objective Structured Clinical Examination (OSCE) Station

Introduction Neurology residents perform lumbar punctures (LPs) at least weekly on the inpatient services and regularly teach LP to rotating residents and medical students. To ensure there is explicit teaching and assessment of residency skills amidst reduced work hours, LP simulators are increasingly being utilized by residency programs. This station is part of a seven-station OSCE delivered to adult and pediatric neurology residents, but could be a stand-alone assessment. Methods The OSCE station uses a LP simulator and a standardized medical student. Resident OSCE station instructions, examiner questions and marking sheet, standardized medical student instructions, and instructor's guide are included. Formative feedback is given to examinees immediately by the examiner and standardized medical student and summative feedback is given to the residency programs. Results Residents provided immediate informal feedback of the station to the examiners during debriefing. Resident response was uniformly favorable, with many residents reporting it was fun and realistic. There were 25 senior neurology residents examined (PGY-3 to 5) from 3 universities. Using a pass threshold of 70%, 80% of residents passed the station. Resident scores ranged from 58% to 94% with a mean of 78% (SD 10%). Discussion LP and teaching skills are part of the national objectives of training for neurology in Canada, but direct supervision of resident's ability to teach LP during a clinical rotation is not always attainable, especially at night. The LP checklist was based current evidence and the teaching structure was based on a 1-minute preceptor. The LP Teaching Skills OSCE station has been used successfully assess pediatric and adult neurology resident knowledge of LP and the ability to teach the procedure to a medical student.