WMC-NYPH Clinical Neurophysiology Program: Educational Goals

General Statement

Training in Clinical Neurophysiology includes the six Core Competencies: (a) compassionate, effective, and appropriate patient care, (b) medical knowledge, (c) practice-based learning and improvement, (d) interpersonal and communication skills, (e), professionalism, and (f) systems-based practice. The trainee is expected to take an active role in training and self-assessment in all of these areas.

Upon completion of the program, the trainee should be competent to: (i) develop an appropriate clinical neurophysiologic evaluation plan for a patient with suspected or established neurologic disease, (ii) to supervise or carry out the neurophysiologic evaluation, (iii) to interpret the results of the neurophysiologic evaluation, and (iv) to integrate these findings with other clinical and laboratory findings to enhance patient care. In addition, the trainee should establish a sufficiently in-depth knowledge of at least one of the disciplines of clinical neurophysiology (e.g., epilepsy or peripheral neurology) to be able to train others in this area, and to contribute to the state of the art through clinical or basic research. To this end, all trainees are required to carry out a research project, and to prepare the results of this work for publication, under the mentorship of one of the program faculty.

Specific Areas of Knowledge and Competence

Note: The expected clinical skills and competencies detailed below are formalized in part by a Delineation of Privileges grid, which indicates the expected competencies upon entry to the Program and upon completion of each of the tracks. Evaluation of progress in the “Six Core Competencies” will be accomplished by multiple means, including a “360 degree” evaluation (with input from staff, other residents, technologists, and others), periodic review of a journal maintained by the trainee, a structured observation of clinical skills, and cognitive evaluations.

The Six Core Competencies

• Compassionate, effective, and appropriate patient care in clinical neurophysiology in general, and in one or more areas of subspecialization as itemized below
• Medical knowledge, including the scientific basis of clinical neurophysiologic procedures and their interpretation
• Practice-based learning and improvement, including self-assessment, appraisal and assimilation of scientific evidence, improvements in patient care, and dissemination of such improvements
• Interpersonal and communication skills that result in effective information exchange and with patients, their families, and other health professionals including technologists and nurses
• Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
• Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value

EEG and related areas

• Scientific basis and clinical role of electroencephalography intensive video-EEG monitoring and bedside monitoring, electrocorticography, Wada tests, and functional mapping
• Principles of management of epilepsy
• Interpretation of electroencephalograms in adults and children

• Interpretation and performance of intensive video-EEG monitoring and bedside monitoring, electrocorticography, Wada tests, and functional mapping
• Interpretation of neonatal EEG's
• Experience in the management of clinical trials of antiepileptic medications

EMG and related areas

• Scientific basis and clinical role of nerve conduction studies, electromyography, and neuromuscular transmission studies
• Principles of management of neuromuscular disease
• Interpretation of nerve conduction studies and electromyograms in adults

• Intepretation and performance of nerve conduction studies, electromyography, and neuromuscular transmission studies in adults, children, and infants
• Experience in the management of clinical trials of therapy in neuromuscular disease

Other areas

• Scientific basis, clinical role, and interpretation of visual, auditory, and somatosensory evoked potentials
• Scientific basis and clinical role of polysomnography
• Scientific basis and clinical role of intraoperative neurophysiology
• Scientific basis and clinical role of magnetoencephalography
• Scientific basis and clinical role of functional imaging methods

• Performance of intraoperative monitoring procedures, including intraoperative EMG, intraoperative somatosensory evoked potentials with surface and epicortical recording, electrocorticography, and cortical stimulation for functional localization

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Last revised:12/6/07