(611) Effect of Neurocritical Care-Trained Faculty on Neurology Resident In-Service Training Exam Scores

Introduction: Not all hospitals have Neurocritical Care (NCC) trained and board certified faculty, but NCC topics are tested on the annual resident in-service training exam (RITE). The RITE was developed by the American Academy of Neurology to assess current level of knowledge, identify areas for potential growth and track progression throughout residency. Studies have shown a correlation between RITE scores and American Board of Psychiatry and Neurology board certification rates. We hypothesized that RITE scores would increase after addition of three NCC trained and board certified faculty to our neurology residency program.

Methods: Single center retrospective cohort study of neurology residents at a tertiary care center. RITE scores were reviewed from an annual program report which contains the total percent correct and percentile rank by subject/category and year of training.

Results: The pre-NCC faculty cohort included RITE scores from 2019-2021 (n=48). The average overall percentage correct for this group in the "adult vascular and critical care" section was 69. The average overall percentile rank was 43.1 and by year: PGY2 39, PGY3 47 and PGY4 43.3. The post-NCC faculty cohort included RITE scores from 2022-2023 (n=36). The average overall percentage correct for the group was 62. The overall percentile rank was 51.3 and by year: PGY2 44, PGY3 54.5 and PGY4 55.5.

Conclusions: Addition of NCC faculty did not have an impact on overall percentage correct, but there was an increase in overall percentile ranking across programs nationally, which was most pronounced in the PGY4 group. We postulate this is due to an increasing level of difficulty in RITE question writing. This finding is relevant as there has been an association between RITE scores and board certification pass rates. Reasons for improved performance may include system based rounding in a closed unit, addition of a simulation based curriculum and creation of a high yield didactic series. NCC faculty have a positive impact on neurology resident knowledge, assessed by the RITE, and this may correlate to improved board certification pass rates.