Abstract Details

Title A Modified Delphi Consensus Approach to Define Entrustable Professional Activities for Neurocritical Care Advanced Practice Providers

Topic Education, Research, and Methodology

Presentation(s) S39 - Broadening the Scope of Medical Education in Neurology (4:18 PM-4:30 PM)

Poster/Presentation
Number 005

Background Advanced practice providers (APPs) are essential members of neurocritical care teams. As neurologic education in APP degree programs is limited, significant on-the-job training is required for new neurocritical care APPs. Curricula for onboarding neurocritical care APPs have been developed; however, methods for evaluating readiness to deliver care without direct supervision are not available.

Objective To define consensus entrustable professional activities (EPAs) for neurocritical care APPs.

Design/Methods The steering committee developed a list of possible EPAs from Emergency Neurological Life Support course topics, the Neurocritical Care Society’s APP orientation course, and internal APP onboarding resources. We used a modified Delphi approach to generate consensus amongst neurocritical care APP leaders and expert neurointensivist medical educators. Panelists were encouraged to add additional EPAs. Items reaching 80% consensus after 2 rounds of voting were retained. The quality and structure of core EPAs were evaluated using the EQual rubric. We additionally performed an exploratory analysis of variations in entrustment expectations based on provider type, years of experience, and years of APP presence on unit.

Results The panel included 18 APPs and 12 neurointensivists from 16 institutions across the United States. The steering committee generated an initial list of 61 possible EPAs. The panel proposed 30 additional EPAs. A total of 47 unique nested EPAs were retained. The steering committee defined 6 core EPAs encompassing the nested EPAs, all of which were retained after 1 round of voting. Entrustment expectations did not vary by the specified groups.

Conclusions Expert consensus was used to create EPAs for neurocritical care APPs. We did not identify variables that significantly predicted entrustment expectations. These EPAs will be a valuable tool in the design of educational interventions for and assessment of new neurocritical care APPs. This list could be adapted for other groups of learners and trainees in the neurologic ICU.

Authors/Disclosures
Daniel S. Harrison, MD (Boston Medical Center) PRESENTER	Dr. Harrison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scientia Imaging.
Erika Sigman, MD	Dr. Sigman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Neuroscience.
Judy H. Ch'ang, MD (Weill Cornell)	Dr. Ch'ang has nothing to disclose.
Aarti Sarwal, MD, FAAN (Medical Center Blvd)	Dr. Sarwal has received personal compensation in the range of $0-$499 for serving as a Consultant for Stimdia, Inc. Dr. Sarwal has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Critical Care Medicine. The institution of Dr. Sarwal has received research support from Butterfly, Inc. The institution of Dr. Sarwal has received research support from Bard. The institution of Dr. Sarwal has received research support from Biogen. The institution of Dr. Sarwal has received research support from Novartis. The institution of Dr. Sarwal has received research support from CVR Global. The institution of Dr. Sarwal has received research support from NIH/NIA R01 AG066910-01 . The institution of Dr. Sarwal has received research support from Image Monitoring. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker/Faculty, CME courses with Society of Critical Care Medicine . Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker at annual congress with Intensive Care Society. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker at annual congress with Indian Society of Critical Care. Dr. Sarwal has received personal compensation in the range of $0-$499 for serving as a Subject expert for thesis review with UNIVERSITY OF TECHNOLOGY . Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Research participation in clinical trial funded by AHRQ with MEDSTAR HEALTH RESEARCH INSTITUTE . Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a speaker/Faculty for Annual meeting, travel compensation with European Society of Intensive Care Medicine. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME event with Thomas Jefferson University . Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Visiting Professor with University of Pittsburgh. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker with ISICEM. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Associate Editor, Clinical Neuroimaging with American Society of Neuroimaging . Dr. Sarwal has a non-compensated relationship as a Social Media Editor with Neurocritical Care that is relevant to AAN interests or activities. Dr. Sarwal has a non-compensated relationship as a Board of Directors with American Society of Neuroimaging that is relevant to AAN interests or activities. Dr. Sarwal has a non-compensated relationship as a President with Association of Indian Neurologists in America that is relevant to AAN interests or activities.
Abigale Celotto (University of Maryland Medical Center)	No disclosure on file
Alexandra Malone (UKMC)	No disclosure on file
Ariel Nowicki	Ms. Nowicki has nothing to disclose.
Ashley Martin (Emory Healthcare)	No disclosure on file
Bryan Boling	No disclosure on file
Christa O'hana S. Nobleza, MD	Dr. Nobleza has nothing to disclose.
Christopher Reeves	No disclosure on file
David M. Greer, MD, FAAN (Boston University School of Medicine)	Dr. Greer has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Thieme, Inc. Dr. Greer has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for multiple. The institution of Dr. Greer has received research support from Becton, Dickinson and Company. Dr. Greer has received publishing royalties from a publication relating to health care. Dr. Greer has received publishing royalties from a publication relating to health care.
Diane McLaughlin	No disclosure on file
Elizabeth Woods (Massachusetts General Hospital)	No disclosure on file
Emmaculate M. Fields, NP (University of California San Diego)	Mrs. Fields has a non-compensated relationship as a Board of Directors and Treasurer with American Society of Neuroimaging that is relevant to AAN interests or activities.
Erica Perets	No disclosure on file
Gemi Jannotta	No disclosure on file
Jennifer Mears (New York Presbyterian)	No disclosure on file
Kaitlyn Twomey (New York Presbyterian Hospital)	Kaitlyn Twomey has nothing to disclose.
Kelly A. Rath, NP (University of Cincinnati Medical Center)	Mrs. Rath has nothing to disclose.
Kelly Peronti	No disclosure on file
Krista Garner (Emory University Hospital)	No disclosure on file
Matthew B. Bevers, MD, PhD (Brigham and Women's Hospital)	Dr. Bevers has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for EBSCO. An immediate family member of Dr. Bevers has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Hinshaw Law. An immediate family member of Dr. Bevers has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Colorado Department of Law. The institution of Dr. Bevers has received research support from NINDS. The institution of an immediate family member of Dr. Bevers has received research support from AHRQ. The institution of an immediate family member of Dr. Bevers has received research support from NIH/Kowa Industries.
Nicholas A. Morris, MD, FAAN (University of Maryland Medical Center)	The institution of Dr. Morris has received research support from National Institute of Neurological Disorders and Stroke. Dr. Morris has received personal compensation in the range of $0-$499 for serving as a Grand Rounds Speaker with New York University. Dr. Morris has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Speaker with Mount Sinai Health System. Dr. Morris has received personal compensation in the range of $500-$4,999 for serving as a Continuum Article Author with American Academy of Neurology. Dr. Morris has received personal compensation in the range of $0-$499 for serving as a Reviewer with Society of Critical Care Medicine. Dr. Morris has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Speaker with New York Medical College. Dr. Morris has received personal compensation in the range of $500-$4,999 for serving as a Webinar Speaker with Kreg Therapeutics.
Paola Martinez, MD	Dr. Martinez has nothing to disclose.
Sahar Zafar, MD	Dr. Zafar has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Corticare. Dr. Zafar has received research support from NIH. Dr. Zafar has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker for a lecture with Marinus.
Sarah Livesay, RN, NP, DNP (Rush University)	Dr. Livesay has received personal compensation for serving as an employee of Lombardi Hill/stroke challenges LLC. Dr. Livesay has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Neurocritical Care Society. Dr. Livesay has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Baptist Health South Florida . Dr. Livesay has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Scott and Patton. Dr. Livesay has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for PCVA Law .
Sarah Wahlster, MD	Dr. Wahlster has nothing to disclose.
Thomas Lawson (Ohio State University)	No disclosure on file
Casey S. Albin, MD (Emory Healthcare)	Dr. Albin has received personal compensation in the range of $0-$499 for serving as a Consultant for Azurity Pharmaceutical. Dr. Albin has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum: Life Long Learning in Neurology. Dr. Albin has received research support from American Academy of Neurology. Dr. Albin has received publishing royalties from a publication relating to health care. Dr. Albin has received personal compensation in the range of $500-$4,999 for serving as a Instructor with Resuscitation Leadership Academy.