Abstract Details

Neurology residents may have inconsistent opportunities to perform LPs. The Vanderbilt Neurology residency established a weekly LP Clinic to perform outpatient LPs under direct attending supervision.Data were collected regarding (1) resident attitudes towards and experience performing LPs and (2) technical aspects of the LPs, comparing before and after initiation of LP clinic.

Neurology residents were asked to complete a twelve question anonymous survey to assess attitude (e.g., confidence and comfort with LPs) and estimated experience (e.g., average number of LPs performed, LP success rate) prior to and annually after the LP Clinic launch.  Residents indicated post-graduate year (PGY), number of intervertebral attempts, and whether the LP was completed without attending assistance. The impact of the LP Clinic on resident attitude, experience with LPs, and success rate was examined using logistic regression models comparing responses from pre-clinic to post-clinic.  Associations between outcome measures were assessed using Spearman’s correlations. Differences in perceived confidence and comfort were assessed using a Mann-Whitney test.

Comparing pre- versus post-LP Clinic surveys, there was no significant difference in the estimated number of LPs performed, comfort level, or confidence. After the LP Clinic was initiated, the residents’ reported personal success rate significantly increased 15% (p=0.04), which did not correlate with observed LP Clinic success rate. Pre-launch, PGY4s were 13-times less likely to need assistance compared to PGY3s (p=0.03); post-launch, they were as likely to need attending assistance as PGY3s. Percentage of LPs in which the attending helped did not change before versus after clinic launch.