Boot Camp for the Brain: Enhancing Neurocritical Care Readiness Through Simulation

Introduction: Preparedness for neurologic emergencies is critical in neurocritical care (NCC), yet early neurology trainees often lack exposure to high-acuity situations. Simulation-based education offers a controlled and safe environment to build clinical competence, but its integration into NCC education remains limited compared to other acute care specialties.


Methods: A one-day neurocritical care boot camp was conducted for 6 PGY-2 neurology residents, with limited prior exposure to neurocritical care. The curriculum included didactics, simulation cases, and hands-on procedural training regarding management of status epilepticus, elevated intracranial pressure, coma, ultrasound-guided lumbar punctures and transcranial dopplers. High-fidelity manikins simulated realistic neurologic findings including seizures, pupillary changes, and herniation syndromes. Structured debriefs followed each case, focusing on clinical management, treatment algorithms, communication, and teamwork. Participants completed pre and post-intervention surveys using Likert scales to assess confidence, knowledge, teamwork and communication.


Results: The mean learner confidence scores improved in all domains. Statistically significant improvements were observed in general confidence (3.17 0.60 to 4 0.51; p-value 0.02) and and reduced fear of NCC (2.83 0.42 to 2 0.67; p-value 0.04). Improvements in communication (3.83 0.79 to 4.16 0.61; p-value 0.61), team work (3.83 0.79 versus 4 0.72 p-value 0.61), and presentation skills (3.33 0.97 versus 3.83 0.60 p-value: 0.20) were noted but did not reach statistical significance. In knowledge domains, significant improvements were observed in ICP management (58.33 30.12 versus 95.838.17 p-value: 0.03) and ultrasound-guided lumbar puncture: (74.08 14.52 versus 99.45 7.44 p-value: 0.03). Other domains, including status epilepticus (91.67 10.33 versus 100 0 p-value: 0.17) and identifying coma (70.83 15.06 versus 79.17 8.17 p-value: 0.17), showed improvement without statistical significance.


Conclusions: A focused NCC simulation bootcamp led to significant increases in trainee confidence and knowledge, particularly in areas of low baseline exposure. These findings support the value of simulation-based training in early NCC education and warrant further evaluation in larger prospective cohorts.