To be eligible for the ABPN board exam, residents must pass Clinical Skills Evaluations in 5 areas (see below).

The standard for acceptable performance = that of a competent practicing neurologist in medical interviewing skills, neurological examination skills, humanistic qualities, professionalism, and counseling skills.

General Principles

Clinical skills evaluations (CSEs) are required for all physicians wishing to become certified in neurology. Physicians must demonstrate mastery of the following three clinical skills to apply for certification in the specialties of neurology:

• Medical interviewing skills

• Neurological examination skills

• Humanistic qualities, professionalism, and counseling skills

Demonstration of competency in evaluating a minimum of five different patients with at least three different ABPN-certified evaluators is required of current residents. The fifth clinical skills evaluation must be completed within five years of the first evaluation, and the evaluations are valid for seven years after completion of residency training.

Each evaluation session should last approximately one hour. The physician should be given up to 45 minutes to conduct the history and neurological examination. Thereafter, they should have 10-15 minutes to present a summary of the important findings on history and neurological examination. The remainder of the time should be spent in discussion and feedback from the evaluator who observed the encounter.

Components of Clinical Skills Evaluations

Adult neurologists must successfully evaluate a patient from 5 different categories. Select one of the below categories when completing the evaluation form:

1) Critical Care: One critically ill adult patient with neurological disease (may be in either an intensive care unit or emergency department setting or an emergency consultation from another inpatient service)

2) Neuromuscular: One adult patient with a neuromuscular disease (may be in either an inpatient or outpatient setting)

3) Episodic/Ambulatory: One adult patient with an episodic disorder, such as seizures or migraine (most likely in an outpatient setting)

4) Neurodegenerative: One adult patient with a neurodegenerative disorder, such as dementia, a movement disorder, or multiple sclerosis (most likely in an outpatient setting)

5) Child Neurology: One child patient with a neurological disorder (most likely in an outpatient setting)

How to Submit

1. Log into MedHub

2. From the home page click on the Procedures Tab

3. On the Right-hand side of the screen, click on View Procedures/Cases

4. You are now on a new screen. On the Left-hand side of the screen, click on the + Log New Procedure Button. Make sure your name is in the resident box. If not, scroll down and click on your name.

5. On the Log Procedure Screen input the following:

a. Procedure Date – Defaults to current date. If you need to change the date, click on the date to change.

b. Location – 2 choices. It defaults to Other which is selected for any Inpatient Service. Using the pull down you can select Clinic which is any Outpatient Clinic. On the long box next to the location, type in where you are completing the CSE – Inpatient example would be NICU West, and an Outpatient example would be Neurology Ambulatory Center

c. Supervisor – using the pulldown menu, select the faculty that will be supervising the exam.

6. Under Patient Information use the pull down to select information.

7. Then proceed to the Add Standard Procedure Section – Surrounded in Blue Trim. Scroll to the bottom of the list and click on the correct CSE exam.

Once you click on the CSE exam, the box above Add Procedure will populate with the exam you selected.

If you selected the wrong exam, click on the x delete button and then repeat step 7.

8. Scroll to the bottom of the page and type in:

a. Diagnosis in the text box

b. Complications – only if needed

c. Procedure Notes – give a brief detail of the patient history that will assist the supervisor in remembering this patient

d. Click the green Log Procedure button.

9. When you click on the Log Procedure button, the procedure information you input along with the CSE evaluation will be forwarded to the supervisor you selected to complete the evaluation. The information entered will assist the supervisor in remembering the details of the patient and confirm that the appropriate exam type is selected.

10. Should you need assistance with completing this process, please contact Brooke in the Neurology Education Office (brooke.oster@som.umaryland.edu).

Determination of Acceptable Performance

The individual evaluator will determine if the physician performed acceptably on all three components (medical interviewing, neurological examination, humanistic qualities/professionalism/counseling skills) of the clinical evaluation.

An acceptable score is required for all three components (medical interviewing, neurological examination, humanistic qualities/professionalism/counseling skills). Regardless of when during training a resident takes the evaluation, the standard for acceptable performance remains the same: that of a competent practicing neurologist. Because a physician may take each of these clinical skills evaluations multiple times if necessary (which will not affect the physician’s admissibility to the ABPN certification examination), there should not be pressure to score a physician’s performance as acceptable on an evaluation.

Scoring Criteria of the Clinical Skills Evaluation

Criteria A. Medical Interviewing Skills

At the end of the history, both the physician and the evaluator should have a clear understanding of the nature of the patient’s neurological illness.

A score of 5 or greater is required to pass this component of the clinical skills evaluation.

Criteria B. Neurological Examination Skills

At the end of the examination, both the physician and the evaluator should have a clear understanding of the location and nature of the patient’s neurological illness. The findings on the examination should be compatible with the patient’s neurological history.

A score of 5 or greater is required to pass this component of the clinical skills evaluation.

Criteria C. Humanistic Qualities/Professionalism/Counseling Skills

A score of 5 or greater is required to pass this component of the clinical skills evaluation.

Criteria D. Presentation/Formulation

The ABPN does not require that neurologists/child neurologists perform acceptably on this component, but it has been included on the rating forms and guidelines for scoring.