Don Hoang, MD
Resident Physician
Penn State Health, Department of Physical Medicine and Rehabilitation
Hummelstown, Pennsylvania, United States
Morgan Voulo, BS
Medical Student
Penn State College of Medicine
Hershey, Pennsylvania, United States
.jpg "Natasha Romanoski, DO photo")
Natasha Romanoski, DO
Associate Professor, Department of Physical Medicine and Rehabilitation
Penn State Health, Department of Physical Medicine and Rehabilitation
Hummelstown, Pennsylvania, United States
While intrathecal baclofen (ITB) is overall safe and effective in treating severe spasticity, errors in management can be fatal. Consequently, ITB education is crucial for clinicians that frequently manage ITB, notably in neurosurgery, anesthesiology, physiatry, and neurology. However, ITB exposure, particularly in PM&R residency, varies, with residents performing zero to eighty-four ITB pump refills per ACGME.1 Consequently, this review aims to evaluate the state of ITB education in literature.
Design:
Articles regarding ITB education were compiled from PubMed, Ovid MEDLINE, Ovid HealthSTAR, ERIC, Scopus, and Web of Science using search term: “(Baclofen) AND (Intrathecal) AND ((Education) OR (Training) OR (Learning) AND (Curriculum)).” Implementing a PRISMA framework, articles were identified, first removing duplicates and unavailable articles, then screening by title and abstract, and finally screening by full-text, including those discussing “intrathecal baclofen” and “clinician education” and excluding those only discussing “intrathecal medications other than baclofen.”
Results:
Across all databases, there were 437 results, 255 after removal of duplicates and unavailable items. Screening by title and abstract, only five met above criteria, and three, Chaiban et. al, Kivlehan et. al, and Weppner et. al, were identified after full-text review.
Conclusions:
Chaiban et. al discuss a theorized intrathecal drug delivery system curriculum, without validation of its effectiveness.2 Kivlehan et. al demonstrates effectiveness of simulation-based mastery learning for procedural skill, medical knowledge, and confidence in ITB management, but limited sample size and absence of a control group necessitates further testing of simulation-based approaches.1 Weppner et. al discussed negatives and overall positives of utilizing microvideos in teaching ITB compared to traditional lecture formats, introducing opportunities to evaluate mixed approaches incorporating virtual and in-person components.3 Furthermore, with varying exposure to ITB management per institution, the authors question how to approach ITB training in institutions with limited opportunities. Overall, with limited literature, there necessitates further research to improve ITB training.
