Over the past several months, we’ve been talking with many of you about gaps in fellowship education related to multimodal monitoring, physiologic data, and clinical informatics. Those conversations have convinced us that this is a topic worth discussing more broadly.

In my previous company, we not only developed the first FDA-cleared multimodal monitoring system, but also helped develop the applications and, ultimately, the market around it. Along the way, we created a considerable amount of educational material—from basic explanations of how different monitors work to case-based examples demonstrating how multiple streams of physiologic data can be interpreted together.

Recently, several colleagues suggested that some of these resources might be useful for training neurocritical care fellows. What began as a relatively simple internal project to organize those materials quickly led to a much broader conversation about how multimodal monitoring and informatics are taught today.

A few themes emerged repeatedly:

• There is tremendous variability among fellowship programs in exposure to multimodal monitoring, high-resolution physiologic data, and analytics.
• The educational need extends beyond fellows to attendings, nurses, advanced practice providers, and other members of the neurocritical care team.
• Programs without routine access to multimodal monitoring often address these topics through lectures, journal clubs, or rotations at centers where these technologies are used.
• Simulation, already widely used in areas such as brain-death determination and pediatric critical care, could provide another powerful way to teach physiologic monitoring and interpretation.
• Case-based learning is consistently viewed as one of the most effective approaches.
• Seeing cases in which monitoring reveals an actionable physiologic change helps clinicians understand both the value and the limitations of these technologies.
• Perhaps most importantly, multimodal monitoring provides an unusually effective way to teach the underlying physiology of the injured brain.

This raises a larger question:
Should there be a more consistent approach to informatics and multimodal monitoring education across neurocritical care training programs?

We believe the answer is yes—but we don’t believe any single company or institution should define what that education looks like.

Over the next several months, we plan to collect and categorize educational resources we have developed over the years and make them available through Neuromonitoring.com. We also hope to work with professional and academic organizations to identify gaps where additional tools or resources might be useful. To be clear, we do not see our role as being the educators. Rather, we hope to provide tools that educators can use, modify, and build upon.

One message from our conversations was particularly clear: people learn this material best by working through real cases.

That has influenced how we are developing the Moberg Clinical Platform. We are building tools that can make it easier to turn interesting clinical cases into teaching material. Many people in the field have seen cases captured from our earlier CNS Monitor because it provided a simple way to create snapshots both at the bedside and during retrospective review. Similarly, cases generated using ICM+ have become familiar teaching tools within the multimodal monitoring community.

We would like to take that concept further. Imagine a shared library of de-identified neurocritical care cases in which fellows could work through changes in ICP, CPP, autoregulation, brain oxygen, EEG, systemic physiology, and other parameters—and discuss not simply what happened, but what the data meant and what they would do next.

Such a library could eventually become a foundation for case conferences, fellowship curricula, simulation exercises, and perhaps even competency assessment. More importantly, it could allow institutions with limited access to advanced multimodal monitoring to expose their trainees to cases they otherwise might never see.

But this should be a community effort.

We would like to hear from fellowship directors, educators, fellows, nurses, APPs, and others interested in this area. What should every neurocritical care fellow understand about physiologic data and informatics? What cases would be most valuable? What teaching tools already exist that we should be highlighting rather than recreating? And where are the biggest gaps?

We plan to continue this conversation at our booth during the upcoming Neurocritical Care Society Annual Meeting in Seattle. If this topic interests you, please stop by. Bring an idea, a teaching resource—or even a case.

Perhaps together we can begin building a more consistent approach to teaching the informatics of neurocritical care.