1607 - Implementing a Resident Neurorehabilitation Continuity Clinic in PM&R: A Quality Improvement Initiative

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

HS

Hank Shipman, MD

Resident Physician
University of Utah
Salt Lake City, Utah, United States

Co-Author(s)

AL

Arianna Lanpher, DO

Resident Physician
University of Utah
Salt Lake City, Utah, United States

Submitter(s)

HS

Hank Shipman, B.S.

University of Utah School of Medicine
Salt Lake City, Utah, United States

Objectives: To design, implement, and evaluate a PM&R resident continuity clinic focused on neurorehabilitation, with the goals of enhancing resident clinical ownership and improving continuity of care for patients with complex neurologic conditions.

Design: Using a Plan–Do–Study–Act framework, a weekly half-day continuity clinic was launched, staffed by two senior PM&R residents under faculty supervision. Residents managed a patient panel longitudinally. Data were collected on patient demographics and surveys administered to residents and attendings at baseline and after 8 months. Surveys used a 0–5 Likert scale to assess competence across seven domains: billing/documentation, autonomy, medical decision-making, procedural skills, coordination of care, longitudinal management, and preparedness for independent practice.

Results: Thirty-four patients (age 17–84, mean 52.4; 50% male, 50% female) were managed in the resident continuity clinic over the first 8 months. The primary diagnoses included spinal cord injury (56%), multiple sclerosis (12%), stroke (9%), TBI (6%), cardiopulmonary debility (6%), and other neurorehabilitation conditions. Survey ratings improved across all seven domains. Resident-reported gains were largest in billing/documentation, coordination of care, comfort with longitudinal management, and procedural skills (all +1.5 on 1-5 Likert scale), with additional increases in autonomy, medical decision-making, and preparedness for independent practice (all +1.0). Attendings most strongly noted growth in comfort with longitudinal management (+1.67) and in billing/documentation, procedural competence, and readiness for independent practice (each +1.33). Qualitative feedback emphasized the value of longitudinal exposure, patient ownership, and interdisciplinary collaboration, while highlighting several logistical challenges, including referral sources and coordinating schedules.

Conclusions: A resident-led neurorehabilitation continuity clinic is feasible and enhances longitudinal PM&R training. Both resident and attending surveys demonstrated meaningful growth in clinical competence. Qualitative feedback underscored the clinic’s educational value while identifying logistical barriers to sustainability. This model may serve as a framework for integrating continuity experiences into other subspecialty areas within physiatry training.