Aprendizaje a través de las interconsultas neurológicas intrahospitalarias: un estudio prospectivo sobre la exposición clínica del residente y las oportunidades educativas.

Resumen

Objective. To evaluate in-hospital neurological consultations as a potential workplace-based learning environment and to analyze clinical exposure, case complexity, and care processes relevant to neurology residency training. Methodology. Prospective observational study of in-hospital consultations attended during regular working hours by a fourth-year neurology resident over a 6-month period (July–December 2025). Clinical and care-related variables were analyzed. Results. A total of 239 consultations were included. Cerebrovascular disease was the most frequent diagnosis (25.1%), followed by encephalopathy/confusional states (15.1%) and epilepsy (12.6%). Median time to evaluation was 0.20 hours (IQR 0.90) and was significantly shorter in urgent consultations (p < 0.001). Follow-up was required in 12.6% of cases, and 30.1% were classified as complex. Cerebrovascular disease was independently associated with hospital admission (OR 6.36; 95% CI 2.77–14.61; p < 0.001), whereas origin from the Emergency Department did not remain significant after adjustment. The model showed good discriminative performance (AUC 0.826; 95% CI 0.759–0.894). The estimated total workload reached 587 neurological evaluations. Conclusions. In-hospital neurological consultations represent a high-workload activity with substantial educational value. Cerebrovascular disease was the main determinant of hospital admission, whereas case complexity was mainly related to the underlying neurological condition. These findings highlight in-hospital consultations as a high-value workplace-based learning setting, offering broad clinical exposure and potentially supporting experiential learning during neurology residency training.