Development of an Educational Curriculum for Implanting and Managing Vagus Nerve Stimulators for Epilepsy

Neuromodulation. 2025 Jun;28(4):551-557. doi: 10.1016/j.neurom.2024.12.008. Epub 2025 Feb 18.

Abstract

Background: Vagus nerve stimulation (VNS) devices are commonly used for extracranial neuromodulation of drug-resistant epilepsy. These devices are implanted by multiple surgical subspecialties and managed by practitioners with varying levels of epilepsy-specific expertise. The North American Neuromodulation Society (NANS) education committee presents a curriculum defining level-dependent recommendations within the six-core competency rubric for the implantation and management of VNS devices.

Material and methods: A multidisciplinary (anesthesiology, neurology, neurosurgery, and physiatrists) and diverse (advanced practice providers, physicians, and surgeons) subcommittee of the NANS education committee met virtually over a year to develop a curriculum following the Accreditation Council for Graduate Medical Education (ACGME) core competencies. The subcommittee used a consensus approach, evidence-based development strategy; once completed, the VNS curriculum was approved by the NANS board.

Results: The subcommittee developed a VNS curriculum as a standard to be used for implanting surgeons, managing physicians, and advanced practice providers. The vertical orientation of the curriculum uses the ACGME educational core competencies framework; within this paradigm is a horizontal progression of skills with distinct competency groups for implanting surgeons and/or managing physicians. The horizontal progression defines the expected competence for early learner, advanced learner, and independent practitioner.

Conclusion: A NANS education subcommittee iteratively developed a VNS curriculum for defining progressive competence of myriad care providers, including clinicians and advanced practice providers, within the ACGME six core competencies.

Keywords: Curriculum; education; learners; neuromodulation; vagus nerve stimulation.

MeSH terms

  • Clinical Competence* / standards
  • Curriculum* / standards
  • Education, Medical, Graduate* / methods
  • Epilepsy* / therapy
  • Humans
  • Vagus Nerve Stimulation* / instrumentation
  • Vagus Nerve Stimulation* / methods
  • Vagus Nerve Stimulation* / standards