The healthy concern to improve neurological teachings

Abstract

T raditionally, the purpose of undergraduate education at virtually all medical schools has been to prepare students to enter practice immediately after graduation 1 . The quality of medical teachings has been long discussed. In 1913 William Osler wrote: "In every department of human knowledge men are asking guidance in the solution of a world-old problem -how to train the mind and the heart of the young". Already at that time Osler recommended simplifying the medical curriculum to give students more time to study and also emphasized the important role of teachers in helping students to observe and reason 2 . A major problem in medical education today is the lack of integration of basic science and clinical information into a cohesive whole. If either of these is taught in a vacuum, the medical student frequently is unable to reason through clinical problems, and this can result in anxiety, dislike, and eventual disinterest in the subject matter. These negative sentiments are applicable to the study of neurology in medical schools. Students perceive that the neural sciences and clinical neurology are overly complex, and many of them develop a fear of the neural sciences and clinical neurology due the inability to apply their knowledge of basic sciences to clinical situations, creating a "neurophobia syndrome" 3 . In our country, the Brazilian Academy of Neurology requested a survey that compared the panorama of neurology teaching in Brazil with that in other countries. The results of this well-prepared study were presented exactly a half century ago, at the first Brazilian Academy of Neurology Congress, and this document, alongside other recommendations stressed the importance of integrating clinical neurological education with neuroanatomy, neurophysiology, and the fundamentals of neuropathology 4 . Aspects that remains fully valid until today. Reflection and critique of teaching techniques are vital to propel medical schools towards promoting and aiming for excellence in medical education 5 . There needs to be a debate on whether major changes are needed in the way neuroscience and neurology are taught to medical students, to make the subject more accessible and more users friendly 6 . Along the last several decades, many new models of medicine curriculums have been created. The problem-based learning curriculum (PBLC) for example, adopted at McMaster University, Canada, in 1969 7 , although costly has grown in popularity and spread to many parts of the world, reaching as far as Hong Kong 8 . In this issue of Arquivos de Neuropsiquiatria, Magalhães et al. 9, concerned about the neurological teaching in Brazil, publish the article "A Brazilian original pedagogical approach to the teaching of neurology," in which they discuss survey results from students and teachers to compare his method of teaching neurology, Clinical Decision/Diagnostic Workshop (CD/DW), to traditional undergraduate teaching methods (lectures, seminars and traditional case-discussions). The authors highlight the needlessness to change curricu...

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“…Youssef (2009) reported that medical students who identified neurology as the subject they found most difficult and had least knowledge of suggested that greater clinical and practical exposure, more time spent on the subject, and improved teaching skills were needed to improve teaching of neurology. Multiple changes have been made to medical training in neurology in the past decade (Humbert & Chang, 2014;Maranhao-Filho, 2014;McColgan, McKeown, Selai, Doherty-Allan, & McCarron, 2013). Many medical schools are integrating the neurological sciences into interdisciplinary courses, and methods of instruction are changing from lecturebased to small-group, problem-based learning formats (Galetta, Jozefowicz, & Avitzur, 2006).…”