Demystifying neurology

Menken, Matthew

doi:10.1136/bmj.324.7352.1469

Cited by 29 publications

(17 citation statements)

References 7 publications

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“…A number of papers in recent years have highlighted the difficulties medical students and doctors at all levels have in dealing with patients with neurological problems [1,2]. It has been suggested that this is due, in part, to perceptions that neurology is a particularly academic subject, that it is merely a ‘diagnostic’ specialty, and that the teaching of the subject is not particularly good.…”

Section: Introductionmentioning

confidence: 99%

‘Neurophobia’– attitudes of medical students and doctors in Ireland to neurological teaching

Flanagan

Walsh

Tubridy

2007

Euro J of Neurology

129

155

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(i) To determine whether neurology is the medical specialty with which Irish students and doctors have most difficulty, (ii) appraise attitudes towards how neurology is taught, and (iii) suggest ways teaching might be improved. A questionnaire on medical teaching was given to 457 medical students and junior doctors in Ireland. Perceived difficulties with neurology compared with seven other medical specialties were analysed. Other aspects of teaching were assessed including why neurology is perceived as difficult and ways teaching could be improved. Neurology was perceived as the most difficult of the eight medical specialties assessed. Participants felt they learned most at bedside tutorials with surprisingly few learning online. Neurology was perceived as difficult because of insufficient exposure to the subject, lack of teaching, and perceived complexity. Neurology teaching could be improved by increasing the number of bedside tutorials and by greater exposure to neurological patients for the students in clinical training. Medical students and doctors find neurology difficult. The teaching of neurology is reported as moderate to poor. The reasons for this are wide ranging but an emphasis on increased numbers of tutorials and greater integration of pre-clinical neurology to clinical years would improve teaching.

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Section: Introductionmentioning

confidence: 99%

‘Neurophobia’– attitudes of medical students and doctors in Ireland to neurological teaching

Flanagan

Walsh

Tubridy

2007

Euro J of Neurology

129

155

View full text Add to dashboard Cite

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“…And without this link, students do not know which parts of a detailed study of neuroanatomy are of clinical interest (Tarolli & Jozefowicz, 2018). Indeed, many details of basic neuroscience are often irrelevant to clinical neurology (Haines et al, 2002).It would be recommendable to consider developing a new approach in which the teaching of neurology to students begins with clinical signs and phenomenology, with explanations and reasons, rather than with basic disciplines lacking clinical focus (Menken, 2002;Gupta et al, 2013). If we could achieve a suitable vertical integration turning all these neuroscience disciplines into a single one, the problem would be mitigated (Shelley et al, 2018).But the issue may be approached more aggressively, as by Zinchuk et al: Is neuroanatomy really important?…”

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confidence: 99%

Neurophobia: why, how much, consequences and solutions

Hernando‐Requejo¹

2020

MedEdPublish

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The term neurophobia was defined by Jozefowicz as "a fear of the neural sciences and clinical neurology that is due to the students' inability to apply their knowledge of basic sciences to clinical situations, leading to a paralysis of thought or action". In this paper we review what we see as the key aspects of neurophobia. What gives rise to it? Notable among multiple causes are how basic and clinical neurosciences are taught, the peculiarities of neurological patient history, examination and differential diagnosis in the field, and how neurology and neurologists are seen from outside the field. We will also review the extent of the issue, for in view of its prevalence, many students will reject a specialty in increasing demand (as the incidence of neurological disorders will not cease to grow), along with its consequences: more patient referrals to neurology (owing to neurophobia or defensive medicine), or overprescription of ancillary tests for diagnosis. Finally we will look at the solutions proposed, especially those aiming to bring about changes in the form and content of teaching, how the teaching of neurological examination and of new technologies is to be approached, and the use of those technologies as teaching aids. DefinitionThe term neurophobia was first used by Poser in 1959(Poser, 1959, though we owe its durable definition to Jozefowicz: "a fear of the neural sciences and clinical neurology that is due to the students' inability to apply their knowledge of basic sciences to clinical situations, leading to a paralysis of thought or action" (Jozefowicz, 1994). Neuroscience truly does engender anxiety in medical students, and this continues when on starting their clinical activity they are faced with neurological patients; if doctors are not trained in neurology, neurological examination and its interpretation will remain a real mystery.Hernando-Requejo V MedEdPublish https://doi. CausesIn this section we will consider what give rise to neurophobia. Notable among its multiple causes are how basic and clinical neurosciences are taught, the peculiarities of neurological patient history, examination and differential diagnosis in the specialty, and how neurology and neurologists are perceived from outside the field. Basic neuroscienceA common denominator in studies is to regard the separation of clinical and basic disciplines as the chief cause of neurophobia, especially if the latter are separated into neuroanatomy, neurophysiology, neuropathology and neuropharmacology (Fantaneanu et al., 2014;Pakpoor et al., 2014), for these subjects are normally taught by different specialists not linked to each other or to clinical practice. Moreover a lack of knowledge of basic neuroscience is one of the main reasons why medical students would reject a neurology residency (Gupta et al., 2013). In his 1994 paper, Jozefowicz asserts that for students, separating the (basic) "science" and the (clinical) "art" makes the former irrelevant and the latter mystical (Jozefowicz, 1994).A 2018 study by Tarolli et al. with a sa...

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“…The most common reasons behind this phenomenon were students' inability to apply their knowledge of basic sciences to clinical situations and poor quality of teaching neurological content (25,30). Employing active learning methods has been recommended to cope with "neurophobia" among learners (15,16). A limited number of reports have been published in literature about use of TBL as an active learning method for teaching neurology in undergraduate medical education (2,3,27).…”

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confidence: 99%

The effectiveness of TBL with real patients in neurology education in terms of knowledge retention, in-class engagement, and learner reactions

Alimoğlu

Yardim

Uysal

2017

Advances in Physiology Education

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In our medical school, we changed from a lecture-based method to a team-based learning (TBL) method to teach "polyneuropathies" in the neurology clerkship starting from the 2014 to 2015 academic year. Real patients were used instead of written scenarios in TBL sessions. This study aimed to compare former lecture-based and the current TBL methods in terms of knowledge retention, in-class learner engagement, and learner reactions. First, we determined in-class engagement and satisfaction of the students for the lectures given in the 2013-2014 academic year. The following year, besides the same criteria, we also determined individual (IRAT) and group readiness test (GRAT) scores in the TBL group. End-of-clerkship exam scores for both groups were recorded. Additionally, opinions of patients about their experiences throughout the TBL process were determined. One year later (2015 for lecture and 2016 for TBL), both groups sat for an MCQ test to determine their knowledge retention levels. We found no difference between groups regarding end-of-clerkship exam scores. The mean knowledge retention test score of the TBL group was significantly higher than that of the lecture group (5.85 ± 1.74 vs. 3.28 ± 1.70). The differences between IRAT, GRAT, and retention test scores in the TBL group were significant. The mean student satisfaction score on a five-point scale was 3.01 ± 0.9 (median = 3) in the lecture group and 4.11 ± 1.1 (median = 4) in the TBL group. Our results seem encouraging for use of TBL performed with real patients in neurology education to achieve better long-term knowledge retention and higher in-class engagement and student satisfaction.

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Demystifying neurology

Cited by 29 publications

References 7 publications

‘Neurophobia’– attitudes of medical students and doctors in Ireland to neurological teaching

‘Neurophobia’– attitudes of medical students and doctors in Ireland to neurological teaching

Neurophobia: why, how much, consequences and solutions

The effectiveness of TBL with real patients in neurology education in terms of knowledge retention, in-class engagement, and learner reactions

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