Neurology Education Research Articles

Clinical practice applicability and relevance to non-specialists of a paediatric EEG online learning tool

BackgroundPaediatric electroencephalography (EEG) training is inadequate amongst healthcare practitioners and technicians managing children with epilepsy in sub-Saharan Africa. An entry level handbook was developed for healthcare practitioners in sub-Saharan Africa and subsequently made globally accessible via the International Child Neurology Teaching Network.AimTo investigate the usefulness of a paediatric online EEG handbook.MethodA survey of the ICNApedia online EEG handbook was circulated (December 2021–June 2022), to all 108 handbook registered participants (39 countries) via the research electronic data capture (REDCap) from the University of Cape Town (UCT).ResultsFifty participants from 25 countries responded: 8 from high income, 16 upper-middle income, 21 lower-middle income and 5 from low-income. 32 (64%) fully and 18 (36%) partially completed the survey. 35/50 (70%) had completed the handbook and seven respondents had partially completed the handbook. Responses supported the handbook as a good entry point to learn EEGs, especially for paediatrics. Likert scale ratings supported the handbook as relevant for gaining/enhancing knowledge and improving diagnosis and management of patients with confidence. The handbook was considered user friendly, comprehensible, and provided a practical experience. For improving EEG reading skills the handbook helped skills development via reinforcement and good illustrations. 29/32 (90%) of respondents confirmed that they are using learnt skills from the handbook in their current work.ConclusionIn resource limited settings non-specialist clinicians often provide extended services including EEG interpretation. The survey supports that the handbook is supporting this niche skills area, especially for the accessibility of knowledge gained. The handbook will continue to be adapted in-line with survey feedback.

Neurology Educators On the Pros and Cons of a Law Aimed at Widening Path for IMGs to Practice in the US

Neurology Educators On the Pros and Cons of a Law Aimed at Widening Path for IMGs to Practice in the US

Exploring strategies to improve the effectiveness of neurology ideology teaching team building using machine learning techniques

Abstract This paper takes the students of neurology specialty in a medical school as the research object and analyzes the current situation of its educational team construction. A machine learning algorithm based on weighted plain Bayes is used to construct an evaluation model, through which different weights are given to each index to explore the effectiveness enhancement strategy of neurology ideology and politics teaching team construction. Finally, the teaching performance and comprehensive ability of Civics and Politics were compared between the two groups of students to explore the effect of infiltrating the course Civics and Politics in neurology teaching. The results showed that 54.65% believed that teaching neuroscience ideology and politics in team construction should be improved as soon as possible. The mean value of “exerting the guiding role of professional teachers of Civics and Politics” was 23.76 points, which was also the furthest away from a perfect score, and was the focus of the subsequent team-building concern. The teaching performance and comprehensive ability of the students in the experimental group were better than that of the reference group (P<0.001), and the full penetration of the relevant elements of the course Civics in the teaching of clinical internships can transform the students’ ideological concepts and conscious behaviors.

Digital Technology Enablers of Tele-Neurorehabilitation in Pre- and Post-COVID-19 Pandemic Era - A Scoping Review.

Neurorehabilitation (NR), a major component of neurosciences, is the process of restoring a patient's damaged/disorganized neurological function, through training, therapy, and education, while focusing on patient's independence and well-being. Since the advent of the COVID-19 pandemic, various applications of telecare and telehealth services surged drastically and became an integral part of current clinical practices. Tele-Neurorehabilitation (TNR) is one of such applications. When rehabilitation services were disrupted globally due to lockdown and travel restrictions, the importance of TNR was recognized, especially in developed, low, and middle-income countries. With exponential deployment of telehealth interventions in neurosciences, TNR has become a distinct stand-alone sub-specialty of neurosciences and telehealth. Digital technologies, such as wearables, robotics, and Virtual Reality (VR) have enabled TNR to improve the quality of patients' lives. Providing NR remotely using digital technologies and customized digital devices is now a reality, and likely to be the new norm soon. This article provides an overview of the needs, utilization, and deployment of TNR, and focuses on digital technology enablers of TNR in pre- and post-COVID-19 pandemic era.

The Role of Nursing Care in the Management of Patients with Traumatic Subarachnoid Hemorrhage

Traumatic subarachnoid hemorrhage (tSAH) is a critical condition that requires comprehensive management to optimize patient outcomes. Nursing care plays a key role in the overall management of patients with tSAH via various aspects of care, including neurological assessment, monitoring, intervention, and education. In this review, we aim to evaluate the significant contributions of nursing care in managing patients with tSAH. Nurses perform initial neurological assessments, including the glasgow coma scale, pupil reactivity, vital signs, and sensory-motor evaluations. These assessments provide valuable information for early identification of deteriorating neurological status and prompt intervention. Additionally, nurses closely monitor intracranial pressure (ICP), cerebral perfusion pressure, and other hemodynamic parameters, assisting in the prevention and timely detection of secondary brain injury. For example, some strategies to manage ICP include elevating the head of the bed, maintaining adequate oxygenation and ventilation, administering proper medications, and ensuring fluid and electrolyte balance. Also, through careful monitoring, early recognition, and appropriate preventive measures, nursing care could prevent complications, including infections, deep vein thrombosis, and pressure ulcers. Furthermore, nursing care extends beyond physical management and encompasses psychosocial support for patients and their families. Nurses establish therapeutic relationships, providing emotional support, education, and counseling to alleviate anxiety, address concerns, and facilitate coping mechanisms. Education regarding medication management, lifestyle modifications, and the importance of regular follow-up enhances patient compliance and promotes long-term recovery.

The Role of Nursing Care in the Management of Patients with Traumatic Subarachnoid Hemorrhage

Traumatic subarachnoid hemorrhage (tSAH) is a critical condition that requires comprehensive management to optimize patient outcomes. Nursing care plays a key role in the overall management of patients with tSAH via various aspects of care, including neurological assessment, monitoring, intervention, and education. In this review, we aim to evaluate the significant contributions of nursing care in managing patients with tSAH. Nurses perform initial neurological assessments, including the glasgow coma scale, pupil reactivity, vital signs, and sensory-motor evaluations. These assessments provide valuable information for early identification of deteriorating neurological status and prompt intervention. Additionally, nurses closely monitor intracranial pressure (ICP), cerebral perfusion pressure, and other hemodynamic parameters, assisting in the prevention and timely detection of secondary brain injury. For example, some strategies to manage ICP include elevating the head of the bed, maintaining adequate oxygenation and ventilation, administering proper medications, and ensuring fluid and electrolyte balance. Also, through careful monitoring, early recognition, and appropriate preventive measures, nursing care could prevent complications, including infections, deep vein thrombosis, and pressure ulcers. Furthermore, nursing care extends beyond physical management and encompasses psychosocial support for patients and their families. Nurses establish therapeutic relationships, providing emotional support, education, and counseling to alleviate anxiety, address concerns, and facilitate coping mechanisms. Education regarding medication management, lifestyle modifications, and the importance of regular follow-up enhances patient compliance and promotes long-term recovery.

Investigation of Neurophobia amongst North American Veterinary Students and Development of a Veterinary Neurophobia Scoring Tool (VetNeuroQ).

"Neurophobia" is a phenomenon in human medical education where students develop negative attitudes towards neurology, impeding student learning and future clinical practice. While suspected to exist in veterinary medical education, it remains unstudied. The main objectives of this study were to examine North American veterinary student attitudes towards neurology and neurology education and explore elements that might contribute to neurophobia. Additional objectives were to evaluate veterinary educators' perceptions of student neurophobia and to develop and validate a scoring tool (VetNeuroQ) to quantify veterinary neurophobia. Veterinary students and faculty at North American veterinary schools were surveyed. A scoring tool was developed from a subset of questions and validated using confirmatory factor analysis. Six hundred six anonymous responses were collected from students at all stages of veterinary education. Neurology training was reported as insufficient by 35.9% and most respondents perceived neurology to not be easy to learn. Neuroanatomy/physiology and neurolocalization were considered difficult concepts. Students rated low confidence in neurology (vs. other topics), and low interest in the Neurology/Neurosurgery specialty. 61.7% of educators reported neurophobia amongst their students. The proposed VetNeuroQ scale showed high reliability (Cronbach's alpha >0.7) and validity (p < .05; CFI >0.9, RMSEA <0.08). VetNeuroQ scores were low but improved over the course of veterinary education. These findings demonstrate low self-efficacy, interest, and confidence, along with perceptions of difficulty, amongst veterinary students, consistent with neurophobia. Contributing elements are discussed. The VetNeuroQ scale allows quantification of veterinary student neurophobia and may be useful for screening students and assessing the impact of educational interventions.

How to Peer Review a Neurology Education Manuscript.

Peer review is an essential process in scientific research, ensuring the comprehensiveness, accuracy, and suitability of manuscripts for publication. Neurology education research differs from biomedical clinical research in several ways. These differences encompass specific paradigms, the use of theoretical frameworks, and different methodological approaches. Despite the high number of studies and journal publications on neurology education, there is a dearth of resources and guidance on how to perform a formal review on this specific literature. This article aims to review the distinctive features of neurology education from clinical research while proposing an organizational framework and model for performing peer reviews of papers focused on neurology education.

Continuum in neurologic education: The Nigerian experience

Continuum in neurologic education: The Nigerian experience

The COVID-19 pandemic and neurology: A survey on previous and continued restrictions for clinical practice, curricular training, and health economics.

The COVID-19 pandemic has significantly impacted health systems worldwide. Here, we assessed the pandemic's impact on clinical service, curricular training, and financial burden from a neurological viewpoint during the enforced lockdown periods and the assumed recovery by 2023. An online 18-item survey was conducted by the European Academy of Neurology (EAN) NeuroCOVID-19 Task Force among the EAN community. The survey was online between February and March 2023. Questions related to general, demographic, clinical, work, education, and economic aspects. We collected 430 responses from 79 countries. Most health care professionals were aged 35-44 years, with >15 years of work experience. The key findings of their observations were as follows. (i) Clinical services were cut back in all neurological subspecialties during the most restrictive COVID-19 lockdown period. The most affected neurological subspecialties were services for patients with dementia, and neuromuscular and movement disorders. The levels of reduction and the pace of recovery were distinct for acute emergencies and in- and outpatient care. Recovery was slow for sleep medicine, autonomic nervous system disorders, neurorehabilitation, and dementia care. (ii) Student and residency rotations and grand rounds were reorganized, and congresses were converted into a virtual format. Conferences are partly maintained in a hybrid format. (iii) Affordability of neurological care and medication shortage are emerging issues. Recovery of neurological services up to spring 2023 has been incomplete following substantial disruption of neurological care, medical education, and health economics in the wake of the COVID-19 pandemic. The continued limitations for the delivery of neurological care threaten brain health and call for action on a global scale.

Global transformation of neurological education to include a cocept of advocacy leadership

Global transformation of neurological education to include a cocept of advocacy leadership

Simulation-based education in neurology: lessons from the COVID-19 pandemic

ObjectivesThe COVID-19 pandemic has led to the disruption of all sectors of the economy including education. According to UNESCO over 1.37 million young people including medical students, were affected by the lockdowns in response to COVID-19 and the subsequent closure of the education system. The primary challenge for medical education was to provide clerkships in a biosafety environment. This study aimed to determine the impact of a simulated hospital in a neurology clerkship of 5-year medical students during the coronavirus pandemic and compare their results with a non-pandemic group in Bogotá, Colombia.ResultsThe students in the pandemic group answered a Likert scale survey regarding their satisfaction with the simulated hospital. Both groups were required to perform an oral, mid-term and final examination. From the results, it is clear that students perceived that exposure to a simulated hospital facilitated their learning process (93.1%) and allowed greater interaction with the teacher compared to a face-to-face environment (77.3%). There were no clinically significant differences in test results. This experience indicates that a simulated hospital is a valuable method to acquire clinical skills in trainees, that could be integrated into the curricular milestones of medical education programs regardless of the pandemic.

Neurophobia among medical students and resident trainees in a tertiary comprehensive hospital in China

sBackgroundMedical students and residents have been revealed to have extraordinary difficulties in managing patients with neurological complaints. However, specific information on Chinese trainees is scarce. Herein, we aimed to uncover the presence of, contributing factors for, and potential solutions to neurophobia among medical students and resident trainees in China.MethodsQuestionnaires were administered to the medical students of Peking Union Medical College and residents of the Internal Medicine Residency Training Program at Peking Union Medical College Hospital. We asked about perceived difficulty, knowledge, interest, and confidence in neurology in contrast to six other specialties. The reasons why neurology is regarded as difficult and approaches for improving neurological teaching have been appraised.ResultsA total of 351 surveys were completed by 218 medical students and 133 residents. The response rate exceeded 70% in both groups. The prevalence of neurophobia was 66.1% and 58.6% among medical students and residents, respectively. Respondents declared that greater difficulty was observed in neurology than in other specialties, and the management of patients with neurological problems was the least comfortable (p < 0.0001). Neurophobia has various perceived causes, and neuroanatomy is regarded as the most important contributor. Nearly 80% of medical students felt that improvements in neurology teaching could be achieved through further integration of preclinical and clinical neurological teaching.ConclusionsThe findings of the first survey on neurophobia in China are in accordance with those of previous studies. Neurophobia is highly prevalent in Chinese medical students and residents. Strategies to improve teaching, including enhanced integration of teaching and more online resources, are needed to prevent neurophobia.

Neurophobia Among Medical Students: Is Virtual Teaching the Answer?

Introduction‘Neurophobia’ is well-recognised to dissuade medical students from the neuro-centric specialities and limit the success of neurology and neurosurgery teaching at medical school. Past studies have associated neurophobia with deficiencies in medical education. AimsWe performed a cross-sectional analysis on medical students’ confidence and perceived level of knowledge in recognising the following neurosurgical and neurological emergencies- ischaemic stroke, haemorrhagic stroke, status epilepticus, subarachnoid haemorrhage, raised intracranial pressure, acute hydrocephalus, spinal cord injury, cauda equina syndrome and traumatic brain injury. Additionally, we assessed the utility of virtual seminars in neurosurgery and neurology teaching. MethodsMedical students from King’s College London were invited to a virtual teaching session. We obtained pre- and post- teaching scores for students’ subjective ability to recognise specific neurological and neurosurgical emergencies, along with their confidence in the subject. Results97 medical students attended the teaching session. For our sample group’s subjective rating on their confidence in neurology or neurosurgery as a subject, we obtained a mean score of 3.87 and a median score of 4.Across all domains, there was a significant forward shift in the distribution curve of scores post-teaching.We obtained statistically significant differences for all 9 neurological and neurosurgical emergencies evaluated in our questionnaire (Asymp.Sig. <0.001). Median scores for all 9 conditions improved after the teaching session, with >50% positive ranks seen within each group.Across the teaching modalities compared; placement-teaching was the highest scoring while online lectures received a better rating than in-person lectures. ConclusionIn neurosurgery teaching, virtual seminars may compensate for deficiencies that currently exist within medical education, hence limiting the effects of neurophobia.

Neurological semiology learning and technological-digital perspectives: a scoping review

This study aimed to assess the use of digital technologies in teaching neurological semiology to medical students. This scoping review followed the JBI Manual for Evidence Synthesis and PRISMA-ScR Checklist. A comprehensive search was conducted using the PubMed/Medline, LILACS, and SciELO databases to identify relevant articles published in English or Portuguese between 2017 and May 2022. Nine studies were included in the present review. The results suggest an emerging interest in nontraditional methods applied to teaching, such as board games and simulations. The use of alternative resources can improve short-term knowledge retention; however, digital technologies are lacking. This scoping review provides evidence to support the use of simulation in neurological semiology education; however, we found a lack of technological-digital approaches to this matter, a gap that should be studied further, as it could be crucial for solving several problems in neurological semiology education.

Integrating Virtual Teaching in a New Era of Medical Education: Lessons from a Neurology Course.

The COVID-19 pandemic has led to a sudden shift toward virtual learning in neurology education, which presents challenges for educators. However, virtual learning is here to stay for three key reasons: demand among students, ease of dissemination, and potential to improve educational quality. Despite challenges, educators can teach effectively using appropriate virtual tools and methods, with innovative approaches that will ultimately lead to sustained improvements in neurology education. Here, we aim to help educators effectively incorporate virtual instruction into their "new normal" by offering practical, evidence-based tips for balancing in-person and virtual learning, selecting the appropriate tools and methods for virtual teaching, and creating a supportive virtual learning environment. Using a systematic approach, educators can identify specific, achievable goals, determine the content's scope, appropriate assessments, select appropriate teaching methods, and create the session schedule and materials. Here we described evidence-based strategies for best practices, developing virtual material, and creating the appropriate virtual learning environment.

Curriculum Innovations: A Podcast-Based Neurologic Emergency Flipped Classroom Curriculum for Neurology Residents.

Education on the management of neurologic emergencies is vital for neurology residents, and effective educational methods are needed. This study aims to implement and evaluate the impact of a podcast-based flipped classroom curriculum in neurologic emergencies. "Flipped classroom" instructional methods have been used in GME and informed by experiential learning theory. The objectives of this curriculum were to (1) compare the clinical phenomena discussed in the neurologic emergencies podcast(s) with your own clinical experience; (2) discuss the pitfalls in the management of the neurologic emergencies discussed in the podcast(s); and (3) develop a management plan for the neurologic emergencies discussed in the podcast(s). At 10 neurology residency programs, we implemented a 3-session flipped classroom curriculum covering topics in acute stroke, movement disorder emergencies, and status epilepticus. Each session consisted of a Neurology® podcast followed by content discussion with a clinical expert. Assessment of the curriculum included presession and postsession surveys focused on learners' confidence and attitudes toward podcast-based education. Our data sample consisted of survey responses from residents, with response volumes ranging from 29-111 across all surveys. Podcasts are already highly used by neurology residents in their self-directed education. Confidence increased among learners in the management of movement disorder emergencies (18% confident before vs 79% confident after, p < 0.001) and status epilepticus (72% confident before vs 91% confident after, p = 0.014) among those who completed the curriculum. A change in confidence in acute stroke management was not found (p = 0.15). Podcasts were consistently preferred over lectures and reading-based instructional methods while less preferred compared with simulation-based learning and case-based discussion with faculty. The podcast-based curriculum studied here showed high levels of enjoyment and perceived utility. We present a 3-part curriculum to help build learners' familiarity and confidence in 3 neurologic emergency categories. The educational impact is established in Level 1 of the Kirkpatrick paradigm. Future studies can explore a higher-level impact of this curriculum. Evolution in neurology education is shifting increasingly toward immediately accessible information via digital media. This curriculum can be useful to neurology educators who need to be increasingly agile and facile with multiple educational techniques to meet learners' needs.

Education Research: Monitoring and Tracking Neurophobia: Evidence From a Temporal Analysis of Brazilian Medical Schools.

Neurologic disorders are common medical conditions. However, even with a higher demand for neurologic care, the capacity to train neurologists is impaired. The fear of neurosciences/neurology by medical students, known as neurophobia, may cause multiple adverse effects in neurologic assistance. The objectives of this study were to estimate the current prevalence and characteristics of neurophobia in medical students in Brazil and to compare neurophobic symptoms at 2 time points. This is a cross-sectional study conducted with students from 4 medical schools in Pará, Brazil, who matriculated into the preclinical stage, clinical stage, and internship were submitted to a questionnaire to assess the perception of clinical specialties, including neurology. Reasons for neurophobia, probable strategies to improve neurologic education, and a specific scale to detect neurophobia were also evaluated. Furthermore, we performed a temporal comparison of current results with those from a previous study from 2015. Neurophobia was detected in 63.3% of medical students. The perception of the difficulty in neurology/neurosciences was very high in all stages, and the perception of interest and quality of teaching worsened during the internship. The need to understand neuroanatomy and neurophysiology was cited as the most important reason for neurophobia. More and better bedside tutorials were the most mentioned suggestion to improve neurologic education. The temporal comparison between 2015 and 2022 showed that the level of knowledge, quality of teaching, and likelihood of pursuing a career in neurology has become more favorable in 2022. The prevalence of neurophobia in Brazil was higher than that in high-income countries. Unfavorable opinions about neurology tended to increase throughout the medical course, but the temporal comparison showed that the impact of neurophobia has decreased. Surveillance systems for monitoring and tracking neurophobia should be implemented in medical schools.

Neurological Consequences of COVID-19: A Systematic Review of the Pandemic's Impact on Neurology Training.

The COVID-19 pandemic had a significant impact on neurology training programs, leading to disruptions and changes that may have long-term implications for neurological education. The objective of this study was to investigate the impact of COVID-19 on neurological training programs, collecting available data relating to residents' experience worldwide. We performed a systematic search of the literature published on PubMed from January 2020 to March 2023, including studies referring to quantitative analysis of residents'/trainees' perspectives. Specifically, we included studies that examined how the pandemic has affected clinical and research activities, the use of telemedicine, the delivery of education and the psychological status of residents. Of the 95460 studies identified through database searching, 12 studies met the full criteria and underwent data extraction. In conclusion, the COVID-19 pandemic has had significant impacts on neurology training programs, highlighting the need for resilience and flexibility in medical education. Future research should focus on the long-term outcomes of these adaptations in the quality of neurology education and patient care.

Essential Competencies in Entry-Level Neurologic Physical Therapist Education: Erratum.

Essential Competencies in Entry-Level Neurologic Physical Therapist Education: Erratum.