Medical student attitudes and educational interventions to prevent neurophobia: a longitudinal study

Report from the child neurology education and training workshop at the International Child Neurology Congress 2024: Expert'saddressing the training gap

This report summarizes the key findings of a workshop undertaken at the International Child Neurology Congress in 2024 by child neurologists with expertise in training education and invested colleagues. The workshop aimed to explore global issues which have impact on access to child neurology training. The major findings supported a great need for more training programs globally, that consensus is needed for the minimum standards of training, and that training programs can be strengthened via global health partnerships especially with collaborations from regions with more available resources. The group concurred that the phenomena of 'neurophobia' amongst general paediatricians and medical trainees, was a reality, and creates barriers both working with paediatric colleagues, as well as recruiting specialists to the field. Optimal teaching practices for child neurology should include the expansion of learning through global partnerships and virtual educational resources. Measures must be put into place for fledgling training programs, to support colleagues in less resourced settings and to avoid their burn-out. Collegial and collaborative work is essential to support the future of child neurology across the globe, both to reach the current capacity needs but also to meet the necessary growth in the field.

Global impact of a virtual neurology morning report

The global shortage and inequitable distribution of neurologists has led to significant gaps not only in neurology care, but also in neurology education. In order to increase access to neurology education, we developed neurology virtual morning report (NVMR), a virtual, open-access, case-based clinical reasoning conference available to learners worldwide. To evaluate NVMR's impact on participants' perception of, interest in, and confidence in neurology, we conducted a survey. Respondents represented 25 different countries of various income levels. The majority of respondents reported that NVMR decreased their perception of difficulty in understanding neurology and increased confidence in various clinical reasoning domains in neurology. Additionally, the majority of medical student participants showed an increased interest in pursuing neurology as a future specialty after participating in NVMR. NVMR represents a potential model for virtual educational conferences and highlights the opportunities digital education has to improve equitable access to neurology education.

Level of knowledge and perceived challenges associated with learning movement disorders topics: a critical review of final-year medical students at a Nigerian private university

Background

To determine the level of knowledge and challenges associated with learning movement disorders among final-year medical students. Methodology: A cross-sectional survey of 79 final-year medical students at the Madonna University, Elele, Rivers State. Consenting students filled out the study questionnaire, which consisted of socio-demographic variables and questions on the knowledge and challenges of learning movement disorders. Data were collected and analysed using the Statistical Package for Social Sciences Version 20.

Results

The mean age of the study participants was 27.41±2.78 years, with a male-to-female ratio of 1.3:1. Almost (91.1%) all the study participants had heard about parkinsonism from their lectures, followed by chorea (88.6%). More than half of the participants knew about one type of movement disorder or the other. Forty-three (54.4%) students expressed difficulty understanding movement disorder lectures. Inadequate exposure to patients with movement disorders and lack of audiovisual aids to enhance learning experience were the greatest challenges in learning movement disorders.

Conclusion

Parkinsonism was the most recognized movement disorder among the study participants. More than half of the participants admitted to having challenges with movement disorder lectures. Paucity of movement disorders cases during clinical rotation and lack of teaching aids were cited as major challenges affecting learning and appreciation of movement disorder lectures. Medical educators are encouraged to deploy appropriate methods that optimize learning experience among medical students during movement disorder lectures.

Attitudes of physiotherapy students toward neurology: does "neurophobia" exist among physiotherapy students?

BACKGROUND

Evidence is accumulating that medical students and practitioners have particular difficulty in neurology and have neurophobia. However, little is known about attitudes toward neurology in physiotherapy students.

PURPOSE

This study aimed to assess the attitudes of physiotherapy students toward neurology and compare it with other core specialties, identify contributors to difficulties of neurology, and obtain feedback for improving the quality of neurology and neurological rehabilitation education.

METHODS

A structured survey was distributed to final-year physiotherapy students in different universities across Turkey. Perceived level of knowledge, confidence, interest, difficulty, and desire to pursue a career in four main physiotherapy specialty areas (neurology, musculoskeletal, cardiopulmonary, and pediatric) were assessed. Reasons for perceived difficulty and ways to improve neurological physiotherapy education were asked by Likert-type and open-ended questions.

RESULTS

Three hundred ninety-one students participated from 12 universities. Neurology was perceived as the most challenging discipline (p < .001), but a lack of knowledge, interest, and confidence were not reported. The reasons for perceived difficulties with neurology were the need-to-know basic neuroanatomy and neurophysiology, difficulty integrating information into the clinic, and the complexity of the subject. To improve learning, most students recommended increasing clinical teaching, including bedside tutorials, exposure to more patients, and case discussions.

CONCLUSION

Physiotherapy students considered neurology as the most challenging discipline. Improving the integration of basic neurosciences into the clinic may improve neurology learning along with increased clinical teaching.

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.

New innovations and educational process in undergraduate neurology education in blended learning

Many undergraduate students suffer from 'neurophobia,' which refers to a lack of knowledge or confidence in neurology, and this can influence their career choices. Various measures have been taken to address this issue, including the implementation of new technologies and methodologies. Significant advancements have been made in the development of blended learning, and the integration of student-centered learning modules, multimedia, and web-based devices has become a common teaching approach. Nonetheless, the optimal delivery form, as well as assessment for the selected learning format and teaching quality in both theory and clinical practice, are being investigated. The purpose of this review is to provide a summary of the current understanding of blended learning as well as innovative methods, technologies, and assessments of undergraduate neurology education. It aims to highlight opportunities for implementing a novel, comprehensive learning model with a suitable blended learning method within a framework of customized technology-assessment processes for future neurology classes, encompassing both theoretical and clinical training.

A novel 3D surgical neuroanatomy course for medical students: Outcomes from a pilot 6-week elective

BACKGROUND

Developing and maintaining a three-dimensional working knowledge of neuroanatomy is an essential skill in neurosurgery. However, conventional 2D head, neck, and neuroanatomy education is typically characterized by the separate rote learning of constituent tissues and often fails to provide learners with a contextual understanding of the relationships between these highly complex and interconnected structures. This can pose a significant challenge to medical students entering neurosurgery who lack a topographic understanding of intracranial anatomy.

METHODS

We report on the design and efficacy of a novel 6-part 3D surgical neuroanatomy pilot elective for medical students that utilized a navigation-based pedagogical technique with the goal of providing students with a framework for developing a 3D mental map of the skull base, neurovasculature, ventricular system, and associated brain regions. Students took on the perspective of physically traveling along the paths of key structures with a 360-degree view of surrounding anatomy such that they could appreciate the integration and relative spatial relationships of the varying tissues within the cranium. Mental navigation exercises and pre- and post-course surveys were used to assess students' baseline and learned familiarity with the different anatomical regions covered.

RESULTS

At the conclusion of the course, all students were able to successfully complete all of the multifaceted mental navigation exercises. Post-course survey data indicated that respondents perceived significant increases in their knowledge of cranial nerves; anterior, middle, and posterior skull base anatomy; anterior and posterior cranial circulation; and the ventricular system.

CONCLUSION

3D navigation-based fly-through instruction is a novel and effective technique for teaching complex anatomy and can provide learners with the foundational skills for developing and maintaining a 3D mental map of intracranial anatomy.

Neurophobia: A Side Effect of Neuroanatomy Education?

Neuroanatomy in the medical curriculum tends to be challenging for both lecturers and students. Students and lecturers perceive the relevance and importance of neuroanatomy differently. If not taught sufficiently, students develop a dislike or fear (termed neurophobia) for the subject. This fear prevents them from being receptive to the teaching and consequently applying the neuroanatomy knowledge in the clinical environment. Information on the approach and perception of undergraduate neuroanatomy lecturers in South Africa regarding neuroanatomy in the medical curriculum is scarce and inconclusive. A study was undertaken to explore the attitudes and perceptions of neuroanatomy lecturers towards the relevance of neuroanatomy, as well as the teaching techniques and approach thereof, in the medical curriculum. In order to determine whether the lecturers' teaching approach and attitudes could be a contributing factor to neurophobia. In a cross-sectional qualitative study, neuroanatomy lecturers from the nine South African medical schools were invited to complete an anonymous online questionnaire. Results were thematically analysed and grouped. Lecturing staff from seven of the medical schools participated in this study and included fourteen respondents. The respondents classified themselves mainly as either proficient (78.6%) or experts (15.8%) in their neuroanatomy teaching experience. All the respondents acknowledged that neuroanatomy is important in their students' medical training. A lecturer's perceptions and attitude towards the subject or content, greatly affect the facilitation approaches and techniques used. This might have far- reaching consequences for students as it might impact on their attitude towards the content.

Introduction of the Modified Neuroanatomy Motivation Questionnaire and Its Role in Comparing Medical Student Attitudes Towards Learning Neuroanatomy Between Neuro-enthusiasts and Standard Students

BACKGROUND

Neurophobia has been identified as a potential barrier to adequate knowledge of neurology in the medical community, and therefore to patient safety. There is a drive to identify the source of neurophobia, in the hope of tackling it. Comparing the learning motivations of standard medical students with those who enjoy neuroanatomy may be a way of doing this.

METHODS

The science motivation questionnaire (SMQ) was modified for neuroanatomy. It was distributed to three cohorts of second year medical students and students attending the extracurricular National Undergraduate Neuroanatomy Competition (NUNC). Cohen's D test for effect size was used to compare standard medical students and those attending the NUNC.

RESULTS

Five hundred ninety-seven questionnaires were completed by second year students, and 320 by NUNC attendees. The differences in motivation to learn neuroanatomy between the 2 groups mainly fell into themes of career motivation, personal relevance, intrinsic motivation and assessment anxiety.

CONCLUSION

This study has demonstrated the use of the SMQ in neuroanatomy, and found differences in motivators to learn neuroanatomy between self-selecting "neurophiles" and standard medical students, mainly relating to intrinsic motivation and its role in their lives. More research is needed to further explore these differences and how they might apply to interventions in medical school curricula.

Longitudinal Qualitative Study of Career Decision-making of First-Year Medical Students: Why Neurology (or Not)?

Objective

The growing shortage of neurologists is in part due to suboptimal recruitment. Little is known about students' decision making regarding a career in neurology, particularly early in training. Using a longitudinal qualitative approach, we aimed to understand factors that influence first-year medical students' decisions about neurology.

Methods

We conducted 1-on-1 semistructured interviews with 15 first-year medical students at 1 institution before and after the preclinical neurology course (2018-2019). In the first interview, we asked about career intentions, factors likely to influence specialty choice, and perceptions of neurology. In the second interview, we asked about changes in students' views over the year. Using thematic analysis, we generated codes and clustered coded data into themes.

Results

The 2 most prominent factors influencing career choice in general were lifestyle and personal interest. No students expressed concerns about lifestyle in neurology. Most students were neutral about neurology or had a positive personal interest, which typically increased after the neurology course. Students frequently worried about content difficulty and the curative potential of neurology.

Conclusions

Interventions should include early education about the factors important to students in determining specialty choice, including lifestyle, and address potentially negative perceptions of neurology. Increasing time allotment to the preclinical neurology course may combat perception of the content as difficult.

Training in Neurology: Neuro Day: An Innovative Curriculum Connecting Medical Students With Patients

OBJECTIVE

To determine whether increased patient interaction, exposure to the neurologic examination, and access to positive neurology mentors increase interest in neurology for first-year medical students.

METHODS

Neuro Day was a 2-part experience for first-year medical students. The first part consisted of a flipped classroom to teach the standard neurologic examination. The second part involved patient encounters modeled off of the traditional patient rounds. Students rotated from room to room, listening to patients' experiences with different neurologic diseases and eliciting pathologic neurologic examinations. Students were surveyed before and after Neuro Day.

RESULTS

The result of the binomial test indicated that the proportion of medical students interested in neurology significantly increased from 78% to 85% (95% confidence interval [CI] 0.79-0.92; p = 0.034) after participating in Neuro Day. The proportion of students' knowledge of clinical neurology increased from 45% to 63.1% (95% CI 0.54-0.72; p < 0.0001), comfort with performing a neurologic examination increased from 30% to 78.4% (95% CI 0.70-0.86; p < 0.0001), and fear of studying neurology decreased from 46% to 26% (95% CI 0.17-0.34; p < 0.0001) following Neuro Day. One hundred percent of students indicated that they would recommend Neuro Day to their peers.

CONCLUSION

Neuro Day is a feasible and effective model to incorporate into medical education. There was increased interest in and decreased fear of neurology. We anticipate that this paradigm can be used in the future to encourage students to consider a career in neurology.

NeuroQ: A neurophobia screening tool assesses how roleplay challenges neurophobia

BACKGROUND

Neurophobia is a chronic disease of medical students and junior doctors. Early detection is needed to facilitate prevention and management as this fear can negatively impact patient care.

METHODS

We conducted a two-part mono-centric study at the faculty of Medicine, Sorbonne University, in Paris. Part one: a cross-sectional study to validate a newly constructed neurophobia scale, NeuroQ. Part two: a prospective longitudinal study to assess the impact of The Move on student neurophobia using NeuroQ. A population-based sample of second-year medical students of the 2019 and 2020 class of the Faculty of Medicine of Sorbonne University were invited to participate.

RESULTS

NeuroQ incorporates the main themes of the neurophobia definition and demonstrates uni-dimensionality. Three hundred and ninety-five medical students participated in the study (mean age was 20.0 years, SD: 2.1 years) assessing the effect of The Move teaching on neurophobia. Two hundred and eighty-eight (72.9%) students were female. After the Move teaching the mean NeuroQ score was significantly lower compared to the baseline NeuroQ score (mean [SD] variation, -1.1 [2.6], p < 0.001). There was a 22.3% relative reduction in the number of neurophobic students after The Move teaching.

CONCLUSION

Our results highlight the utility of NeuroQ in assessing (i) baseline neurophobia and (ii) the impact of pre-clinical educational interventions on neurophobia. Furthermore, we have shown the importance of pre-clinical educational interventions, such as The Move, in tackling neurophobia.

Medical Students' Knowledge and Perception of Deep Brain Stimulation

BACKGROUND

Deep brain stimulation (DBS) is a well-established neurosurgical procedure commonly used in movement and psychiatric disorders. Its widespread clinical implementation, however, may not be commensurate with medical education. No current assessment of medical student's understanding of DBS as a treatment option for indicated conditions is available, potentially threatening the availability of DBS to future patients. The aim of the present study is to explore the current knowledge and attitudes of medical students toward DBS as a treatment modality.

METHODS

A total of 65 medical students at Virginia Tech Carilion School of Medicine were surveyed regarding their knowledge of DBS. The survey consisted of a 25-item questionnaire including a demographic section and 3 separate inventories designed to assess bias, knowledge, and self-assessment of knowledge specific to DBS therapy. Students in pre-clinical and clinical years were analyzed separately to describe changes in knowledge or attitude associated with clinical exposure to DBS. Comparisons were analyzed using t tests, ANOVA, and Pearson correlations.

RESULTS

Of surveyed students, 36% were unsure of the FDA approval status of DBS treatment; 65% of students believed they had not been adequately educated about DBS and its utility; and 10.6% of students believed that DBS is likely associated with severe adverse effects and/or brain damage. The overall baseline attitudes of students toward DBS were positive. There was no observed difference between surveyed pre-clinical and clinical students, highlighting a lack of exposure throughout the clinical years of medical school education.

CONCLUSION

Although DBS is an effective treatment modality for various conditions, current education is non-commensurate with its application, which can negatively impact awareness and understanding for its implications by medical professionals. In order to better serve patients who may benefit from DBS, medical curricula must change to educate future physicians on the benefit of this intervention.

Current provision of myelopathy education in medical schools in the UK: protocol for a national medical student survey

INTRODUCTION

Degenerative cervical myelopathy (DCM) is a common, disabling and progressive neurological condition triggered by chronic compression of the cervical spinal cord by surrounding degenerative changes. Early diagnosis and specialist management are essential to reduce disability, yet time to diagnosis is typically prolonged. Lack of sufficient representation of DCM in undergraduate and postgraduate medical curricula may contribute to the poor recognition of DCM by non-specialist doctors in clinical practice.In this study, our objective, therefore, is to assess DCM teaching provision in medical schools throughout the UK and to assess the impact of teaching on the DCM knowledge of UK medical students.

METHODS AND ANALYSIS

A 19-item questionnaire capturing data on medical student demographics, myelopathy teaching and myelopathy knowledge was designed. Ethical approval was granted by the Psychology Research Ethics Committee, University of Cambridge. An online survey was hosted on Myelopathy.org, an international myelopathy charity. Students studying at a UK medical school are eligible for inclusion. The survey is advertised nationally through university social media pages, university email bulletins and the national student network of Myelopathy.org. Advertisements are scheduled monthly over a 12-month recruitment period. Participation is incentivised by entering consenting participants of completed surveys to an Amazon voucher prize draw. Responses are anonymised using participant-chosen unique identifier codes. A participant information sheet followed by an explicit survey question captures participant informed consent. Regular updates on the progress of the study will be published on Myelopathy.org.

ETHICS AND DISSEMINATION

Ethical approval for the study was granted by the Psychology Research Ethics Committee, University of Cambridge (PRE.2018.099). The findings of the study described in this protocol, and all other related work, will be submitted for publication in a peer-reviewed journal and will be presented at scientific conferences.

Five ways to get a grip on grouped self-assessments of competence for program evaluation

Self-assessments conducted by individuals when taken together (grouped) provide valid and accurate measures of learning outcomes of the group. This is useful for program evaluation. Grouped self-assessments are simple to understand and construct, easy to implement, relatively accurate, and do not require extensive and complex pre-post testing measures. However, group self-assessments have the potential to be misused. To examine how group self-assessments have been used in medical education, we conducted a search of journal articles published in 2017 and 2018 from eight prominent medical education journals. Twenty-seven (n = 27) articles that used self-assessments for program evaluation were selected for data extraction and analysis. We found three main areas where misuse of self-assessments may have resulted in inaccurate measures of learning outcomes: measures of "confidence" or "comfort", pre-post self-assessments, and the use of ambiguous learning objectives. To prevent future misuse and to build towards more valid and reliable data for program evaluations, we present the following recommendations: measure competence instead of confidence or comfort; use pre-test self-assessments for instructional purposes only (and not for data); ask participants to do the post-intervention self-assessments first followed by retrospective pre-intervention self-assessments afterwards; and use observable, clear, specific learning objectives in the educational intervention that can then be used to create the self-assessment statements.

Clinical reasoning in feline spinal disease: which combination of clinical information is useful?

OBJECTIVES

The aim of this study was to evaluate if a combination of discrete clinical characteristics can be used to identify the most likely differential diagnoses in cats with spinal disease.

METHODS

Two hundred and twenty-one cats referred for further evaluation of spinal disease were included and categorised as follows: non-lymphoid neoplasia (n = 44); intervertebral disc disease (n = 42); fracture/luxation (n = 34); ischaemic myelopathy (n = 22); feline infectious peritonitis virus myelitis (n = 18); lymphoma (n = 16); thoracic vertebral canal stenosis (n = 11); acute non-compressive nucleus pulposus extrusion (n = 11); traumatic spinal cord contusion (n = 8); spinal arachnoid diverticula (n = 7); lumbosacral stenosis (n = 5); and spinal empyema (n = 3). Information retrieved from the medical records included signalment, clinical history and clinical presentation. Univariate analyses of variables (clinical history, breed, age, sex, general physical examination findings, onset, progression, spinal hyperaesthesia, asymmetry, ambulatory status and neuroanatomical location) were performed, and variables were retained in a multivariate logistic regression model if P <0.05.

RESULTS

Multivariate logistic regression revealed that intervertebral disc disease most often occurred in middle-aged, purebred cats with a normal general physical examination and an acute onset of painful and progressive clinical signs. Ischaemic myelopathy occurred most often in older cats with a stable or improving, non-painful, lateralising, C6-T2 myelopathy. Spinal fracture/luxation occurred most often in younger cats and resulted most often in a peracute onset, painful, non-ambulatory neurological status. Concurrent systemic abnormalities or abnormal findings detected on general physical examination were significantly associated with feline infectious peritonitis virus myelitis, spinal lymphoma or spinal empyema.

CONCLUSIONS AND RELEVANCE

This study suggests that using easily identifiable characteristics from the history and clinical examination can assist in obtaining a preliminary differential diagnosis when evaluating cats with spinal disease. This information could aid veterinary practitioners in clinical decision-making.

The role of residents in medical students' neurology education: current status and future perspectives

BACKGROUND

Neurophobia, a well-described fear of neurology, affects medical students worldwide and may be one of the factors contributing to a shortage of neurologists in the United States. Residents spend a considerable amount of time with medical students; therefore, we sought to understand better the impact neurology residents have on medical students during their neurology clerkship and their subsequent interest in neurology. We aimed to identify and implement strategies to decrease neurophobia and increase the number of students pursuing neurology as a career.

METHODS

Third-year medical students (n = 234) of UTHealth's McGovern Medical School rotating through their neurology core clerkship completed two surveys regarding their rotation experiences. Surveys were completed anonymously before and after the clerkship to measure their interest and confidence in neurology and the impact of their interactions with the neurology residents during the clerkship. In parallel, residents participated in a teaching workshop focused on small group teaching to improve their teaching effectiveness. Non-parametrical comparison and ordinal regression analyses were utilized for data analyses.

RESULTS

Medical students reported a statistically significant increase in their confidence in managing neurological conditions and interest in pursuing a neurology residency after their clerkship. There was a significant association between the medical students' overall rotation experience and the residents' teaching effectiveness. The overall clerkship experience correlated with the medical students' interest and confidence in neurology. There was a trend towards an increase in residents' teaching effectiveness and students' rotation experience after a resident teaching workshop. Additionally, of note, students who rotated on both and outpatient and inpatient sites during their clerkship reported an increased interest in neurology.

CONCLUSION

Our study supports that resident-led teaching efforts are important in improving medical students' neurologic education and their interest in neurology. Our data also supports that the interest in neurology increased for medical students after their neurology clerkship. We examined future strategies to implement "near-peer" teaching activities to enhance the medical students' neurologic educational experience. These strategies could potentially mitigate neurophobia and ultimately lead to a much-needed increase in future neurologists.

Neurophobia: why, how much, consequences and solutions

This article was migrated. The article was marked as recommended. 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 over-prescription 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.

Neurologic and neuroscience education

Neurologic disorders are among the most frequent causes of morbidity and mortality in the United States. Moreover, the current shortfall of neurologists is expected to worsen over the coming decade. As a consequence, many patients with neurologic disorders will be treated by physicians and primary care providers without formal neurologic training. Furthermore, a pervasive and well-described fear of neurology, termed neurophobia, has been identified in medical student cohorts, residents, and among general practitioners. In this article, members of the American Academy of Neurology A.B. Baker Section on Neurological Education review current guidelines regarding neurologic and neuroscience education, contextualize the genesis and the negative consequences of neurophobia, and provide strategies to mitigate it for purposes of mentoring future generations of health care providers.

The Basic Four Approach to Clinical Neuroscience Instruction: Using Cognitive Load Theory to Enhance Case-based Learning

Among medical students, neurosceince is considered a notoriously difficult subject. This challenges faculty to teach preclinical neurology in more engaging, efficient, and prioritized ways. Traditional approaches to neuroscience instruction typically begin with neuroanatomy and advance to clinical problem solving after this foundation of knowledge is in place. Over the past 45 years, neurology faculty at Mayo Clinic Alix School of Medicine have developed and iteratively refined an inverted approach called The Basic Four. The Basic Four uses authentic clinical scenarios as the basis for neuroscience instruction and incorporates principles from cognitive load theory to calibrate load on students' working memory. This perspective describes The Basic Four and illustrates how cognitive load theory can be used to enhance case-based learning.