Summary of Neurology Clerkship Objectives

Neurology Clerkship – Goals and Objectives1

Summary of Neurology Clerkship ObjectivesJune 7, 2011

Students will learn to obtain a neurological history, to perform a competent neurological examination, and to interpret the findings

Students will learn the basics of localization and differential diagnosis in neurology

Students will obtain exposure to a variety of neurological disorders

Students will understand the role of diagnostic tests in neurology

Students will understand the role of medical and surgical treatment and rehabilitation of neurological disorders

Students will obtain feedback on neurological history taking and examination

Students will present and deliver a clear, concise (but thorough) written and/or verbal case

Detailed Goals and Objectives

Learn to obtain a neurological history, to perform a competent neurological examination, and to interpret the findings:

Students will be provided a framework for neurological history-taking and examination that they will utilize when examining patients on the floor.
They will also observe attendings and residents perform the neurological examination on the floor and in the clinics.
Students will learn how to perform a focused but thorough exam that may include how to perform a neurological examination on patients with an altered level of consciousness and/or how to recognize and interpret abnormal findings on the neurological exam.
Upon completion of the clerkship students should have the ability to distinguish normal from abnormal findings on a neurological examination.

Criteria for Success: Students will perform an observed neurological exam on standardized patients. They must pass the standardized patient exam to pass the course.

Learn the basics of localization and differential diagnosis in neurology:

Students will recognize features differentiating lesions of the cerebral hemispheres, the posterior fossa, the spinal cord, the peripheral nervous system, the neuromuscular junction, and the muscle.
Students will learn about the basics of localization during an orientation session with the clerkship director, and will learn the importance of localization in making a differential diagnosis and guiding imaging studies.
Students are expected to gain the ability to formulate a differential diagnosis based on lesion localization, time course, and relevant historical and demographic features.

Criteria for Success: Students will build on this knowledge while working on their clinical rotations, and will demonstrate this knowledge in patient presentations, and interactions with faculty and residents, as well as in the OSCE and Shelf examinations.

Obtain exposure to a variety of neurological disorders:

On the inpatient floor and in the neuron-intensive care unit students will have exposure to acute presentations of stroke, seizures, multiple sclerosis, and neuromuscular disorders.
During the outpatient week students have the opportunity to work with attendings in specialty clinics in pediatric neurology, multiple sclerosis, neuromuscular disease, movement disorders, and neuro-oncology, as well as general neurology.

Neurology Clerkship – Goals and Objectives1

During clinical rotations, through supplemental reading as well as clinical exposure, students will become aware of presentations and conditions that may include (but are not limited to): elevated intracranial -pressure, toxic-metabolic encephalopathy, subarachnoid hemorrhage, meningitis/encephalitis, status epilepticus, acute stroke (ischemic or hemorrhagic), myelopathy, head trauma, temporal arteritis, seizures, Alzheimer’s disease, Parkinson’s disease, essential tremor, multiple sclerosis, migraine, Bell’s palsy, carpal tunnel syndrome, diabetic polyneuropathy, brain death.
Upon completion of the clerkship students should have the ability to recognize symptoms that may signify neurological disease (including disturbances of consciousness, cognition, language, vision, hearing, equilibrium, motor function, somatic sensation, and autonomic function).
Students will record exposures to patients in each of several categories of neurological disorders on the on-line documentation system E-Value.

Criteria for Success: Successful completion of experience cards and assigned cases.

Understand the role of diagnostic tests in neurology:

Students will have the opportunity to see patients undergoing EMG and EEG tests as part of their outpatient rotation.
They will also have the opportunity to understand the role of multiple diagnostic modalities including CT, MRI and ultrasound imaging as well as lumbar puncture and other lab investigations relevant to patients seen on the floors and in the clinics.
By the end of the rotation students should demonstrate an awareness of the use and interpretation of common tests used in diagnosing neurological disease

Criteria for Success: Successful completion of experience cards, and demonstrated awareness of neurological diagnosis on the Shelf exam.

Understand the role of medical and surgical treatment and rehabilitation of neurological disorders:

Students will have exposure to various acute and chronic modalities of medical treatment as applied to patients seen on the floor and in the clinic.
They will also be exposed to the role of surgical treatments in epilepsy, Parkinson’s disease, cerebrovascular disorders, and CNS tumors.
By the end of the clerkship students should demonstrate an awareness of the principles underlying a systematic approach to the management of common neurological diseases.

Criteria for Success: Demonstrated awareness of an appropriate treatment plan in patient presentations and in the detailed case write-up, and proficiency in the Shelf exam.

Neurology Clerkship – Goals and Objectives1

Obtain feedback on neurological history taking and examination:

Students will obtain feedback on history /examination skills on the floors and in the clinic.
Students on the inpatient services (neurology ward and Neuro-ICU) will present at least one history and physical examination per week to their attendings during their inpatient weeks. They will be given feedback on their history taking and localization skills during these presentations.
Key elements of the neurological examination will also b reviewed at these feedback sessions.

Criteria for Success: Successful presentation of a competent history & physical examination, and active participation in feedback process.

Present and deliver a clear, concise (but thorough) written and/or verbal case:

Students are expected to deliver a clear, concise, and thorough written/verbal case over the course of the clerkship. The case should demonstrate that the student has been able to solicit a complete and reliable patient history, perform a satisfactory neurological exam, recognize key neurological symptoms, and accurately understand relevant patient management.

Criteria for Success: Successful presentation of written/oral case presentation.

Neurology Clerkship – Goals and Objectives1