Medical Student Education – Third-Year Clinical Clerkship

 

The OU College of Medicine neurology clerkship is a mandatory 4-week rotation occurring in the third year.  The goal of the neurology clerkship is to teach medical students as effectively as possible how to care for patients with common and urgent neurologic conditions by providing two concurrent and complementary curricula:  (1) a standardized, competency-based, didactic curriculum utilizing case-based learning, simulation, focused skills assessments, directed self-learning, gaming, essay assignments, and small-group discussions; and (2) a traditional curriculum based on clinical experiences tailored to the learner’s interests.  The standardized curriculum provides students with the core knowledge, skills, and attitudes in clinical neurology that are essential for future non-neurologists while the experiential curriculum provides context and validity, thereby enhancing retention of the core content and facilitating supplemental gains in knowledge and skills.  See “Medical Students” webpage for contact information.

 

The components of the standardized (didactic) curriculum are:

 

  • Case-Based Learning (CBL). Twenty essential neurologic cases—10 common outpatient conditions and 10 key emergency conditions.Students review 10 cases in instructor-led sessions and 10 in self-learning format.A brief quiz follows each CBL assignment.
  • Brain Imaging Self-Study. A self-learning PowerPoint file the first week of the rotation followed by a quiz covering CT and MRI images of the brain, both anatomy and pathology, with emphasis on CT neuroanatomy, including CSF cisterns.
  • Essential Neurologic Findings (ENF) Self-Study. A self-learning online program containing videos or still images of 26 key clinical findings in neurology that every primary-care clinician should be able to recognize & understand.The program includes descriptions, animations depicting pathophysiology, practice exercises, and self-assessment questions.There is a quiz on the ENF material at the end of the first week.
  • Case Summaries. Students complete case-summary forms for two patients per week for a total of 8 case summaries for the entire clerkship—four written case summaries in 100 words or less and four oral case summaries presented in 2 minutes or less. Students receive formative assessments (feedback without grade) the first two weeks and summative assessments (grades) the last two weeks for their case-summary performances.
  • Standardized-Patient (SP) Sessions. Each student participates in two SP sessions:an aphasic SP focused on the neurologic exam of an aphasic patient and a coma SP focused on the neurologic exam of a comatose patient and counseling of the patient’s caregiver.The SP assessments are formative, not summative (i.e., no grade).
  • Neurotransmission Interdisciplinary Communication Reading & Game. Students study a narrative of an interdisciplinary team meeting involving four patients, then participate in a PowerPoint Jeopardy-style game. After the game, students take a graded quiz in which they are asked to match clinical responsibilities with the corresponding health professional(s).
  • Ethics & Professionalism Readings, Essays, & Discussion. Students write essay responses to questions regarding an unprofessional patient note, a photograph of a physician-patient interaction, and two stories concerning end-of-life issues (brain death and Alzheimer disease).Students then participate in a faculty-led session to discuss the essays, their pertinent personal experiences, the definition of professionalism, the role of a doctor, and the influence of bias in decision making.
  • Ward-Based Learning (WBL) Presentation. For a grade, each student presents a patient to other students and a senior resident with emphasis on impression/assessment, including lesion localization, differential diagnosis, and a detailed management plan. The student also demonstrates the key neurologic findings of the patient.The resident evaluates the student’s presentation, providing feedback and demonstrating findings not shown by the student.

 The components of the traditional (experiential) curriculum are:

 

  • Inpatient Services. Students are assigned to two 2-week rotations among four different neurology services:OU Admit Neurology, OU Consult Neurology, VA Neurology, and OU Child Neurology.Assignments are made on orientation day based on student career goals. Students follow their own patients and attend inpatient team rounds weekdays and one weekend day.
  • Call. Students take call on 4 days—three weekdays from 5:00 pm to ​8:00 pm and one weekend day starting from 6-8 am and ending at ​8:00 pm.
  • Clinics. Students attend OUMC Residents’ Neurology Clinic 1-2 afternoons during the rotation.