Objective:

To create a novel educational workshop that improves medical student confidence in performing the neurological exam by emphasizing pitfalls to avoid.

Background:

Teaching medical students how to perform an accurate neurological exam is a primary objective of the neurology clerkship. Despite this emphasis, medical students are often not confident performing the neurological exam. No previous studies have examined the effectiveness of teaching medical students the neurological exam with a workshop that emphasizes exam pitfalls to avoid along with paired practice.

Design/Methods:

65 third-year medical students participated in our study (control group=49, intervention group=16). The control group received a didactic session describing the neurological exam. The intervention group received a workshop focusing on 9 items to avoid while performing the neurological exam with associated paired practice. The 9 items were determined using surveys distributed to medical students, residents, and faculty. Pre- and post-clerkship surveys evaluated medical student confidence in performing the neurological exam, including testing visual fields, extraocular movements, motor strength, and deep tendon reflexes. The post-survey also evaluated the perceived benefit of the control or intervention teaching method on students’ neurological exam skills. Two-tailed, two sample equal variance t-tests were used to compare pre-post differences within and between groups.

Results:

Confidence scores in both groups significantly increased following the clerkship (p<0.04), with no significant differences in pre-survey scores between groups (p>0.05). Post-survey confidence scores in the intervention group significantly increased for grading reflexes compared to controls (p=0.042). Students reported significantly higher agreement with the interventional workshop being helpful for their neurological exam skills than the control didactic (p=0.0086).

Conclusions:

Emphasizing challenging pitfalls of the neurological exam may be an effective method for improving student confidence. Ongoing implementation and assessment are underway to evaluate the benefit of this approach for increasing student confidence in performing neurological exam skills beyond grading reflexes.