Neuromuscular Buckets: A Proposed Educational Framework to Simplify Neuromuscular Disorders in Clinical Practice and Combat Neurophobia
Objective:
To propose an educational framework to assist with localization and guide workup in the diagnosis of neuromuscular disorders.
Background:
Neurophobia, or the fear of neurology, is a well-documented term in medical education stemming largely from the gap in basic neurosciences and their implementation in clinical practice. Educational interventions such as case-based teaching have proven to be most effective in bridging that gap. Here, we introduce the concept of anatomical “buckets” that can be used to guide clinical reasoning.
Design/Methods:
We used Canva™ to visually organize neuromuscular disorders into six anatomical “buckets” arranged from proximal to distal: motor neuron, nerve root, plexus, nerve (including mono- and polyneuropathies), neuromuscular junction, and muscle. Each bucket was populated with representative conditions to create a practical, hands-on framework for clinical reasoning. Learners applied this tool to categorize patients and guide subsequent diagnostic evaluation.
Results:
Implementation of “neuromuscular buckets” in resident clinics and through social media educational posts generated strong engagement and positive feedback. Learners reported that the framework simplified diagnostic reasoning and improved confidence in approaching neuromuscular cases. Informal feedback highlighted its clarity, visual organization, and applicability to real-world patient encounters.
To demonstrate: A 56-year-old female presented with two months of pain and tingling in the hands and feet, weakness in the legs, and falls. The exam showed areflexia, ⅗ bilateral proximal leg weakness, patchy sensory loss, and sensory ataxia. Using the “buckets” tool, we can rule out motor neuron, neuromuscular junction, and muscle given mixed sensory and motor symptoms. With bilateral symptoms, plexus can likely be ruled out, leaving nerve roots and peripheral nerves. This can further guide workup, such as EMG, to differentiate axonal versus demyelinating neuropathies.
Conclusions:
The visual and systematic approach of this framework makes neuromuscular disorders accessible to trainees, thus combating neurophobia. Future steps include formally validating this tool using surveys and feedback.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.