Clinical Neurology Clerkship

Total Contact Hours:

174.5 hours

Director:

Cassandra J. Milling, M.D., Director, Neurology Education, and Assistant Professor, Neurology


Learning Goals, Assessment, Practice, Teaching and Learning Activities, and their Integration with the Institutional Educational Objectives:

 

What does our institution want our graduates to do?

If your students mastered the content of your course, what would they be able to do?
 

What will students need to do for them and others (peers, professors) to know whether they have achieved this specific learning goal?

How will students get the information they need to learn?

1.
Institutional Objectives

2.
Learning Goals

3.
Assessment
Activities (graded)

4.
Practice/Feedback Activities (non-graded)

5.
Teaching and Learning Activities

K1

C1, C2, C3

P1, P2, P3

1. Perform and document a neurologic examination including a

  • Comprehensive neurologic exam

  • Screening neurologic exam

  • Neurologic examination in patients with altered level of consciousness

Preceptor evaluation

Quizzes

TBL IRAT/GRAT

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient write-up

TBL GAPP

Case Conference

Didactic conferences

Patient care

Role Modeling

Reading assignments

K1

C1, C2, C3

P1, P2, P3

2. Recognize and interpret abnormal findings on a neurological exam

Preceptor evaluation

Quizzes

TBL IRAT/GRAT

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient write-up

TBL  GAPP

Case Conference

Didactic conferences

Patient care

Role Modeling

Reading assignments

K1

C1, C2, C3

P1, P2, P3

3. Obtain and organize clinical data from a patient history and neurological exam to hypothesize lesion localization and neurologic diagnosis

Preceptor evaluation

Quizzes

TBL  IRAT/GRAT

NBME Shelf Exam

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient write-up

TBL  GAPP

Case Conference

Didactic conferences

Patient care

Role Modeling

Reading assignments

K1

C2, C3

P1, P2, P3

4. Explain the general principles differentiating lesions at the following levels

  • Cerebral hemisphere

  • Posterior fossa

  • Spinal cord

  • Nerve root/Plexus

  • Peripheral nerve (mononeuropathy, polyneuropathy, and mononeuropathy multiplex)

  • Neuromuscular junction

  • Muscle

Preceptor evaluation

Quizzes

TBL  IRAT/GRAT

NBME Shelf Exam

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient write-up

TBL GAPP

Case Conference

Didactic conferences

Patient care

Role Modeling

Reading assignments

K1

C1, C2, C3

P1, P2, P3

5. Demonstrate a systematic approach to the evaluation and differential diagnosis of patients who present with:

  • Focal weakness

  • Diffuse weakness

  • Clumsiness

  • Involuntary movements

  • Gait disturbance

  • Urinary or fecal incontinence

  • Dizziness

  • Vision loss

  • Diplopia

  • Dysarthria

  • Dysphagia

  • Acute mental status changes

  • Dementia

  • Aphasia

  • Headache

  • Focal pain

  • Facial pain

  • Neck pain

  • Low back pain

  • Neuropathic pain

  • Numbness or paresthesias

  • Transient or episodic focal symptoms

  • Transient or episodic alteration of consciousness

  • Sleep disorders

  • Developmental disorders

Preceptor evaluation

Quizzes

TBL IRAT/GRAT

NBME Shelf Exam

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient write-up

TBL  GAPP

Case Conference

Didactic conferences

Patient care

Role Modeling

Reading assignments

K1, K3

C1, C2, C3

P1, P2, P3

6.  Demonstrate a systematic approach to the evaluation and management of the following neurologic illnesses (either because they are important prototypes, or because they are potentially life-threatening):

  • Increased intracranial pressure
  • Toxic-metabolic encephalopathy and acute mental status change
  • Subarachnoid hemorrhage
  • Meningitis/Encephalitis
  • Status epilepticus
  • Acute stroke (ischemic or hemorrhagic)
  • Spinal cord or cauda equina compression
  • Head Trauma
  • Acute respiratory distress due to neuromuscular disease (e.g., myasthenic crisis or acute inflammatory demyelinating polyradiculoneuropathy, a.k.a Guillain-Barre Syndrome )
  • Temporal arteritis
  • Neuroleptic malignant syndrome
  • Amyotrophic Lateral Sclerosis
  • Brain Death
  • Primary and metastatic CNS tumors
  • Coma
  • Dementia (notably Alzheimer’s Disease)
  • Seizures
  • Multiple Sclerosis
  • Myasthenia Gravis
  • Migraine
  • Movement disorders (notably Parkinson’s Disease, essential tremor, tardive dyskinesia)
  • Myopathies (notably polymyositis) and Muscular Dystrophies
  • Cranial Neuropathies (notably Bell’s Palsy and third nerve palsy)
  • Peripheral Neuropathies
  • Acute (e.g. Guillain-Barre Syndrome)
  • Chronic (e.g. diabetic polyneuropathy, carpal tunnel syndrome)

Preceptor evaluation

Quizzes

TBL IRAT/GRAT

NBME Shelf Exam

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient write-up

TBL GAPP

Case Conference

Didactic conferences

Patient care

Role Modeling

Reading assignments

K1

C1, C2, C3

P1, P2, P3

7. Recognize the indication for and basic interpretation of ancillary studies including:

  • serological studies

  • electrophysiological testing

  • neuroimaging studies

  • neuropsychological testing

  • cerebrospinal fluid testing

Preceptor evaluation

Quizzes

TBL IRAT/GRAT

NBME Shelf Exam

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient write-up
TBL GAPP

Case Conference

Didactic conferences

Patient care

Role Modeling

Reading assignments

K2, K3

C1, C2,

P2

8. Establish professional relationships and effective communication with patients and their families.

Preceptor evaluation

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient care

Role Modeling

C2, C3

P2

9. Establish professional relationships and effective communication with other health care team members.

Preceptor evaluation

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient care

Role Modeling

K2, K3

C2, C3

P2

10. Work effectively with the broad, interdisciplinary team involved in patient care and appropriately incorporate their unique care skills.

Preceptor evaluation

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient care

Role Modeling

P2

11. Demonstrate the ability to act:

  • with honesty and integrity while maintaining ethical duties to patients and others

  • in a manner that is dependable, dedicated and punctual 

  • with patience, altruism and equanimity

Preceptor evaluation

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient care

Role Modeling

K1

C2,

P3

12. Demonstrate the ability to acquire and soundly manage knowledge, including:

  • Acknowledging when they don’t know something

  • Asking questions of others, where and when appropriate to do so

  • Carrying out reading directed by patient circumstances or other important topics

  • Effectively managing knowledge resources of different kinds, including those for ‘background’ and for ‘foreground’ knowledge

  • Sharing the yield of these learning efforts with others on the team, i.e. teaching and advocacy

Preceptor evaluation

Preceptor mid-rotation evaluation

Clinical formative feedback

Year 2 CDM course

Patient care

Role Modeling

C2, C3

P1, P2

13. Demonstrate the ability to seek out and listen to feedback on performance, accept it positively, and respond to it constructively by improving performance.

Preceptor evaluation

Preceptor mid-rotation evaluation

Clinical formative feedback

Patient care

Role Modeling