Stanford University, Palo Alto, CA, USA.
Wake Forest, Winston-Salem, NC, USA.
Acad Psychiatry. 2021 Apr;45(2):185-189. doi: 10.1007/s40596-020-01324-8. Epub 2020 Oct 14.
Psychiatry training is lacking examples of neuroscience education that translates neuroscience literature into accessible clinically oriented concepts. The authors created a teaching activity using patient-centered neuroscience education that focused on delivering the diagnosis of functional neurological disorder (FND). This study aimed to (i) develop a workshop modeling a clinician-patient interaction, (ii) provide a modern neuroscience perspective of FND, and (iii) evaluate the change in clinicians' perceptions of FND.
A total of six workshops (each 1 h long and consisting of a video, PowerPoint slides, and pre and post questionnaires) were conducted. Paired t tests were used to measure the change.
Forty-seven clinicians participated. After completing the workshop, nearly all endorsed that functional symptoms are "real" (95%) and that treatment is helpful (100%). Participants also reported a greater comfort level with discussing FND diagnosis (46% vs 85%, p < 0.001), an overall increase in understanding the disorder (33% vs 82%, p < 0.001), assessing need for tests (33% vs 66%, p < 0.001), understanding treatment options (26% vs 89%, p < 0.001), and recognition that treatment can help control these symptoms (81% vs 100%, p < 0.01). In addition, learners were more likely to report that patients with FND are truthful (75% vs 95%, p < 0.001) and less likely to be manipulative (48% vs 80%, p < 0.001).
A brief, educational intervention using neuroscience-based content was found to significantly improve clinicians' perception and confidence when delivering the diagnosis of FND.
精神科培训缺乏将神经科学文献转化为易于理解的临床导向概念的神经科学教育范例。作者创建了一项使用以患者为中心的神经科学教育的教学活动，重点是提供功能性神经障碍（FND）的诊断。本研究旨在：（i） 模拟医患互动的研讨会，（ii） 提供 FND 的现代神经科学观点，以及（iii） 评估临床医生对 FND 的看法的变化。
共进行了六次研讨会（每次 1 小时，包括视频、PowerPoint 幻灯片以及预诊和复诊问卷）。使用配对 t 检验来衡量变化。
共有 47 名临床医生参加了研究。完成研讨会后，几乎所有参与者都认为功能性症状是“真实的”（95%），治疗是有帮助的（100%）。参与者还报告说，他们更愿意讨论 FND 诊断（46% 对 85%，p < 0.001），对疾病的总体理解有所提高（33% 对 82%，p < 0.001），评估测试需求（33% 对 66%，p < 0.001），理解治疗选择（26% 对 89%，p < 0.001），以及认识到治疗可以帮助控制这些症状（81% 对 100%，p < 0.01）。此外，学习者更有可能报告 FND 患者是诚实的（75% 对 95%，p < 0.001），而不太可能是操纵者（48% 对 80%，p < 0.001）。
使用基于神经科学的内容进行简短的教育干预，发现可显著改善临床医生在提供 FND 诊断时的看法和信心。
