Evaluation of an introductory course in neurology.

The aim of this study was to distinguish factors which may influence student perception of what constitutes a good introductory course in clinical neurology. This should lead to the development of improved teaching techniques. Previous work has shown that even those students who retain accessible knowledge of preclinical subjects, such as neuro-anatomy, find it difficult to use this in a clinical context. This study is preliminary to looking at correlations between student perception of what they like about a clinical topic and the ability to integrate clinical knowledge with pre-existing knowledge structures. The evaluation was carried out on 36 fifth year students who were taught clinical neurology in small groups concurrently with another topic, clinical decision making (CDM), by the same teacher. Neurology consistently rated at over 80% for enjoyment, interest and perceived clinical relevance. This contrasted with low ratings of less than 25% on all these parameters for CDM. An analysis of teaching methods showed that in neurology, contrasting with CDM, procedural rules were supplied for the application of preclinical knowledge at the bedside, students had an opportunity for active participation and problem solving in class, as well as frequent patient interaction. All these factors are important for student acceptance of a course, but further studies are needed to look at the interplay of preclinical knowledge and the acquisition of clinical expertise. The findings of this preliminary work may have significant implications for curriculum planners when developing introductory clinical courses.