NeuroQ: A neurophobia screening tool assesses how roleplay challenges neurophobia

Neurophobia among students and interns at the Abidjan Faculty of Medicine (Côte d'Ivoire)

Introduction

As defined by Jozefowicz in 1994, neurophobia is the fear of neuroscience and clinical neurology. We carried out this study, the first on neurophobia in the Ivory Coast, in order to assess its prevalence among medical students and interns in the Ivorian environment, to identify the factors involved and to propose solutions.

Methodology

This was a prospective cross-sectional study carried out during the 2022-2023 academic year at the Abidjan UFR of Medical Sciences. The study population consisted of all students in years 3ème to 6ème and hospital interns. The Schon questionnaire, transcribed using google form software, was sent to students using the "wathsapp" social network.

Result

We obtained 284 responses, i.e. 23 % of all respondents (n = 1228). The sex ratio was 1.65 in favour of men. The subjects considered that they had a level of competence in neurology higher than 6 of the nine specialities selected. These were nephrology, cardiology, rheumatology, endocrinology, psychiatry and geriatrics. Neurology was considered more difficult than cardiology, endocrinology, psychiatry and geriatrics. Subjects' level of knowledge in neurology was rated higher than in nephrology, cardiology, rheumatology, endocrinology, psychiatry and geriatrics. The subjects' level of interest in neurology was higher than in the other specialities. 27.46 % of subjects surveyed were neurophobic.

Conclusion

The impact of neurophobia remains harmful to public health, as it is a factor in the sub-optimal management of patients with neurological disorders.

Neurology Undergraduate Medical Education: A Scoping Review

PURPOSE

To map the current literature on undergraduate neurology medical education and research. Recommendations for future undergraduate neurology education and research are described.

METHOD

PRISMA-Scoping Review guidelines and Arksey and O'Malley's methodological framework are followed. Four databases and gray literature was searched with Oxford Evidence-Based Medicine level of evidence applied. A thematic framework was used to identify the main study outcomes. A narrative description and quantitative frequency analysis were used for results.

RESULTS

Nine-hundred and twenty-two articles were retrieved, 102 studies met the inclusion criteria. We identified four main study outcomes using a thematic framework. Our review found that (1) the main undergraduate neurology teaching styles are didactic and experiential teaching methods. (2) Research design of undergraduate neurology teaching is heterogenous. (3) The outcome measures most frequently used in undergraduate neurology research are student perception and knowledge.

CONCLUSION

Undergraduate neurology education research is challenging due to the heterogeneity in research design and teaching methodology. Evidence-based guidelines are limited. This gap in the literature represents an opportunity to develop tailored guidelines for undergraduate neurology education and research.

Investigation of Neurophobia amongst North American Veterinary Students and Development of a Veterinary Neurophobia Scoring Tool (VetNeuroQ)

"Neurophobia" is a phenomenon in human medical education where students develop negative attitudes towards neurology, impeding student learning and future clinical practice. While suspected to exist in veterinary medical education, it remains unstudied. The main objectives of this study were to examine North American veterinary student attitudes towards neurology and neurology education and explore elements that might contribute to neurophobia. Additional objectives were to evaluate veterinary educators' perceptions of student neurophobia and to develop and validate a scoring tool (VetNeuroQ) to quantify veterinary neurophobia. Veterinary students and faculty at North American veterinary schools were surveyed. A scoring tool was developed from a subset of questions and validated using confirmatory factor analysis. Six hundred six anonymous responses were collected from students at all stages of veterinary education. Neurology training was reported as insufficient by 35.9% and most respondents perceived neurology to not be easy to learn. Neuroanatomy/physiology and neurolocalization were considered difficult concepts. Students rated low confidence in neurology (vs. other topics), and low interest in the Neurology/Neurosurgery specialty. 61.7% of educators reported neurophobia amongst their students. The proposed VetNeuroQ scale showed high reliability (Cronbach's alpha >0.7) and validity (p < .05; CFI >0.9, RMSEA <0.08). VetNeuroQ scores were low but improved over the course of veterinary education. These findings demonstrate low self-efficacy, interest, and confidence, along with perceptions of difficulty, amongst veterinary students, consistent with neurophobia. Contributing elements are discussed. The VetNeuroQ scale allows quantification of veterinary student neurophobia and may be useful for screening students and assessing the impact of educational interventions.

Report from the child neurology education and training workshop at the International Child Neurology Congress 2024: Expert'saddressing the training gap

This report summarizes the key findings of a workshop undertaken at the International Child Neurology Congress in 2024 by child neurologists with expertise in training education and invested colleagues. The workshop aimed to explore global issues which have impact on access to child neurology training. The major findings supported a great need for more training programs globally, that consensus is needed for the minimum standards of training, and that training programs can be strengthened via global health partnerships especially with collaborations from regions with more available resources. The group concurred that the phenomena of 'neurophobia' amongst general paediatricians and medical trainees, was a reality, and creates barriers both working with paediatric colleagues, as well as recruiting specialists to the field. Optimal teaching practices for child neurology should include the expansion of learning through global partnerships and virtual educational resources. Measures must be put into place for fledgling training programs, to support colleagues in less resourced settings and to avoid their burn-out. Collegial and collaborative work is essential to support the future of child neurology across the globe, both to reach the current capacity needs but also to meet the necessary growth in the field.

Attitudes of physiotherapy students toward neurology: does "neurophobia" exist among physiotherapy students?

BACKGROUND

Evidence is accumulating that medical students and practitioners have particular difficulty in neurology and have neurophobia. However, little is known about attitudes toward neurology in physiotherapy students.

PURPOSE

This study aimed to assess the attitudes of physiotherapy students toward neurology and compare it with other core specialties, identify contributors to difficulties of neurology, and obtain feedback for improving the quality of neurology and neurological rehabilitation education.

METHODS

A structured survey was distributed to final-year physiotherapy students in different universities across Turkey. Perceived level of knowledge, confidence, interest, difficulty, and desire to pursue a career in four main physiotherapy specialty areas (neurology, musculoskeletal, cardiopulmonary, and pediatric) were assessed. Reasons for perceived difficulty and ways to improve neurological physiotherapy education were asked by Likert-type and open-ended questions.

RESULTS

Three hundred ninety-one students participated from 12 universities. Neurology was perceived as the most challenging discipline (p < .001), but a lack of knowledge, interest, and confidence were not reported. The reasons for perceived difficulties with neurology were the need-to-know basic neuroanatomy and neurophysiology, difficulty integrating information into the clinic, and the complexity of the subject. To improve learning, most students recommended increasing clinical teaching, including bedside tutorials, exposure to more patients, and case discussions.

CONCLUSION

Physiotherapy students considered neurology as the most challenging discipline. Improving the integration of basic neurosciences into the clinic may improve neurology learning along with increased clinical teaching.

Education Research: Monitoring and Tracking Neurophobia: Evidence From a Temporal Analysis of Brazilian Medical Schools

Background and Objectives

Neurologic disorders are common medical conditions. However, even with a higher demand for neurologic care, the capacity to train neurologists is impaired. The fear of neurosciences/neurology by medical students, known as neurophobia, may cause multiple adverse effects in neurologic assistance. The objectives of this study were to estimate the current prevalence and characteristics of neurophobia in medical students in Brazil and to compare neurophobic symptoms at 2 time points.

Methods

This is a cross-sectional study conducted with students from 4 medical schools in Pará, Brazil, who matriculated into the preclinical stage, clinical stage, and internship were submitted to a questionnaire to assess the perception of clinical specialties, including neurology. Reasons for neurophobia, probable strategies to improve neurologic education, and a specific scale to detect neurophobia were also evaluated. Furthermore, we performed a temporal comparison of current results with those from a previous study from 2015.

Results

Neurophobia was detected in 63.3% of medical students. The perception of the difficulty in neurology/neurosciences was very high in all stages, and the perception of interest and quality of teaching worsened during the internship. The need to understand neuroanatomy and neurophysiology was cited as the most important reason for neurophobia. More and better bedside tutorials were the most mentioned suggestion to improve neurologic education. The temporal comparison between 2015 and 2022 showed that the level of knowledge, quality of teaching, and likelihood of pursuing a career in neurology has become more favorable in 2022.

Discussion

The prevalence of neurophobia in Brazil was higher than that in high-income countries. Unfavorable opinions about neurology tended to increase throughout the medical course, but the temporal comparison showed that the impact of neurophobia has decreased. Surveillance systems for monitoring and tracking neurophobia should be implemented in medical schools.

Perception of neurology among undergraduate medical students - what can be done to counter neurophobia during clinical studies?

BACKGROUND AND PURPOSE

With a global increase in the burden of neurological diseases, the aversion towards neurology (neurophobia) may challenge the sufficient provision of new specialists in this field. We investigated the possible determinants of neurophobia among medical students and its influence on the intent to pursue neurology residency.

METHODS

From September 2021 to March 2022, an online questionnaire was distributed to medical students in Lithuania. It included questions about knowledge, confidence, interest, and teaching quality of various medical specialties (including neurology), as well as the willingness to choose neurology for residency.

RESULTS

Eight hundred fifty-two students responded to the survey (77.2% female) - they rated neurology as significantly more difficult than other medical areas and lacked confidence in assessing patients with neurological problems (p < 0.001). However, neurology was selected as one of the most interesting subjects and was reportedly well-taught. The prevalence of neurophobia among respondents was 58.9%. Most of them (207, 87.7%) indicated that neurology professors positively affected their outlook towards this medical specialty - such experience was associated with lower odds of neurophobia (odds ratio (OR) = 0.383, 95% confidence interval (CI) = 0.223 to 0.658). Being less neurophobic (OR = 1.785, 95% CI = 1.152 to 2.767) and having conducted neurology research (OR = 2.072, 95% CI = 1.145 to 3.747) increased the odds of a student being willing to pursue a career in neurology.

CONCLUSION

Neurophobia was frequent among students in Lithuania and was inversely related to the positive influence by neurology professors. Together with previous research experience in the field, low levels of neurophobia were associated with the inclination to enter neurology residency.

Attitudes towards the neurological examination in an unwell neonate: a mixed methods approach

Background

The neurological examination of an unwell neonate can aid management, such as deciding if hypothermia treatment is warranted in hypoxic ischaemic encephalopathy or directing investigations in hypotonic neonates. Current standardised examinations are not designed for unwell or ventilated neonates, and it is unclear how confident paediatricians feel about the examination or what aspects they perform. 

Aim

This study aimed to review the confidence of UK paediatricians on the neurological examination in unwell neonates, describe their attitudes towards it, and determine what could improve practice.

Methods

An explanatory sequential mixed methods approach (QUAN → QUAL) with equal weighting between stages. A survey on attitudes to the neonatal neurological examination was sent to all UK neonatal units and members of the British Paediatric Neurology Association. Volunteers were sought for semi-structured interviews. Thematic analysis was used to interpret qualitative data, which was triangulated with quantitative questionnaire data.

Results

One hundred ninety-three surveys were returned, 31.0% from neonatologists, 9.3% paediatric neurologist. The median range for confidence was 4 (IQR3-5). Twenty-three interviews occurred. Thematic analysis revealed three themes: “Current culture on neonatal units”, “ Practicalities of the neurological examination in unwell neonates”, and “Changing the culture”. Most interviewees did not feel confident performing or interpreting the neurological examination in unwell neonates. Many units had a culture of seeing it as low priority, did not see its relevance in the acute management of unwell neonates. A few interviewees worked in units with a positive culture towards the neurological examination who used adapted standardised examinations and provided training. 72% of questionnaire responders wanted a new standardised neurological examination designed for the unwell neonate, which should be short, utilise pictures like the Hammersmith Neonatal Neurological Examination, contain an assessment of consciousness, be developmentally appropriate and achievable in unwell, ventilated neonates, be accompanied by a schematic to aid interpretation, and for greater training and assessments of competence.

Conclusions

There are barriers preventing paediatricians being able to perform a neurological examination in unwell neonates, and a culture of neurophobia is common. A new standardised examination is needed, alongside aids to interpretation, training, and assessment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03616-4.