Curriculum

Clinical Neurology Clerkship

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

Clerkship Description: During the Neurology Clerkship you will gain experience and understanding of most common neurological disorders that affect the population, in both ambulatory and inpatient clinical settings.

Boonshoft SOM Educational Objectives/Competencies

Code

What competencies / milestones will this unit address?  

Foundational Knowledge – Medical Knowledge: Master fundamental biomedical concepts, terms, processes, and system interactions

1.1A

Apply knowledge of the expected changes in organ function as well as normal physiologic changes across the lifespan into the care of patients with core medical problems

1.1B

Describe how the altered structure and function of the body and its major organ systems are manifest through major diseases and conditions

1.1C

Describe the scientific basis for the diagnostic tests used in medicine

Foundational Knowledge – Medical Knowledge: Describe the determinants of health

1.2A

Using available data, compare and describe the health status of the U.S. to the health status of other countries for key health indicators

1.2B

Identify determinants of health, risk factors and protective factors that influence the diagnosis of a specific patient with a health condition

Foundational Knowledge – Medical Knowledge: Utilize evidence in making clinical decisions

1.3A 

Develop a clinical question, identify relevant research findings, critically evaluate the validity and reliability of that research, and apply the findings to the care of patients

1.3B

Incorporate pertinent biomedical information and research findings into clinical decision making and identify barriers to implementation

1.3C

Apply basic statistical approaches to clinical situations

Application – Patient Care (Clinical Skills): Conduct patient interviews and physical examinations

2.1A

Independently conduct an organized, comprehensive history and physical and recognize common abnormal findings

2.1B

Independently conduct a focused, prioritized history and physical

Application – Patient Care (Clinical Skills): Diagnose patient health problems

2.2A

Prioritize a differential diagnosis by applying knowledge of the basic sciences and pathophysiology

2.2B

Propose appropriate ancillary diagnostics and summarize diagnostic results

Application – Patient Care (Clinical Skills): Propose evidence-based health maintenance and therapeutic treatments

2.3A

Develop a cost-effective plan of care under supervision

2.3B

Identify and select relevant, evidence-based health promotion and education tools, as well as materials for common acute and chronic conditions encountered in the clinical setting

2.3C

Demonstrate the ability, under supervision, to perform basic medical procedures 

Integration – System-Based Practice: Connect knowledge of patient populations and health delivery processes in making diagnoses and therapeutic recommendations

3.1A

Describe the reporting process for disease surveillance

3.1B

Describe the epidemiologic investigation process

3.1C

Identify available community resources to improve the health of individuals and populations

Integration – System-Based Practice: Advocate for the humane, just, safe and prudent care of persons

3.2A

Demonstrate behavior that conveys caring, honesty, genuine interest and tolerance when interacting with a diverse population of patients and families

3.2B

Recognize the impact of contextual factors on patient care

3.2C

Recognize the importance of effective communication in the prevention of medical errors

Integration – System-Based Practice: Adapt to the complex economic and social structure of health care delivery

3.3A

Recognize how the health care delivery system in which one works affects patient care

3.3B

Recognize the improvements in systems can enhance quality of care and identify strategies to improve systems of care

Human Dimension – Personal and Interpersonal Professional Development Goals: Reflect upon one’s personal strengths and weaknesses to make changes in one’s behavior

4.1A

Seek and integrate feedback from patients, peers and faculty to better understand one’s development as a physician and as a member of the health care team

Human Dimension – Personal and Interpersonal Professional Development Goals: Find one’s own meaning in medicine

4.2A

Develop the skill of self-reflection and apply the insights to one’s professional 

Human Dimension – Personal and Interpersonal Professional Development Goals: Take care of oneself

4.3B

Engage in formal and informal self-awareness practices

4.3C

Demonstrate flexibility within the dynamic medical environment

Human Dimension – Personal and Interpersonal Professional Development Goals: Deliver effective patient presentations and document accurately in the medical record

4.4A

Present patient encounters accurately and succinctly

4.4B

Document patient encounters accurately in a timely, focused, and prioritized way

4.4C

Document supervised procedures accurately and succinctly in the medical record

Human Dimension – Personal and Interpersonal Professional Development Goals: Communicate and work effectively with others

4.5A

Seek feedback on one’s communication skills

4.5B

Effectively assimilate into the appropriate role and contribute to the health care team

4.5C

Communicate with patients and families in a timely, clear, empathetic, and humble manner

Human Dimension – Personal and Interpersonal Professional Development Goals: Demonstrate leadership skills in a variety of settings

4.6A

Meaningfully contribute to the clinical team

Caring/Valuing – Professionalism Goals: Value and behave in a manner consistent with the highest ethical standards of the profession

5.3A

Demonstrate the highest standards of individual and team-based ethical behavior that is patient centered, culturally sensitive, and socially just

5.3B

Apply knowledge of medical ethics to clinical situations

Learning How to Learn – Practice-Based Learning:Appropriately utilize evidence-based resources to address uncertainty in medicine and gaps in knowledge/skills

6.3A

Identify appropriate resources to address uncertainty in medicine and gaps in knowledge/skills

Clerkship-Level Objectives

Code What are the clerkship-level objectives for this course?  

Boonshoft SOM
Objectives

LO1

Frame a patient encounter in an organized fashion, reinforcing etiology, pathophysiology, clinical manifestations, localization, diagnostic strategies and therapeutic interventions.

1.1abc, 2.1a

LO2

Explain disease specific treatment strategies and associated prognosis and complications.

1.1abc, 2.1b

LO3

Understand the general clinical principles underlying neurologic localization. This includes the differentiation of lesions at the following levels of the nervous system: cerebral hemisphere (frontal, parietal, temporal, occipital), posterior fossa (midbrain, pons, medulla, cerebellum), spinal cord (cervical, thoracic, lumbar), nerve root (cervical, lumbar), peripheral nerve (mononeuropathy, polyneuropathy, and mononeuropathy multiplex), neuromuscular junction, muscle.

1.1abc

LO4

Evaluate patients’ presenting clinical problems, including: (transient or episodic focal symptoms, transient or episodic alteration of consciousness, focal or diffuse weakness, clumsiness, gait disturbance, involuntary movements, dizziness, vision loss, diplopia, dysarthria, dysphagia, aphasia, acute mental status changes, dementia, headache, facial pain, neck pain, low back pain, numbness or paresthesias, common developmental disorders).

1.1ab, 2.1a

LO5

Diagnose and manage patients with acute and chronic conditions including:  increased intracranial pressure, acute mental status change, meningitis/encephalitis, status epilepticus, acute stroke (ischemic or hemorrhagic), spinal cord compression, head trauma, acute respiratory distress due to neuromuscular disease, temporal arteritis, amyotrophic lateral sclerosis, brain death, primary and metastatic CNS tumors, coma, dementia (notably Alzheimers disease), seizures, multiple sclerosis, migraine, movement disorders (notably Parkinson disease, essential tremor, tardive dyskinesia), myopathies (notably polymyositis) and muscular dystrophies, myasthenia gravis, cranial neuropathies, peripheral neuropathies ( acute and chronic)).

1.1ab, 2.1ab, 2.2ab, 2.3c

LO6

Apply the fundamentals of neurological care to coordinate the care of patients with neurological disease.

1.1ab

LO7

Demonstrate systematic approach to patients with neurological disease utilizing sound skills in gathering components of the neurologic history, general physical and neurologic exams. Demonstrate an organized approach to the neurologic exams in patients with normal as well as altered mental status.

2.1ab, 4.4a

LO8

Demonstrate appropriate interpretation of labs and testing.

2.2b

LO9

Begin to formulate diagnostic reasoning, and justify therapeutic decision-making.

1.3abc, 2.2ab, 2.3ab

LO10

Demonstrate clear and concise oral presentations and written documentation reflecting a systematic approach to patients with neurological disease.

2.1ab, 4.4abc

LO11

Identify the social determinants of health for a specific patient, and develop a plan to coordinate care to include community resources to try to improve the health of the individual.

1.2ab, 31.abc, 3.2abc

LO12

Consider patient, physician, and system barriers to successfully negotiate treatment plans and patient adherence; and identify strategies that may be used to overcome these barriers.

1.2b, 3.1bc, 3.2abc

LO13

Identify the role of each team member to the care of the patient, and call on interdisciplinary resources to provide optimal and comprehensive care.

3.3ab, 4.5bc, 4.6a

LO14

Establish professional relationships and effectively communicate with patients, their families, instructors, colleagues and staff.

4.1a, 4.3c, 4.5abc, 4.6a

LO15

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

4.1a, 4.3c, 4.5b, 4.6a

LO16

Demonstrate the ability to act with honesty/integrity while maintaining ethical duties to patients and others.

5.3ab

LO17

Demonstrate the ability to act in a manner that is dependable, dedicated and punctual.

5.3a

LO18

Demonstrate the ability to act with patience, altruism and equanimity.

5.1a, 4.1a, 4.6c

LO19

Recognize when additional information is needed to care for the patient and demonstrate ongoing commitment to self-directed learning.

6.3a

LO20

Demonstrate effective skills in navigating the medical literature to answer clinical care questions.

6.3a

LO21

Demonstrate the ability to acquire and soundly manage knowledge, identify knowledge deficiencies and create a plan for knowledge gains

4.2a, 6.3a

LO22

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

4.5a, 4.3bc, 4.1a

To review all Boonshoft SOM Educational Milestones please visit the Educational Milestones page.  

Required Clinical Experiences

Clerkship/Clinical discipline

Patient type/Clinical condition

Clinical setting

Level of student responsibility

Neurology

Neurocognitive Disorders

Inpatient

Moderate

Neurology

Psychiatric Condition

Ambulatory/inpatient

Moderate

Neurology

Substance Abuse

Ambulatory/inpatient

Moderate

Neurology

Change in strength or movement

Ambulatory/inpatient

Moderate

Neurology

Headache

Ambulatory/inpatient

Moderate

Neurology

Obtundation/Stupor or Coma

Inpatient

Moderate

Neurology

Sensory change (numbness, dizziness, pain, &/or neglect)

Ambulatory/inpatient

Moderate

Neurology

Seizure

Ambulatory/inpatient

Moderate

Neurology

Stroke

Ambulatory/inpatient

Moderate

Neurology

Visual change (blurred vision, visual loss, double vision)

Ambulatory/inpatient

Observation

Observation: Student is observing encounter

Moderate Participation: Student completes the History and Physical(either complete or focused) and participates in the differential diagnosis. (*Student directly interacts with the patient)

Full Participation: Student completes History and Physical (either complete or focused), participates in the differential diagnosis, and then completes a therapeutic treatment plan, which can include documentation.

For procedures:

            Observation

            Assisted in the procedure

            Fully performed the procedure

 

Last edited on 07/12/2018.