Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T23:39:35.119Z Has data issue: false hasContentIssue false
  • English
  • Français

Improving the Neurological Exam Skills of Medical Students

Published online by Cambridge University Press:  02 December 2014

Fraser G. A. Moore  and
Colin Chalk
Fraser G. A. Moore*
Affiliation:
Department of Neurology and Neurosurgery, McGill University, Montréal, Quebec, Canada
Colin Chalk
Affiliation:
Department of Medicine, Centre for Medical Education, McGill University, Montréal, Quebec, Canada
*
3755 Côte-Sainte-Catherine E-005, Montréal, Quebec, H3T 1E2, Canada.
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

Determine if distributed practice of neurological exam (NE) skills in first year medical school produces sustained improvements in the skills of second year students.

Methods:

A prospective, controlled, non-blinded study conducted at McGill University (class size = 180 students). Expanded teaching of muscle stretch reflexes was provided to first year medical students. A structured examination of muscle stretch reflexes (max score = 100) was administered in second year medical school after a required two week rotation in Neurology. Results for class A (received the intervention in first year) were compared to the results for the preceding class B (had not received the intervention).

Results:

77 of 177 (44%) eligible students in class A and 69 of 166 (42%) eligible students in class B participated. Results were analyzed separately for each of two examiners. Mean (SD) scores were 95.2 (5.6) for class A (intervention) and 81.7 (11.1) for class B (control) for the first examiner and 90.4 (8.2) for class A and 83.8 (11.7) for class B for the second examiner. Results were statistically significant (Mann-Whitney test z = 5.27, p < 0.0001 first examiner and z = 2.67, p < 0.0038 second examiner).

Conclusions:

Distributed practice of muscle stretch reflexes during first year medical school results in improved performance by second year medical students after their mandatory clinical rotation in neurology, even when examined up to 14 months after the intervention. This finding has implications for the teaching of the NE.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 1 , January 2012 , pp. 83 - 86
Copyright
Copyright © The Canadian Journal of Neurological 2012

References

1Moore, FGA, Chalk, C.The essential neurological examination. What should medical students be taught? Neurology. 2009;72: 2020–3.Google Scholar
2Donovan, JJ, Radosevich, DJ.A meta-analytic review of the distribution of practice effect: Now you see it, now you don’t. J Appl Psychol. 1999;84(5):795–805.Google Scholar
3Moulton, CAE, Dubrowski, A, MacRae, H, Graham, B, Grober, E, Reznick, R.Teaching surgical skills: What kind of practice makes perfect? A randomized, controlled trial. Ann Surg. 2006;244: 400–9.Google Scholar
4Mitchell, EL, Lee, DY, Sevdalis, N, et al.Evaluation of distributed practice schedules on retention of a newly acquired surgical skill: a randomized trial. Am J Surg. 2011;201:31–9.Google Scholar
5Stefanidis, D, Korndorffer, JR, Markley, S, Sierra, R, Scott, DJ.Proficiency maintenance: Impact of ongoing simulator training on laparoscopic skill retention. J Am Coll Surg. 2006;202: 599–603.CrossRefGoogle ScholarPubMed
6Kerfoot, BP, DeWolf, WC, Masser, BA, Federman, DD.Spaced education improves the retention of clinical knowledge by medical students: a randomised controlled trial. Med Educ. 2007;41:23–31.CrossRefGoogle ScholarPubMed