NeuroLytes: Developing Clinical Reasoning for Medical Students on the Neurology Clerkship

ABSTRACT

Objective: Evaluate the role of virtual case-based discussions lead by neurology residents at supplementing the standard didactic series in the neurology clerkship. Background: COVID-19 created a new barrier to medical education by reducing trainee participation in patient care. Neurophobia is still present in up to 50% of medical students. To encourage critical thinking, we developed a series of virtual case-based resident-led discussions ('NeuroLytes'), simulating neurological cases. Design/Methods: Second and third year medical students were enrolled in NeuroLytes during their neurology clerkship. Each rotation was divided into two groups (one group participating earlier). Each group received a virtual case discussion weekly (migraine and multiple sclerosis (MS)). Both groups completed surveys regarding perception of the experience and a quiz of 10 questions regarding case knowledge, followed by 7 questions regarding confidence on clinical reasoning. Results: 108 students participated in NeuroLytes. Over 96% of students that discussed both cases had a score ≥7/10 in knowledge questions compared with 72.9% of students that did not attend any cases (p=0.005). Over 80% of students that participated in NeuroLytes felt confident in identifying clinical findings of neurological diseases compared to 52.2% of students who had not (p=0.026). Students who participated in NeuroLytes also felt more comfortable building a preliminary differential diagnosis after receiving an initial patient history (90.3% compared to 69.6%, p=0.052). Conclusions: Medical students participating in NeuroLytes reported perceived improvement in formulating differentials and identifying common neurological diseases. Virtual case-based discussions could be an effective supplemental learning tool for developing clinical reasoning.