An Analysis of the COVID-19 Pandemic Impact on Neurology Clerkships

ABSTRACT

Objective: To identify the educational needs of students during their Neurology clerkship as COVID-19 altered clinical exposure to Movement Disorders patients at the University of Alabama at Birmingham (UAB). Background: In the pandemic, programs promoted a flipped classroom and an increase in telehealth opportunities for students [1]. To our knowledge, there has not been a comparison of clinical neurology exposure prior to and after the start of the pandemic. Methods: A survey was distributed to all current UAB third- and fourth-year medical students via email. The questionnaire inquired about clinical exposure, recognition of movement disorders, and preferred study materials. Students were divided into pre-COVID (5/2019-3/2020) and post-COVID (6/2020-1/2021) cohorts. Categorical variables were compared with a chi-squared test. Statistical analyses were performed using SPSS version 27.0.1.0 (IBM Corp., Armonk, NY) with significance defined as p < 0.05. Results: We received 63 responses, and 54 students qualified for inclusion. Overall, students in the post-COVID cohort had less exposure to movement disorders patients (p = 0.018). No students were exposed to telehealth, nor did they report interest in this experience. The post- COVID cohort was less likely to experience Huntington's disease (p = 0.003), dystonia (p = 0.028), or functional movement disorders (p = 0.012). Despite the varied experiences, both groups expressed similar capability diagnosing and treating movement disorders, with the exception of diagnosing Huntington's disease (p = 0.051, which approached significance). Conclusion: In this pilot survey, students who completed their Neurology clerkship during the pandemic reported less overall exposure to movement disorders, and specifically with uncommon disorders. This is not surprising, given the restrictions that went into effect as the pandemic began (limited learners in clinic, less inpatient experience, etc.). Regardless, both groups felt capable diagnosing and treating movement disorders, highlighting the importance of supplemental materials. There were several limitations to this study, including a small sample size, recall bias, and varying experiences across branch campuses. Future studies could evaluate the usefulness of incorporating educational materials (such as online modules) into curriculums.