ABSTRACT
A functional disorder is a constellation of bothersome physical symptoms that compromise regular function but for which there is no identifiable organic or psychiatric pathology. Functional disorders can present with various symptoms. Common forms of functional disorders include functional neurologic symptom disorder (also referred to as "conversion disorder"), functional gastrointestinal disorders, chronic pain syndromes, and chronic fatigue. One-third to one-half of outpatient consultations in many practices are due to functional disorders. Functional disorders must be distinguished from structural and psychiatric disorders but should not be considered diagnoses of exclusion. Recovery is facilitated by good relationships between patients and practitioners, with good explanations of the pathophysiology of functional disorders and effective encouragement and education of patients.
Subject(s)
Chronic Pain , Conversion Disorder , Fatigue Syndrome, Chronic , Gastrointestinal Diseases , Adolescent , Chronic Pain/diagnosis , Chronic Pain/etiology , Chronic Pain/physiopathology , Chronic Pain/therapy , Conversion Disorder/diagnosis , Conversion Disorder/etiology , Conversion Disorder/physiopathology , Conversion Disorder/therapy , Diagnosis, Differential , Fatigue Syndrome, Chronic/diagnosis , Fatigue Syndrome, Chronic/etiology , Fatigue Syndrome, Chronic/physiopathology , Fatigue Syndrome, Chronic/therapy , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/physiopathology , Gastrointestinal Diseases/therapy , Humans , Physician-Patient Relations , Professional-Family RelationsABSTRACT
Among medical students, neurosceince is considered a notoriously difficult subject. This challenges faculty to teach preclinical neurology in more engaging, efficient, and prioritized ways. Traditional approaches to neuroscience instruction typically begin with neuroanatomy and advance to clinical problem solving after this foundation of knowledge is in place. Over the past 45 years, neurology faculty at Mayo Clinic Alix School of Medicine have developed and iteratively refined an inverted approach called The Basic Four. The Basic Four uses authentic clinical scenarios as the basis for neuroscience instruction and incorporates principles from cognitive load theory to calibrate load on students' working memory. This perspective describes The Basic Four and illustrates how cognitive load theory can be used to enhance case-based learning.
