ABSTRACT
Introducción: Definimos neurofobia como el miedo a las neurociencias y la neurología clínica, fundamentalmente asociado a la falta de capacidad del estudiante para aplicar sus conocimientos teóricos. Esta sensación, bien contrastada en el sistema anglosajón, ha sido poco estudiada en otros territorios europeos y nunca en nuestro país. Nuestro objetivo es analizar si este miedo hacia la neurología también existe entre estudiantes de una universidad española. Material y métodos. Estudio mediante encuestas autoadministradas a estudiantes de segundo, cuarto y sexto año de medicina de la Universidad de Zaragoza durante los cursos académicos 2020-2021 y 2021-2022. Cuestionario de 18 preguntas que recoge la percepción hacia la neurología y el resto de las neurociencias y su comparación con respecto a otras especialidades médicas. Resultados: De los 320 encuestados, el 34,1% sufriría neurofobia y tan sólo el 31,2% tendría claro a qué se dedica un neurólogo. A pesar de ser la especialidad considerada más difícil, es también la que mayor interés despierta. Los principales motivos para ese miedo son una enseñanza eminentemente teórica (59,4%), la neuroanatomía (47,8%) y una falta de integración entre las asignaturas de neurociencias (39,5%). Las soluciones consideradas de mayor peso por los alumnos para revertir esta situación irían en esa línea. Conclusiones: La neurofobia es también un problema en la formación universitaria española. Identificada la metodología docente como una de sus causas fundamentales, los neurólogos tenemos la oportunidad y la obligación de intentar revertir esta situación. Para ello, será necesario participar activamente en la formación de los futuros médicos desde las etapas más tempranas del grado.(AU)
Introduction: Neurophobia is defined as the fear of the neural sciences and clinical neurology that is due to the students inability to apply their knowledge of basic sciences to clinical situations. This phenomenon, well documented in the Anglosphere, has seldom been studied in other European countries and never in our country. Our study aimed to determine whether said fear existed among Spanish medical students. Material and methods: A self-administered questionnaire with 18 items was sent to medical students in the second, fourth and sixth years of medical school at a Spanish university during the academic years 2020-2021 and 2021-2022. They were questioned about their fears regarding neurology and neurosciences, causes and potential solutions. Results: Out of 320 responses, 34.1% suffered from neurophobia and only 31.2% felt confident they knew what neurologists do. Despite Neurology being considered the most difficult discipline, it did also arouse the most interest among the students. Main reasons identified for neurophobia were too theoretical lectures (59.4%), neuroanatomy (47.8%), and a lack of integration between neuroscience subjects (39.5%). Solutions considered most important by the students to reverse this situation went along those lines. Conclusion: Neurophobia is prevalent among Spanish medical students too. Having identified the teaching methodology as one of its fundamental causes, neurologists have the opportunity and obligation to reverse this situation. We should strive for more proactive involvement of neurologists at earlier stages of medical education.
Subject(s)
Humans , Male , Female , Young Adult , Adult , Students, Medical , Neurosciences , Fear , Phobic Disorders , Universities , Spain , Neurology , Nervous System Diseases , Surveys and Questionnaires , Neuropsychiatry , Cross-Sectional StudiesABSTRACT
ABSTRACT Background: The olfactory nerve has never been the shining star of neurological examination. Quite the contrary, examining the first cranial nerve is often an overlooked step. As cases of anosmia secondary to COVID-19 infection continue to rise, the 2020 pandemic has shed new light on this much-forgotten nerve, its value as an aid to diagnosis of several diseases and its central role in our daily lives. Objective: We aimed to emphasize how essential and simple clinical examination of the olfactory system can be by highlighting practical techniques and clinical tips for its assessment. We also share pearls and pitfalls in localization and differential diagnosis, which may prove valuable to busy clinicians. Methods: A broad review of the literature was conducted by searching PubMed, Cochrane and Google Scholar for articles and books containing topics regarding examination of the olfactory nerve and its anatomy, physiology and pathology. No particular inclusion or exclusion criteria were used. Results: Forty different works were found, between books and articles, from which 20 were selected after careful analysis. Conclusions: Despite the tragedy and adversity that followed the COVID-19 pandemic, its legacy has taught us a crystal-clear lesson: olfaction should no longer be neglected in clinical practice.
RESUMO Antecedentes: O nervo olfatório nunca foi a estrela do exame neurológico. Pelo contrário, o exame desse nervo craniano é um passo frequentemente ignorado. No entanto, o aumento exponencial de casos de anosmia secundária a COVID-19 o colocou sob os holofotes, tanto em relação á sua função para o ser humano em sociedade, como seu papel no auxílio do diagnóstico de diversas patologias. Objetivos: Enfatizar quão importante é examinar o nervo olfatório e compreender as desordens do seu sistema. Ressaltamos pérolas clínicas e erros comuns no exame deste nervo, além dicas que possam auxiliar no diagnóstico de uma série de doenças neurológicas e sistêmicas. Métodos: Uma ampla revisão da literatura foi conduzida por meio de busca no PubMed, Cochrane e Google Acadêmico por artigos e livros relacionados aos tópicos do exame físico, fisiologia, anatomia e patologia do nervo olfatório. Não foram utilizados critérios específicos de inclusão ou exclusão. Resultados: Foram encontrados 40 artigos itens relacionados na língua inglesa, dentre os quais livros e artigos, tendo sido analisados e selecionados um a um até o total de 20 referências. Conclusões: Apesar da tragédia e adversidade trazidas pela pandemia de COVID-19, uma lição clara permanece: o olfato não deve mais ser negligenciado na prática clínica.
Subject(s)
Humans , Animals , Anseriformes , COVID-19 , Olfaction Disorders/etiology , Olfactory Nerve , Pandemics , SARS-CoV-2ABSTRACT
Resumen La exploración neurológica (EN) es la herramienta clínica más importante con que se cuenta en medicina para la detección y diagnóstico de las enfermedades del sistema nervioso. Como en muchas áreas de la medicina, la integración de los datos clínicos obtenidos mediante la EN con los conocimientos neuroanatómicos y neurofisiológicos resulta de vital importancia para la correcta interpretación de la EN. Para el estudiante de medicina, con frecuencia la EN, y en general las materias relacionadas con las neurociencias, son conceptualizadas como muy extensas, difíciles y áridas, por lo que resulta importante realizar de manera sencilla la enseñanza de las distintas disciplinas neurocientíficas al estudiante de medicina y al médico en general. En este sentido, el objetivo del presente artículo es proponer un esquema para la realización de una exploración neurológica básica (ENB) que le permita al médico de primer contacto identificar eficazmente posibles alteraciones neurológicas (sobre todo las más frecuentes o graves), para así poder brindar un tratamiento inicial adecuado o establecer criterios de referencia oportuna a otro nivel de atención.
Abstract The neurological examination (NE) is the most important clinical tool in medicine for the detection and diagnosis of nervous system diseases. In several medical areas, the integration of clinical data with neuroanatomical and neurophysiological knowledge is of vital importance for the correct utilization and interpretation of NE. Frequently for the medical students, the NE and other subjects related to neuroscience are conceptualized as lengthy, difficult and boring; so it is important to teach these subjects to the medical students and general practitioners in a simple and comprehensive manner. Hence, the main objective of this paper is to propose a scheme for performing a basic neurological examination (BNE) that will allow the primary care physician to readily identify possible neurological disorders (especially the most frequent or severe), in order to provide adequate initial treatment or establish opportune reference criteria to another level of medical assistance.