Goals and Objectives

1. Perform the neurological exam.
   • Curriculum: Residents, attendings and preceptors in the hospital and clinic settings will teach the advanced neurological exam. During Thursday didactics in Seattle, a systematic review of the neurological exam will occur.
   • Benchmark: Two parts of the neurological exam will be benchmarked. The reflex and sensory exams. To learn the exams you will practice them in Thursday didactics, and you can read about the exams and watch a video by going to Mini-CEX.
   • Test: Demonstrate either the reflex or sensory exam benchmark in a clinical setting while observed by your preceptor. The CEX cards are incorporated into the pocket syllabus. You must repeat the CEX until a pass score is achieved. Cards will be collected at the end of the course.
2. Localize symptoms and signs in the nervous system.
   • Curriculum: For this course, the nervous system will be divided into 7 levels. They are brain, brain stem, spinal cord, motor neuron, peripheral nerve, neuromuscular junction, and muscle.
   • Benchmark: Features of each level will be taught at orientation, reviewed during Thursday didactics, and can be found in the pocket syllabus or by clicking here.
   • Test: Six cases will be assigned during the clerkship. Localization is an integral part of each web-based case. Answers are emailed to the clerkship director for review, and case discussion will occur during Thursday didactics or by video lecture for WWAMI students.
3. Discuss a bioethical issue in neurological care.
   • Curriculum: Bioethical issues arise frequently in neurology. You are required to identify, observe, and reflect on at least one clinical scenario during the clerkship.
   • Benchmark: Three bioethical issues will be benchmarked. Each issue is linked to the Ethics In Medicine website. They are Breaking Bad News, Do Not Resuscitate Order, and Termination of Life-Sustaining Treatment. See the Mini-CEX tab for details.
   • Test: Write a reflection on one of the three bioethical options, and email to the clerkship director for review.
4. Participate in the care of patients with neurological disease.
   • Curriculum: It is expected that students will have broad exposure to patients with neurological disease no matter what site they are assigned.
   • Benchmark: See at least one patient in each of the following 7 categories: demyelinating disease, dizziness, headache, movement disorder, neuromuscular disease, seizure disorder, and cerebrovascular disease.
   • Test: On a daily basis, students will log their patients in the pocket syllabus. At the end of each of the first three weeks you will need to record the data by going to the patient log tab. If, at the end of three weeks, you have not seen a patient in each of the first seven categories, please either talk to your preceptor about seeing a patient or do the appropriate on-line case, which automatically emails your answer to the clerkship director.
5. Seek feedback in order to improve.
   • Curriculum: Feedback should be continuous throughout the 4-weeks. In order to ensure that is happening, we are putting you, the student, in charge. A feedback card has been developed for this purpose. Please read the instructions on the front, which urges you to ask for frequent feedback from attendings, preceptors and residents. Keep in mind that feedback should be both positive and negative.
   • Benchmark: All students must receive mid-rotation feedback. Feedback given after the first two weeks of the clerkship should allow you to improve your performance for the second two weeks. See student evaluation tab.
   • Test: The clerkship evaluation form has a question concerning mid-rotation feedback.

Student DESIRED Goals and Objectives

1. Formulate a differential diagnosis for patients with neurological symptoms.
2. Know when to order and how to interpret common tests used in diagnosing neurological disease.
3. Understand the management principles for common neurological diseases.
4. (Ideally) Perform a lumbar puncture.
5. Demonstrate the ability to effectively communicate with patients, families, colleagues, and staff.  Work collaboratively with team members including faculty, staff and other students.

Faculty goals and objectives:

1. Students should see most patients independently with preceptor overseeing the students’ work.
2. Facilitate a broad based exposure to common neurologic problems.
3. Provide regular feedback on student progress.
4. Observe H&P.
5. Critique write-up.
6. Be a positive role model. Examples include:
   • Respectful of patients.
   • Clear and organized.
   • Takes advantage of teaching opportunities.
   • Provides timely feedback.
   • Stimulates self-learning process.
   • Adequate supervision.
7. Insure access to computer and internet.
8. Students should not be expected to dictate patient notes.