An Interactive Mobile Curriculum for Teaching the Hypothesis-Driven Neurological Examination (P1.326)

OBJECTIVE: To develop and evaluate a mobile, longitudinal, and learner-driven neurological examination curriculum emphasizing a hypothesis-driven approach during undergraduate medical training. BACKGROUND: The optimal way of teaching the neurological exam to non-neurologists is not known. Traditionally the exam is taught to students in a head-to-toe fashion but an interactive longitudinal curriculum may allow students to learn a more targeted exam. A symptom-targeted neurological exam engages clinical reasoning and may be more efficient and sensitive than a comprehensive exam. DESIGN/METHODS: A panel of expert neurologists developed a consensus set of examination maneuvers for the essential screening, comprehensive screening, and six common symptom-targeted neurologic exams. Video clips and descriptions of each individual exam maneuver were created using patient volunteers. Cases with video and game-like elements and expert feedback were constructed. The curriculum was deployed as an iPad-based application, NeuroExam Tutor , in the first half of the first year and evaluated with a survey and a standardized patient exam at UCSF. Third year UCSF and UC Irvine medical students were encouraged to use the application during their required neurology clerkships. At the conclusion of the clerkship they are surveyed and participate in interviews on their impressions of the app. RESULTS: Preliminary results showed that first year students who used NeuroExam Tutor (19/27) used it mostly at home, between 2 and 10 times, for an average of 16 min (SD=10) per use, and rated it as useful. Initial results suggest improved performance on late first year standardized patient examination. Students who did not use the NeuroExam Tutor cited lack of access to an iPad and test-pressure as obstacles to use. CONCLUSIONS: Building a mobile teaching app based on current best principles of education is a resource intensive endeavor; however, it is feasible for schools to create and evaluate mobile curricula that are widely used, perceived as useful, and improve clinical skills. Disclosure: Dr. Alegria has nothing to disclose. Dr. Douglas has received personal compensation for activities with Grifols Inc. Dr. Douglas has received personal compensation in an editorial capacity for The Neurohospitalist. Dr. Mayfield has nothing to disclose. Dr. Boscardin has nothing to disclose. Dr. Josephson has received personal compensation in an editorial capacity for Annals of Neurology and Journal Watch Neurology. Dr. Lowenstein has nothing to disclose. Dr. Cornes has nothing to disclose.