Specific Learning Objectives

Below are detailed Objectives on the Knowledge, Skills, and Attitudes you should demonstrate to your teachers, on the OSCE, and on the written shelf. You will likewise be evaluated upon each of these.


Symptom and Approach Based Knowledge

Proficiency in obtaining a complete history, exam, with a comprehensive diagnostic approach for:

  • Disorders of consciousness
  • Mental status and/or behavioral changes
  • Memory complaints
  • Pain in the head, neck, and back
  • Numbness, paresthesias, and neuropathic pain
  • Weakness and clumsiness
  • Dizziness and vertigo
  • Disorders of language
  • Vision loss and diplopia
  • Dysarthria and dysphagia
  • Abnormal movements
  • Sleep-related complaints

Disease Specific Knowledge

Understanding pathophysiology, work-up, and treatments for:

  • Ischemic stroke
    • Presentations
    • Risk factors
    • Subtypes and Etiologies
    • Imaging (i.e. Head CT, Diffusion MRI)
    • Administration of tPA
    • Acute and chronic BP management
    • Pharmacotherapy (i.e. antiplatelets, anticoagulants, statins, BP meds)
    • Testing (i.e. EKG, echocardiogram, carotid Doppler, telemetry)
  • Intracranial hemorrhage
    • Presentations
    • Risk factors
    • Subtypes and etiologies (i.e. intraparenchymal, subarachnoid, subdural, epidural)
    • Diagnosis
    • Acute management
  • Structural coma
    • Presentations
    • Imaging
    • Raised intracranial pressure
    • Hydrocephalus
    • Herniation
    • Acute management
  • Metabolic encephalopathies
    • Presentations
    • Etiologies (i.e. Na, Ca, Glucose, CO2, Cardiac, Hepatic, Thyroid, Infection, Medication/Toxin, Hypoxic-Ischemic)
    • Treatment for hyponatremia and hepatic
  • Neuro-toxicology and vitamin deficiencies
    • Presentations
    • Etiologies (B12, copper, thiamine, lead)
  • Meningitis and encephalitis
    • Presentations
    • Etiologies (i.e. bacterial, Cryptococcus, Tuberculosis, syphilis, Herpes)
    • Treatment (antibiotics, glucocorticoids)
    • Complications
  • Dementia and memory disorders
    • Presentations
    • Etiologies & Pathogenesis (i.e. Alzheimer’s, Lewy Body, Frontotemporal, Head Trauma)
    • Work-up
    • Treatment
  • Seizures and epilepsy
    • Presentations
    • Risk factors
    • Subtypes (i.e. Simple Partial, Complex Partial, Generalized Tonic Clonic, Absence, Non-Convulsive Status)
    • Status Epilepticus
    • Seizure precautions
    • Chronic treatment
  • Syncope
    • Presentations
    • Etiologies & Pathogenesis (arrhythmia, aortic stenosis, orthostasis, intracranial stenoses)
    • Work-up
  • Vertigo
    • Presentations
    • Etiologies (i.e. central, neuronitis, benign positional vertigo, Meniere’s disease)
  • Headache disorders
    • Presentations
    • Etiologies & Pathogenesis (i.e. migraine, cluster, tension, analgesia-overuse, neuralgias, idiopathic intracranial hypertension, temporal arteritis)
    • Treatments (Acute, Prophylaxis)
  • Myelopathies
    • Presentations
    • Etiologies & Pathogenesis (i.e. compressive, inflammatory, nutritional, infectious)
  • Radiculopathies & Plexopathies
    • Presentations (i.e. single cervical or lumbar/sacral root, polyradiculopathy, cauda equina syndrome, conus medularis syndrome)
    • Etiologies & Pathogenesis (i.e. compressive, tumor or carcinomatous meningitis, HIV, syphilis, Lyme)
  • Neuropathies (Carpal Tunnel, Diabetic, B12, Monoclonal, Guillain Barre, CIDP, Alcohol, Vasculitis and Connective Tissue)
    • Presentations
  • Immunologic diseases
    • Presentations
    • Etiologies & Pathogenesis (Multiple Sclerosis, Neurosarcoid, SLE, Paraneoplastic)
  • Movement disorders
    • Presentations
    • Pathophysiology
    • Etiologies & Pathogenesis (i.e. Parkinson’s disease, essential tremor, Huntington’s disease, tics, medication-induced dyskinesias)
  • Neuromuscular disorders
    • Presentations
    • Etiologies & Pathogenesis (i.e. myasthenia gravis, Lambert-Eaton, botulism, myositis/myopathy, ALS)
  • Brain tumors
    • Presentations
    • Etiologies (common primary CNS tumors, nervous system mets and carcinomatous meningitis)

Neurologic History

  • Obtain Complete History with Open, Non-leading Questions
  • Understand how Disease Affects a Person’s Life
  • Obtaining full Psychosocial Background

Neurologic Exam

  • Perform a Complete and Smooth Screening Neurologic Exam within 15 Minutes
  • Correctly Interpret the Exam Findings
  • Perform a Coma Exam

Oral Presentations

  • Concisely Present a Full Medical History and Exam.
  • Organize your Presentation to have a Logical Structure
  • Preview Localization and Differential with Pertinent Positive and Negatives
  • Include a Comprehensive Assessment with Prioritized Differential and Plan

Case Synthesis

  • Determine Key Pieces of the History, Exam, Labs, and Studies to Localize and Rationalize a Prioritized Differential
  • Employ a Mnemonic to Review Categories of Disease (i.e. DVICTIM).

Documentation

  • Write a Clear, Concise, and Comprehensive Initial Work-Up that has Value for Others when they Review the Chart
  • In The Assessment and Plan, Include a Brief Summary Statement Distilling the Quintessential Components and Illustrating your Thought Process and Logic
  • Write Clear SOAP Notes which Effectively Documents Progress and the Thought Process

Establish an Effective Relationship with Patient and Families

  • Listen with Patience and Understanding
  • Professional and Empathetic First Encounter
  • Involve Families in Medical Care
  • Keep Your Patients Informed about Past and Upcoming Tests and Plans
  • Advocate for Your Patient and Ensure a Good Healthcare Experience

Valued and Productive Team Member

  • Reliable Member who Helps Provide Excellent Care and Identifies How to be Helpful
  • Contribute towards Discussion and Learning
  • Communicate Effectively about Patient Care, Your Learning, and Your Whereabouts

Professionalism

  • Professional Appearance and Demeanor
  • Approach the Clerkship with Dedication, Initiative, and a Pro-Active Approach to Patient Care and Learning
  • Seek, Accept, Incorporate Provided Feedback