ObjectiveTo develop an educational framework basis for improving the teaching of the neurologic examination (NE) by asking German neurologists to (1) identify the basic elements of the screening NE and (2) nominate the steps they would deem mandatory for medical students to master.MethodsWe conducted a questionnaire-based survey among neurologists working in a hospital or ambulatory setting in southwest Germany. To define the screening NE, neurologists were asked to list the NE components they normally use in clinical encounters with patients in whom neurologic findings are unlikely. Furthermore, they were asked to identify additional elements of the NE which they would consider mandatory for students to master.ResultsOur neurologists nominated a set of 23 elements as being essential for a screening NE. There was high consensus among the 2 groups, and the results were concordant with international data. Furthermore, nearly 60 additional maneuvers of the NE were deemed obligatory for students to master.ConclusionOur results reinforce the international consensus for screening NE components and confirm a large set of additional examination steps that medical students should master, thereby indicating the need for an educational NE teaching concept. To solve this educational challenge, we propose a longitudinal curriculum that incorporates the “core + clusters” framework, thus combining the screening NE (core) with hypothesis-driven sets of maneuvers (clusters). Based on our data, we provide an initial proposal for the core and neurologic diagnostic clusters which is applicable to both novice and advanced learners across the continuum of training.

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Objective:To compare a blended learning approach with traditional face-to-face instruction in terms of their individual effectiveness in imparting neurological examination (NE) skills in medical students.Methods:We conducted a prospective controlled study of 4th-year medical students (n=163) who were pseudo-randomly distributed into two groups. Group A (n=87) was subjected to a traditional teaching method comprising two face-to-face sessions. Group B (n=76) underwent blended learning, which consisted of an individual preparation period using a course handbook and videoclips, plus a single face-to-face session. NE skill acquisition was assessed by an objective structured clinical examination (OSCE). Questionnaires were used for evaluation.Results:Comparison of mean OSCE scores in Groups A vs. B revealed that NE skill acquisition was better in Group B (blended learning), with a moderate effect size, a smaller OSCE score variance, and fewer students performing poorly than in Group A (face-to-face instruction). Student evaluation revealed that both teaching approaches were well accepted, albeit a higher level of satisfaction was associated with the blended learning approach. This method also provided more time for practice and feedback.Conclusion:The blended learning approach is a highly efficacious and valued method for teaching NE skills. It offers instructors and faculty the advantage of successful skill acquisition in students despite the considerably reduced attendance time.