Primary care perceptions of neurology and neurology services

Loftus, Angela M; Wade, Carrie; McCarron, Mark O.

doi:10.1136/postgradmedj-2015-133683

Cited by 24 publications

(23 citation statements)

References 24 publications

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“…The prevalence of people living with long-term neurological conditions (LTNC) is increasing globally in the context of an ageing population [1,2] and claims on current resources are reported to be unsustainable [3][4][5]. Despite policy and guidelines about community service provision [6][7][8][9], recent evidence indicates that community services are not adequately supporting quality of life for people with LTNC or preventing crises and/or acute admissions [3,[10][11][12][13][14]. It has been proposed that innovative redesign of community services for people with LTNC is required to improve quality, efficiency and patient outcomes [3,5,15,16].…”

Section: Introductionmentioning

confidence: 99%

Patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition: a qualitative systematic review and meta-aggregation

Jackson

Hamilton

Jones

et al. 2018

Disability and Rehabilitation

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Patient reported experiences identified common factors associated with process quality (respect, choice, autonomy, information provision, communication) and activities of patient centered care (personalized care, shared decision-making, self-management support) despite heterogeneity of neurological conditions, service configurations, and geographical location. These factors impact quality of life. Implications for Rehabilitation Patient reported experiences provide useful information about courtesy, respect, choice, autonomy, information provision, and communication. Outcomes of self-efficacy and self-management are important for people with stable and progressive long-term neurological conditions. Interactions with individual professionals influence engagement, self-efficacy, and self-management for people with long-term neurological conditions. Training for health and social care professionals should develop the advanced communication skills and behavior required to facilitate self-efficacy and self-management.

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Section: Introductionmentioning

confidence: 99%

Patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition: a qualitative systematic review and meta-aggregation

Jackson

Hamilton

Jones

et al. 2018

Disability and Rehabilitation

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“…We observed a below average performance in questions grouped under the neurology theme, which included all questions relating to the central and peripheral nervous system. Reduced knowledge pertaining to neurosciences has previously been linked to a term called neurophobia, though this is by no means a universally accepted concept 8 9 23. In one questionnaire study for example, GPs rated neurology as the most difficulty medical specialty and the one for which they had the least confidence compared with cardiology, endocrinology, gastroenterology, geriatrics, respiratory medicine and rheumatology 9.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is conceivable that a lack of understanding of the workup and management of DCM may also contribute. Indeed, DCM would be included within the spectrum of ‘neurophobia’—an aversion to the neurosciences due to perceived difficulty, which has been demonstrated in GPs and GP trainees 8 9…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of medical students’ and physicians’ knowledge of degenerative cervical myelopathy

et al. 2020

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ObjectivesWe have previously identified a delay in general practitioner (GP) referrals for patients with degenerative cervical myelopathy (DCM). The aim of this study was to evaluate whether an education gap existed for DCM along the GP training pathway by quantitatively assessing training in, and knowledge of, this condition.DesignGap analysis: comparison of DCM to other conditions. Comparators selected on the basis of similar presentation/epidemiology (multiple sclerosis), an important spinal emergency (cauda equina syndrome) and a common disease (diabetes mellitus).SubjectsMedical students, foundation doctors and GP trainees.Primary and secondary outcome measures(1) Assessment of training: quantitative comparison of references to DCM in curricula (undergraduate/postgraduate) and commonly used textbooks (Oxford Handbook Series), to other conditions using modal ranks. (2) Assessment of knowledge: using standardised questions placed in an online question-bank (Passmedicine). Results were presented relative to the question-bank mean (+/−).ResultsDCM had the lowest modal rank of references to the condition in curricula analysis and second lowest modal rank in textbook analysis. In knowledge analysis questions were attempted 127 457 times. Performance for DCM questions in themes of presentation (+6.1%), workup (+0.1%) and management (+1.8%) were all greater than the question-bank mean and within one SD. For students and junior trainees, there was a serial decrease in performance from presentation and workup (−0.7% to +10.4% relative to question-bank mean) and management (−0.6% to −3.9% relative to question-bank mean).ConclusionsAlthough infrequently cited in curricula and learning resources, knowledge relating to DCM was above average. However, knowledge relating to its management was relatively poor.

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“…Some GPs, however, are hesitant to apply their knowledge of neurology and neuroscience, a phenomenon already described as neurophobia (Loftus et al, ). Neurophobia has long been recognized (Jozefowicz, ) as a global phenomenon, reported in Europe (Schon et al, ; Flanagan et al, ), the United States (Zinchuk et al, ), Australia (Hudson, ; Lim and Seet, ), Singapore (Kam et al, ), Sri Lanka (Matthias et al, ), China (Lukas et al, ), Nigeria (Gupta et al, ), and Trinidad and Tobago (Youssef, ).…”

Section: Discussionmentioning

confidence: 99%

Neuroanatomy education: The impact on perceptions, attitudes, and knowledge of an intensive course on general practice residents

Arantes

Barbosa

Ferreira

2017

Anatomical Sciences Ed

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General practitioners are responsible for the management of an increasing number of patients with neurological illness, and thus a solid education in neurosciences is a necessary component of their training. This study examines the effects of an intensive clinical neuroanatomy course on twenty general practice residents' perceptions, attitudes, and knowledge. A knowledge test was completed by the participants and by a control group at four different time points. The participants were asked to answer a questionnaire about their reasons for signing up for the course and their attitudes and perceptions toward the course experience. Experimental and control groups demonstrated identical mean baseline test scores. The experimental group significantly increased its test scores (plus 49.0% correct answers, a mean improvement of 120%) relative to controls after the educational intervention. There were no differences among scores from the evaluated time points after the educational intervention in the experimental group. In the control group, there were likewise no significant differences between the four evaluated time points. Most participants indicated that they signed up for the course to update/acquire knowledge and skills in the field of neurosciences, and also because they had difficulty in diagnosing and managing patients with neurological diseases. Participants' attitudes and perceptions toward the course experience were very positive. Most of the participants (n = 17; 85%) rated the course as "extremely useful," and 3 (15%) rated it as "very useful." This study provides evidence demonstrating the potential positive effect of neurosciences education to general practice residents. Anat Sci Educ 10: 465-474. © 2017 American Association of Anatomists.

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Primary care perceptions of neurology and neurology services

Abstract: GPs prefer local NHS neurology services to independent sector contracts. GPs' evaluations should inform commissioning of neurology services. Combating neurophobia should be an integral part of responsive commissioning.

Cited by 24 publications

References 24 publications

Patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition: a qualitative systematic review and meta-aggregation

Patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition: a qualitative systematic review and meta-aggregation

Quantitative analysis of medical students’ and physicians’ knowledge of degenerative cervical myelopathy

Neuroanatomy education: The impact on perceptions, attitudes, and knowledge of an intensive course on general practice residents

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