Grand Rounds as a Teaching Modality in Neuroscience for M1 Students

Laura Bruce, Ph.D., Jayne Murray, M.S. and Floyd Knoop, Ph.D.

Creighton University School of Medicine

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Innovations in educational technologies have driven medical education as traditional forms of instruction are revised. During the past two decades, course directors and medical educators have developed curricula that integrate numerous interactive learning strategies. Among these strategies are enhanced standard laboratories, computerized instruction, patient simulators, small group learning exercises, and interactive teaching in a large group forum. We have used the latter method to provide a clinical foundation in Neuroscience, a first year basic science course. First year medical students, in white coats and professional attire, are required to attend Neuroscience Grand Round exercises in a hospital classroom throughout the course. The exercises are provided by faculty from the Department of Neurology, include the use of clinical patients, and are student-friendly. Educational objectives focus on the process of and criteria for diagnosing neurological patients in an actual clinical case. Each case provides a solid medium for auditory and visual cues in patient evaluation and underscores the value of a neurological examination and history. The presentations allow a format that requires interactive exchange between medical students, clinical faculty and residents, and neurological patients. Clinical assessment of the patient, discussion of a plan for intervention and understanding eventual case outcome provide a foundation for critical thinking skills. Evaluation data demonstrated numerous course comments that were positive, including “This course was by far my favorite course of the M1 curriculum. I like that the physiology was integrated with the medical and pharmacological aspects of neuroscience. One of the highlights of the course was the Grand Rounds presentations. It was great to see patients with the diseases we were studying.” The integration of this type of Grand Rounds into a basic science course is an innovative patient-centered approach that promotes an understanding of those factors that characterize both acute and chronic neurological illnesses. This innovative approach furnishes a format for clinical faculty and residents in medical education/academic medicine and provides medical physicians-in-training experience in discussing clinical cases, problem solving and interacting with patients.