DEMONSTRATION

DEMONSTRATION

Neurological Cases: A Tool for Testing Neuroanatomical Localization

Paul D. Larsen, M.D.
University of Nebraska School of Medicine

ABSTRACT:

Neuroanatomical localization is an essential first step in the diagnosis of neurological disease. It requires a systematic thought process based on the interpretation of the neurological examination using anatomical levels and systems. We have developed a web-based tutorial, NeuroLogic, (demonstrated at the Munich 2001 workshop) to teach this way of thinking.

In order for the student to be able to practice these skills after completing the tutorial, we needed a case format structure that assessed mastery of neuroanatomical localization. Most problem-based formats are too multidirectional for what we wanted to accomplish. Our interactive case format directs student choices and uses progressive analysis and synthesis that are essential for localization. There are four basic parts to each case:

1. The case starts with a brief history. The student is then presented with an icon of the neuraxis and clicks on the portion of the neurological examination (mental status, cranial nerves, coordination, sensory, motor, or gait) that they want to observe. This opens a screen, which allows selection of QuickTime movies of that portion of the examination.

2. After viewing the various parts of the neurological examination, the student is presented with a table of possible abnormal findings from which they select the patient's significant findings. They then compare their list with the expert's.

3. With the important abnormal findings in mind, on the next screen the student clicks over the level of the neuraxis where they think the problem is located. If they make the correct choice then a cross section at that level appears.

4. After deciding right vs. left, the student indicates the involved anatomical structures based on the neurological examination findings by clicking on that area or structure. Upon completion they can then compare their choices with the expert's.

This case testing tool was created with DreamWeaver and cases are being produced for use in the NeuroLogic tutorial, which is now on the web (http://library.med.utah.edu/neurologicexam/). This open source project can be adapted for other teaching settings where anatomical localization is essential for the diagnostic process.

BENEFIT TO PARTICIPANTS ATTENDING SESSION:

This demonstration presents a case format that embodies how a student must think with clinical neurological findings in order to achieve neuroanatomical localization necessary for neurological diagnosis. It provides an interactive step by step format with progressive analysis that helps develop the desired skills. The concept can be adapted for other teaching settings where anatomical localization is essential for the diagnostic process.

Paul D. Larsen, M.D.
University of Nebraska Medical Center
985165 Nebraska Medical Center
Omaha, Nebraska 68198-5165
Phone: 402-559-9539
Fax: 402-559-5763
Email: pdlarsen@unmc.edu

CO-AUTHORS:
1. Suzanne S. Stensaas, Ph.D.
2. Paul E. Burrows
3. Eric Carlson

1. Eccles Health Sciences Library
University of Utah
10 North 1900 East
Salt Lake City, Utah 84112-5890

2&3. KUED Media Solutions
University of Utah
101 South Wasatch Drive 215EBC
Salt Lake City, Utah 84112

Phone: 1. 801-585-1281
2&3. 801-581-7908

Fax: 1. 801-581-3632
2&3. 801-585-3584

Email: 1. suzanne.stensaas@hsc.utah.edu
2. pburrows@media.utah.edu
3. ecarlson@media.utah.edu