RESUMO
BACKGROUND: Neurology is regarded as a difficult component of the medical curriculum. This has been so marked that the term neurophobia and its effects are being investigated. Given the impact of neurological disorders worldwide, neurophobia has the potential to affect the diagnosis and management of such cases. METHODS: A cross-sectional survey was done among clinical fourth and fifth year students at the Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago. A survey tool successfully used in other schools was adapted to assess perceived level of difficulty, knowledge and interest in various medical sub-specialties including, neurology, cardiology, psychiatry, geriatrics, endocrinology, respiratory medicine, gastroenterology and pediatrics. Questions asked included: "What is your current level of interest in the following medical specialties?"; "What is your current level of knowledge in the given medical specialties?"; "Do you think the subject is easy or difficult?" and "Why do you think neurology is difficult?" Students were required to answer using a Likert scale and results were tabulated into mean scores and standard errors. RESULTS: The response rate was 65 per cent (167/255). Neurology was identified as the subject which students found most difficult (score 3.89 +/- 0.068) and had least knowledge of (2.32 +/- 0.075). These scores were significantly different from those observed for the other disciplines (p < 0.001). The need to know basic neuroscience was identified as the biggest contributor to the difficulty associated with neurology (3.89 +/- 0.072) followed closely by the complex clinical examination associated with neurology (3.69 +/- 0.072). Greater clinical and practical exposure, more time being spent on the subject, and improved teaching skills of lecturers were put forward as suggestions for improving the teaching of neurology...
Assuntos
Humanos , Neurologia , Técnicas de Diagnóstico Neurológico , Estudantes de Medicina , Trinidad e TobagoRESUMO
This book in neurology was prepared for students reading for the Doctor of Medicine in Psychiatry. It is also extremely useful for medical students, nurses and young doctors since it is written as an introduction to neurology providing a framework on which to build. Students should find the approach simple to follow with a slight emphasis on the borderland of psychiatry and neurology. Both neurological and psychiatric problems are very common, accounting for 10 percent and 40 percent respectively, of general practice consultations. This book will also serve as a supplement for the brief neurological and psychiatric attachments of students and interns (AU)
Assuntos
Humanos , Neurologia , Educação de Graduação em Medicina , Psiquiatria , Medicina , Trinidad e Tobago , Região do CaribeRESUMO
This paper reports on neurological and neurosurgical referrals overseas from the Queen Elizabeth Hospital (QEH) for the period November 1987 to November 1996, and is a follow up to an earlier report for the period January 1984 to November 1987. It outlines the pattern of referral, diagnoses, referral centres and costs based on examination of the files of all QEH patients transferred overseas under a government aided scheme. There were 203 transfers of 191 patients (69 males, 122 females) including 10 patients who were transferred twice and one patient who was transferred three times. Patients ages ranged from 1 to 80 years (mean 37 years). Twenty overseas centres were used during the period but most patients were transferred to Brooklyn Hospital, New York in 1988, Mount Sinai Medical Center, New York, between 1989 and 1994, and Hospital de Clinicas Caracas, Venezuela (1992 to 1996). 65 percent of the referrals were for neurosurgery and 25 percent were for magnetic resonance imaging scans for diagnosis. The largest diagnostic categories were central nervous system tumors (40 percent) and subarachnoid haemorrhage (25 percent). Estimated costs reached almost BDS$11 million, but the mean actual cost was BDS$63,916 based on information from 123 patient transfers. Thus, the actual total government expenditure was probably closer to BDS$13 million. This study demonstrates the urgent need to establish a neurosurgical service at the QEH and the cost effectiveness of doing so.(AU)
