Barbara Scherokman, MD, FAAN, FACP, is a neurologist in the Mid-Atlantic Permanente Medical Group and a Clinical Professor of Neurology at the George Washington University School of Medicine and Health Sciences. She spoke with Daniel B. Hier, MD, MBA, FAAN, who is Associate Editor for Education for AAN.com.
AAN.com: The AAN has just finished a new curriculum entitled Approach to Common Neurological Symptoms in Internal Medicine. Can you tell us about the motivation for creating this new curriculum?
Scherokman: The idea for the curriculum originated in the AAN Subcommittee on Education of Non-Neurologists (SENN) as a way to reach out to and engage non-neurologist physicians. As a member and past chair of SENN I felt it was important to help internists to quickly and accurately evaluate common neurological symptoms and help them understand which symptoms require urgent referral to neurology.
AAN.com: Who at the AAN was involved in this project? Did you collaborate with anyone at the American College of Physicians (ACP)?
Scherokman: Each chapter of the curriculum was written by a neurologist and an internist to make sure the material was relevant to internists. Most of the chapters were written by members of SENN and co-authored by internists who were members of their local institutions. Patrick C. Alguire, MD, FACP, Director, Education and Career Development, American College of Physicians, made numerous contributions to the curriculum and also helped make it part of the Medical Knowledge Self-Assessment Program (MKSAP), 15th ed., Neurology syllabus and the web enhancement for their textbook for medical students, "Internal Medicine Essentials for Clerkship Students." The web enhancement can be found here. We are also in contact with the Director of Communications at the Alliance for Academic Internal Medicine to make the neurology curriculum available to internal medicine program directors.
AAN.com: The curriculum covers 10 key symptoms seen by internists, including dizziness, headache, visual disturbance, memory impairment, and loss of consciousness. How did you pick these 10 key symptoms?
Scherokman: The curriculum is a symptom-based approach to evaluating patients who present to primary care physicians and is intended to be a basic, rapid methodology and teaching tool for analyzing neurological symptoms. We determined the most common neurological symptoms presenting to primary care by using the National Ambulatory Care Survey: 2000 Summary (National Centers for Disease Statistics: Vital Health Statistics). The list of symptoms was then refined by discussion with Alguire and SENN members.
AAN.com: This curriculum uses some multimedia modalities. Can you tell us how you integrated text, video, images, and audio in this curriculum?
Scherokman: Each author was encouraged to use tables, diagrams, photos and videos to supplement the text. We obtained many videos with the help of John C. Pearson, PhD, of Wright State University from his excellent site, "Neurology Teaching Videos." This website contains over 6,000 videos of neurological exams of normal and abnormal patients that can be downloaded and used for teaching purposes.
AAN.com: Can you tell us how the ACP plans to use this curriculum in training residents in internal medicine?
Scherokman: The curriculum will be distributed to internal medicine program directors to be used in resident training. Also, the curriculum will have wide distribution to residents and internists through the MKSAP 15 Neurology syllabus, which is used by over 40,000 residents and internists throughout the US.
AAN.com: Do you think this curriculum will be useful to medical students on their neurology rotations?
Scherokman: This curriculum should be extremely helpful for teaching both undifferentiated medical students as well as medical students who go into neurology. The AAN Undergraduate Education Subcommittee may be interested in distributing the curriculum to SIGN members and to Clerkship Directors.
AAN.com: Can you envision other uses for this curriculum?
Scherokman: This curriculum would also be helpful for teaching nurse practitioners, physician assistants, and triage nurses.
AAN.com: I noticed you adopted a case-based approach to teaching the curriculum. Why was that chosen?
Scherokman: We used a case-based approach for this curriculum because it serves to capture the attention of the reader and to hopefully simulate common or dangerous presentations that internists are likely to encounter.
AAN.com: The new internal medicine curriculum, Approach to Common Neurological Symptoms in Internal Medicine, is available on AAN.com.
Dr. Scherokman has nothing to disclose
Dr. Hier has received compensation for medical legal testimony and service as an expert witness and as Education Editor for AAN.com. Dr. Hier is a Professor of Neurology and Rehabilitation at the University of Illinois in Chicago.