Clinical Neurosciences

Code:

M4_BC03

Acronym:

NC

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2020/2021 - 1S

Active?	Yes
Responsible unit:	Medical Teaching
Course/CS Responsible:	Integrated Masters Degree in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIM	83	Official Study Plan	4	-	9	97	243

Teaching language

Suitable for English-speaking students

Objectives

Processual skills, capacity to
a) obtain a complete clinical history,
b) perform a directed and structured neurological examination,
c) observe a patient with disturbance of consciousness or altered mental status,
d) knowing how to perform a lumbar punctur
e) make a clear and concise presentation.

Analytical skills, capacity to
a) recognise symptoms and signs that could mean a disease of the nervous system,
b) distinguish normal and abnormal signs through the neurological examination,
c) Using the symptoms and signs to determine the topographical location of the lesion,
d) formulation of differential diagnosis based on the topography of the lesion, clinical progression, epidemiology, socio-demographic information,
e) use, and interpretation of ancillary investigations ,
f) Know the basic pharmacological principals and therapeutics of neurological diseases,
g) know how to refer adequately the patients and recognise the emergency,
h) review and interpret medical literature

Learning outcomes and competences

The adopted methodology was planned to teach neurological semiology at the 3rd year (integrating the Curricular Unit of Semiology and Physiopathology) with the theoretical and  practical components, and also previous curricular units like neuroanatomy, is a base for the Curricular Unit of Clinical Neurosciences of the 4th year. Although with theoretical lectures, the practical component of the Curricular Unite of Clinical Neurosciences, near the patients, is the base for the neurological teaching. The necessary organization to draw up a clinical report, with group discussion afterwards, trains the neurological reasoning, how to choose the most appropriate ancillary investigation, determine the treatment and thinking about the prognosis. Presenting clinical neurological themes implicate a critical review of the literature. The neurosurgical component as ENT, ophthalmology and physical medicine shows other aspect of the neurosciences, including treatment options. Observing patients with different diseases (and stay at the emergency department and at the out-patient clinic, in option) gives the notion of what is emergent in different situations of acute and chronic diseases

Working method

Presencial

Program

Lectures:

Introduction and neuro-epidemiology (1)

Consciousness (3)

Chronobiology of their cyclic processes and adaptive processes (2)

Tumours of the central nervous system and intracranial hypertension (2)

Head trauma (3)

Diseases of the spinal cord and rachis (3)

Pain syndromes (2)

Neurological transitory focal symptoms and signs (2)

Vascular diseases of the central nervous system and stroke I and II (3)

High cortical functions (2)

Theoretical-practical classes and seminars:

Dementia (2)

Epilepsy (2)

Headache I and II (2)

Neuro-Ophthalmology seminar

Oto-Neurology seminar

Movement disorders I and II (2)

Infectious diseases of the nervous system (2)

Immune mediated neurological diseases (2)

Polyneuropathies (2)

Neuromuscular diseases (1)

Genetic diseases of the nervous system (1)

Neurological symptoms and signs of systemic diseases

Neocritical care seminar (3)

Physical medicine for neurological diseases I and II (2)

Neurorehabilitation seminar

Neurology of the old and seminar on neurogeriatric care

Poisoning and environmental consequences for nervous system (2)

Clinical cases

Level (1): Knowledge and understanding of a clinical situation.

Level (2): Ability to identify a problem or medical condition and guide the patient under supervision.

Level (3): Ability to identify a problem or medical condition and guide the patient without supervision

Mandatory literature

Hauser SL et al; Harrison's Neurology in Clinical Medicine, New York, MC Graw-Hill, 17ed, 2010
Ginsberg L; Lectures Notes on Neurology, Blackwell Science
Patten J; Neurological Differential Diagnosis, London, Springer, 2001
Bradley WG et al; Neurology in Clinical Practice. Principles of diagnosis and management, Philadelphia, Butterworth
Netter FH; Nervous System V1 Part I e II, Ciba
Parsons M, Johnson M; Diagnosis in color - Neurology, Mosby, 2001
Fuller G; Neurological examination made easy, Churchill - Livingstone, 1999
.; New England Journal of Medicine
2006; 59(4):583-590 (web site); Ann Neurol
.; The Lancet Neurology
.; Practical Neurology
Fauci AS, Brawnwald E et al; Harrison's principles of internal medicine., McGraw-Hill

Teaching methods and learning activities

Lectures (12h ), theoretical-practical and seminars (26 h) classes could be divide in two groups, in each one half of all course, or, depended on the ciurcunstance, being miniterd on-line (for example by platform colibri/zoom)  

Considering the COVID-19 pandemic, the practical classes (52 hours), 4 hours/week  (divided in two classes of 2 hours) will be adapted now; each classes will be divide in 3 groups (A, B,C), corresponding to 3 or 4 students. In rotation, in adequate rooms, each group will make an interview and clinical observation of a neurological patient, supervised by an assistant, a neurologist or a resident in neurology. A report of the clinical observation will be produced and after discussed. The other two groups stay on the class through colibri/zoom. The clinical reports, discussion of neurological published papers, discussion of clinical cases previously sent by the assistant to students and revisions of neurological themes prepared by the students will be discussed through the platform colobri/zoom.  During practical classes will be presented, on-line, videos of neurological patients. Learning at the Medical Simulation Centre is most recommended, for example, for training the execution of Lumbar Puncture.

Evaluation Type

Distributed evaluation with final exam

Assessment Components

Designation	Weight (%)
Participação presencial	50,00
Teste	50,00
Total:	100,00

Amount of time allocated to each course unit

Designation	Time (hours)
Estudo autónomo	146,00
Frequência das aulas	97,00
Total:	243,00

Eligibility for exams

Disapproval due to lack of frequency if frequency < 75% of practical classes 

Calculation formula of final grade

Disapproval due to lack of frequency if frequency < 75% of practical classes 

Final Classification (FC) = 0 5 continuous evaluation (CC) + 0,5 Final multiple choice test (FMT)

Classification "CA" < 10/20 score imply disapproval to the Curricular Unit

Final adjustment to the unity (Ex.: 10,0 to 10,4 = 10; 10,5 to 10,9 = 11)

Classification on “FMT”<10/20 score imply disapproval to the Curricular Unit, independently of the "CA" evaluation score.

Writing evaluation: multiple choice test; eighty questions with five possibility of response, only one being correct. Duration of the test 90 minutes.
Total score for the test 20 points (0, 25 for each question).
There are no penalization for an incorrect response.

Continuous evaluation

Weightings:

1. Assiduousness, punctuality, conduct 5/20
2. Clinical aptitude 5/20
3. Communication capacity 5/20
4. Practical use of the knowledge 5/20

Special assessment (TE, DA, ...)

Oral exam

CF= 0,5 CC + 0,5 oral exam

Classification improvement

Oral exam