From neurophobia to neurophilia: Fostering confidence and passion for neurology in medical students

Despite the increasing demand for neurological expertise, the United Kingdom has one of the lowest numbers of neurologists per population in Europe (Nitkunan et al., 2020). A potential contributing factor is the prevalence of ‘neurophobia’ – a fear and lack of confidence that many undergraduate students, particularly those in medical courses, feel towards understanding neurology and neuroscience. This challenge is widely reported in medical education literature (for a review, see Moreno-Zambrano et al., 2021).

With the population of many economically developed countries ageing, and neurological diseases, such as dementia, increasingly prevalent, there is a need to ensure enough undergraduate medical students consider pursuing careers in neurological sciences. There is also a need to prepare early career doctors and non-specialists in neurology, such as GPs, nurses and pharmacists, to be confident enough in neurology to recognise and support patients who present with neurological conditions.

There is evidence that early experience of neuroscience/neurology teaching during undergraduate training is influential in establishing student perceptions of neuroscience (Conway and Tubridy, 2018). Neuroanatomy is perceived as the most difficult aspect of neuroscience. Moreover, medical students find the application of neuroscience concepts to clinical situations and clinical reasoning more difficult than other subject areas (Pakpoor et al., 2014). In addition, student perceptions that neurological disorders have limited curative options may also hinder motivation to engage with neuroscience.

Much of the early teaching of neuroscience core concepts to medical students at university is delivered by neuroscientists, meaning neuroscientists can have a significant positive impact on future choices of medical and allied healthcare students. When teaching neuroscience to medical students, consideration of the common perceptions students may have about the subject, and adjusting teaching methods accordingly, could be transformational. Teaching neuroscience to science students is different from teaching neuroscience to medical students.

From a medical student perspective, there are several strategies that could improve perceptions of neuroscience. A challenge of neuroanatomy is the difficulty visualising function from structure and linking it to clinical relevance. Teaching anatomy and function together in the context of damage and disease helps students see relevance. A good example is spinal cord pathways, where medical students respond best to clinical scenarios that allow clinical reasoning to ascertain the site and pathways damaged from signs and symptoms. This can be supported through digital technology, such as virtual 3D neuroanatomy atlases.

A flipped classroom format, where learning objectives and teaching resources (video, activities) are provided prior to neuroscience teaching, is also welcomed by medical students. The focus of sessions then shifts to application of knowledge, question asking and discussion – while allowing students to learn neuroscience concepts at their own pace.

Near-peer teaching, such as through student societies or interprofessional education alongside science students, is also beneficial (Hall et al., 2013). Near-peer teachers can explain neuroscience in a way that is easier to understand, and students can feel more comfortable asking questions. Near-peers also benefit themselves through identifying gaps in their knowledge and solidifying their understanding.

More broadly, educators who are actively involved in research are in a unique position to counter negative perceptions by highlighting ongoing advancements in neurosciences, such as cutting-edge research on neurodegenerative diseases and potential future breakthroughs in treatment – but please avoid sessions heavy with research data! Through presenting a more optimistic outlook, focusing on translational neuroscience, neuroscientists can inspire medical students, instilling a sense of hope and a drive to not only learn but also contribute to this rapidly evolving field.

Once interest in neuroscience is cultivated, aligning teaching with the practical knowledge that medical students will require in clinical settings will further encourage engagement and learning. Medical students need to be equipped to recognise symptoms, conduct relevant investigations and manage neurological conditions effectively. Use of clinical cases helps students build knowledge in a way that they can confidently apply basic neuroscience to real-life scenarios to identify and manage patients with neurological conditions.

Through awareness of medical student perceptions of neuroscience, neuroscientists can be pivotal in transforming medical students from ‘neurophobic’ to ‘neurophilic’!