Education Research: Embracing the Unknown-Introducing Clinical Uncertainty Into the Neurology Clerkship Curriculum

The field of neurology has inherent uncertainty, and there is currently a limited focus on how to navigate uncertainty in formal neurology training. This is an integral issue as uncertainty has been shown to correlate with increasing clinician burnout and overall negative health care outcomes. The aim of this study was to address this gap by introducing diagnostic uncertainty using case-based learning during the neurology clerkship. The objective of the study was to compare medical students' perceptions of clinical uncertainty before and after the course.

Second-year, third-year, and fourth-year medical students participated in a 60-minute case-based learning exercise incorporating uncertainty held at the start of the neurology clerkship. Students were given an optional precourse and postcourse survey incorporating the clinical practice uncertainty domains (CPUDs). Data were collected and analyzed from August 2023 to June 2024.

Eighty-eight medical students participated in this course. There was a statistically significant increase in agreeability to several CPUDs in the postcourse survey compared with the precourse survey, including "I feel prepared to address uncertain situations during clinical clerkships" and "I am confident in my ability to communicate to patients during clinical situations that may be uncertain." Most of the students who responded to the postcourse survey found this session useful.

Implementation of a standardized neurology curricular course focused on uncertainty is feasible and potentially valuable. There are several limitations to this study including the use of a postpositivist approach with the use of quantitative methods and the short follow-up period.