A Vignette-Based Educational Intervention to Reduce Neurophobia and Improve Knowledge for the UK Medical Licensing...

Neurophobia, an aversion to clinical neurology, undermines medical education and may affect patient safety. The UK Medical Licensing Assessment (MLA) emphasizes vignette-based Single Best Answer (SBA) items, requiring practice in applied clinical reasoning. We developed a compact, MLA-aligned educational intervention to reduce neurophobia by improving confidence and knowledge.

Using the Model for Improvement, we produced a 34-page booklet and delivered a 90-min, resident-led, interactive session across two plan-do-study-act cycles at a district general hospital (QIP: 25-586). Sixteen students participated (two cohorts, n=8 each), completing paired pre- and post-session assessments. While limited by a small sample size, this pilot supports proof of concept and warrants multicenter evaluation to strengthen generalizability. The primary outcome was self-rated confidence (five-point Likert). The secondary outcome, assessed in cycle 2, was knowledge measured by a six-item SBA test. Wilcoxon signed-rank tests compared paired scores; effect sizes were reported as [Formula: see text]. Cronbach's alpha assessed reliability.

Both cycles produced significant confidence gains. In cycle 1, median confidence rose from 2.5 (IQR: 2.0-3.0) to 4.0 (IQR: 4.0-4.25) (p<0.05; |r|=0.90). In cycle 2, confidence rose from 3.0 (IQR: 2.0-3.0) to 5.0 (IQR: 4.75-5.0) (p<0.01; |r|=0.89). In cycle 2, mean SBA scores improved from 25.0% (SD: 8.33) to 97.9% (SD: 5.5) (p<0.01; |r|=0.90). The SBA tool showed acceptable reliability (Cronbach's α=0.76). Five of six items reached 100% correct post-session; the sixth reached 87.5%.

A single, low-resource, MLA-aligned session significantly improved medical students' confidence and objective knowledge in neurology. Conducted as a prospective pilot study using QI methodology, it demonstrates proof of concept and supports wider evaluation including multicenter trials and delayed retention testing to mitigate neurophobia and strengthen workforce readiness.