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A structured hands-on CSF diagnostic training module improves diagnostic knowledge in medical students: a prospective
Yang Liu1, Steffen Kottackal2,3, Wenlin Hao4
1Department of Neurology, Saarland University, Kirrberger Straße, Homburg, Saar, 66421, Germany. a.liu@mx.uni-saarland.de.
Background:
Cerebrospinal fluid (CSF) diagnostics is an essential component of neurological practice and requires not only theoretical knowledge but also the ability to interpret cytological findings and integrate them into clinical reasoning. Structured, practice-oriented approaches for teaching CSF diagnostics in undergraduate medical education remain limited. This study evaluated the impact of a structured, hands-on training module in CSF diagnostics on medical students' knowledge acquisition and application of diagnostic knowledge.
Methods:
This prospective educational intervention study included fourth-year medical students participating in a mandatory neurology practical course. The intervention consisted of a pre-test, a structured theoretical session, a practical microscopy session using authentic CSF samples, and a post-test conducted during a single teaching session. Knowledge acquisition was assessed using pseudonymized pre- and post-tests covering CSF-related knowledge domains including indications for lumbar puncture, cytological findings, diagnostic interpretation, microscopy-based diagnosis and procedural aspects of CSF diagnostics. Student evaluations were collected immediately after the session using an anonymous questionnaire. Paired data were analyzed using the Wilcoxon signed-rank test and McNemar's test, as appropriate.
Results:
Eighty-four medical students completed both assessments. Median test scores increased from 3 to 6 correct answers following the intervention (Wilcoxon signed-rank test: Z = - 7.886, p < 0.001). Improvements were observed particularly in procedural knowledge, diagnostic interpretation, cytological assessment, and microscopy-based diagnosis. Baseline performance regarding indications for lumbar puncture was already high and showed no significant change. Student evaluations indicated positive perceptions of the integration of theoretical and practical components.
Conclusions:
A structured, hands-on CSF diagnostics training module was associated with improved short-term knowledge acquisition and application of diagnostic knowledge related to CSF diagnostics among undergraduate medical students. Practice-oriented teaching approaches may complement traditional neurology education and support clinically relevant learning.