It Takes a Village: Building the NeuroExam Tutor App

The UCSF NeuroExam Tutor app seeks to solve a problem that has faced medical educators for decades: medical students are uncertain and timid when performing the neurological exam. Educators suppose that this is because of the complexity of the nervous system and the multitude of ways to investigate its functions. However, it is even more troubling that this insecurity continues into the careers of clinicians from most specialties. To address this problem, UCSF neurologists Susannah Cornes and Vanja Douglas proposed a gentle introduction to the neurological exam over the four years of medical school. This innovative approach could not have been realized without the partnerships that lead to the creation of an iPad app.

app home screen

Features:

  • More than 60 high quality videos
  • In-depth descriptions of how to execute more than 50 different physical exam maneuvers
  • 6 interactive cases with real patient videos
  • Descriptions of 8 exam categories with explanations of terminology and grading scales
  • Quick reference flashcards for 6 common neurological complaints
  • Pearls and pitfalls from the master clinicians at UCSF

While many projects in medical education are carried out by a single motivated educator, increasingly, ideas cannot reach their fullest potential without a team. The NeuroExam Tutor team consisted of several doctors, myself lending the perspective of a medical student, and and the Technology Enhanced Learning team in the UCSF School of Medicine Office of Medical Education. The app team became truly inter-professional when we partnered with Bandwdth, a digital publishing firm with experience creating rich multimedia driven apps. Throughout the process, specialists in educational theory, interface design, videography, and programming were all tapped to make the multimedia NeuroExam Tutor app a reality. This partnership was productive, exciting, and drastically different from most collaborative efforts within the hospital.

He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all. – William Osler

Our experience building this app highlights the fact that medical education is in a time of transition driven by the rising tide of technology and the availability of information. The “books” to which Osler refers are no longer just leather-bound tomes filled with yellowed pages. Today’s medical student is constantly bombarded by websites, apps, feeds and notifications that are the books of our age. Sounds, videos, and interactive problem solving activities promise to develop skills, as well as knowledge, as they guide students in the hospital and clinic. In developing the NeuroExam Tutor app, our aim was to create a resource that fulfills the role of the Osler’s books without forgetting that the ultimate goal is to improve the quality of patients’ lives.

I believe that the multi-disciplinary skills of the people involved in this project allowed us to tell the patient stories in a more engaging way. Students learn directly from the patients couched in those stories, and as a result, we capture some of the spirit of patient interaction and presence that Osler holds to be so fundamental.

In closing, I’d like to note that the NeuroExam Tutor project could not have achieved the goal of educating students while maintaining the primacy of the patient experience anywhere but UCSF. UCSF is a unique institution, insomuch as it embodies a culture of caring and respect for the patient experience, as well as an emphasis on fundamental knowledge and treatment. As medical education transitions to a curriculum that increasingly relies on technologically enhanced resources, UCSF is uniquely poised to imbue those resources with a human touch.

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