Using Patient-Centered Clinical Neuroscience to Deliver the Diagnosis of Functional Neurological Disorder (FND): Results
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IN BRIEF REPORT
Using Patient-Centered Clinical Neuroscience to Deliver the Diagnosis of Functional Neurological Disorder (FND): Results from an Innovative Educational Workshop Michel Medina 1 & Luciana Giambarberi 2 & Shelby Scott Lazarow 1 & Juliana Lockman 1 & Nazlie Faridi 3 & Farnaz Hooshmad 1 & Ariela Karasov 4 & Sepideh N. Bajestan 1 Received: 8 May 2020 / Accepted: 25 September 2020 # Academic Psychiatry 2020
Abstract Objectives Psychiatry training is lacking examples of neuroscience education that translates neuroscience literature into accessible clinically oriented concepts. The authors created a teaching activity using patient-centered neuroscience education that focused on delivering the diagnosis of functional neurological disorder (FND). This study aimed to (i) develop a workshop modeling a clinician-patient interaction, (ii) provide a modern neuroscience perspective of FND, and (iii) evaluate the change in clinicians’ perceptions of FND. Methods A total of six workshops (each 1 h long and consisting of a video, PowerPoint slides, and pre and post questionnaires) were conducted. Paired t tests were used to measure the change. Results Forty-seven clinicians participated. After completing the workshop, nearly all endorsed that functional symptoms are “real” (95%) and that treatment is helpful (100%). Participants also reported a greater comfort level with discussing FND diagnosis (46% vs 85%, p < 0.001), an overall increase in understanding the disorder (33% vs 82%, p < 0.001), assessing need for tests (33% vs 66%, p < 0.001), understanding treatment options (26% vs 89%, p < 0.001), and recognition that treatment can help control these symptoms (81% vs 100%, p < 0.01). In addition, learners were more likely to report that patients with FND are truthful (75% vs 95%, p < 0.001) and less likely to be manipulative (48% vs 80%, p < 0.001). Conclusions A brief, educational intervention using neuroscience-based content was found to significantly improve clinicians’ perception and confidence when delivering the diagnosis of FND. Keywords Functional neurological symptom disorder . Conversion disorder . Medical education . Neuroscience . Neuropsychiatry
In psychiatry training, the lack of neuroscience teaching has been an ongoing problem [1]. The shortage of neuroscientists and neuropsychiatrists to translate the complicated neuroscience literature into material for clinicians’ use has been a major barrier [2, 3]. In this study, the authors sought out to develop a new training method that brings patient-centered * Michel Medina [email protected] 1
Stanford University, Palo Alto, CA, USA
2
Wake Forest, Winston-Salem, NC, USA
3
McGill University, Montreal, Canada
4
William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
neuroscience education to clinical settings. We focused on functional neurological disorders (FND) and not only translated the complicated neuroscience literature into simplified material, but also modeled the clinical use of this knowledge. FND was chosen given the lack of
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