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Neuroscience

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Behavior

Topics




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1.






Course Director
Name: Chris Cohan PhD
Office Location: 4103B JSMBS
Department: PAS
Phone: 829-3081
Email: ccohan@buffalo.edu
Office Hours: as requested
           2.






Administrative Details
Course Designation: Phase 1
Course Type: Required
Year/Semester: 2nd, Fall
Credit Hours: 12
Grading Schema: P/F

3. PARTICIPATING FACULTY

4. COURSE START AND END DATES

Nov 2, 2020 – Feb 12, 2021

5. COURSE DESCRIPTION

This course integrates the basic sciences with clinical applications into a study of neuroscience and behavior in both health and disease. Each of the topics is incorporated into an integrated body of knowledge covering neuroanatomy, neurophysiology, neurology, neuropharmacology, neuropathology, and psychiatry, utilizing both didactic and self-directed learning methods and clinical models.

6. COURSE MAP

MD graduates must achieve competency in several areas prior to graduation. Every course contributes to many of our Medical Education Program Objectives.

Course Objectives
“At the end of this course, students should be able to…”
Jacobs School Medical Education Program Objectives Instructional Methods Assessment Methods
Identify the major structures of the CNS in histologic and gross specimens, cross sections, and CT/MRI imagesIdentify the major structures of the CNS in gross specimens, cross sections, and CT/MRI images; summarize the abnormal findings on a CT/MRI in a concise, complete statement 2.2 Lec, lab, small grp Exam
Summarize the normal abnormal findings on a CT/MRI in a concise, complete statement 2.1 cases, small grp sml grp
Describe the development of the nervous system across the lifespan 2.1 readings Exam
Draw diagrams that represent the overall route of sensory and motor pathways, the cross-sectional shapes of CNS structures at different levels, and the blood supply to the brain and spinal cord that demonstrate a working knowledge of structure and function that form the basis of neurological disorders. 3.1, 3.2 Lec, lab, small grp Exam
Describe the common diagnostic tests used to assess neurological disorders 2.2, 5.1 Lec, lab, small grp Lab observation
Describe the physiological properties of nerve cells and glial cells 2.1 Lec, lab, small grp Exam
Describe the major pathological features of nervous system disorders at the cellular and gross organ levels 2.1 Lec, lab, small grp Exam
Describe the clinical application, mechanism of action, and important side effects of pharmacological therapies used for treatment of common nervous system disorders 2.1, 2.2 Lec, lab, small grp Exam
Differentiate the cause, symptoms, and treatment of common neurological disorders 2.1, 2.2 Lec, lab, small grp Exam
Use deductive reasoning to localize the site of lesions and their likely cause based upon sensory and motor deficits described in patient cases. 2.1, 3.1 Lec, lab, small grp Exam
Use the variety of multimodal resources available to guide self-directed learning 3.1, 3.2, 3.4, 3.5, 8.8 Lab, independent activities Lab/small group observation, exam
Collaborate and communicate effectively in a small group setting, demonstrating accountability to others, as you work together to solve clinical problems. 3.1, 3.4, 3.6, 4.2, 4.3, 5.1, 8.6, 8.8 small grp peer assess
Demonstrate cultural sensitivity and the use of clinical judgement based on evidence to solve clinical problems presented in small group sessions. 3.1, 3.4, 3.6, 4.2, 4.3, 5.1, 8.6, 8.8 small grp peer assess
Demonstrate professional behaviors, including punctuality, reliability, preparation, and participation in interactions with other students, faculty, and other members of the medical education team. 3.1, 3.4, 3.6, 4.2, 4.3, 5.1, 8.6, 8.8 small grp peer assess
7. CHANGES MADE
  1. Completely redesigned the module format to emphasize self-directed learning and problem-solving
  2. Implemented use of the ScholarRX Brick curriculum to merge Step 1 preparation with preparation for clerkships in years 3 and 4
  3. Completely redesigned the small group sessions to increase learning effectiveness and to make them more interactive
  4. Rewrote the lab manual to take advantage of the brain museum specimens
  5. Made the lab manual a completely online document with links to all figures including the brain museum specimens
  6. Developed a web app to display the specimens in the Brain Museum
  7. Revised online tutorials on web site: ventricles, cisterns are no longer flash-dependent; review of structures is coordinated with timing of exams
8. MODULE FORMAT

This module consists of 2 components: Neurology during the first 10 weeks and Psychiatry during the last 3 weeks. These 2 components have different faculty, class activities, and assessments (described below). The Psychiatry component will be described in a separate syllabus by Dr Hernandez.

    Format for the Neurology Component
  1. Module Content – The ScholarRX Bricks curriculum in Neurology will provide the foundation for learning content in the module. Bricks emphasize self-directed learning that you well complete outside of class time in preparation for subsequent discussion.

  2. Lecture activities – occasional lectures will be provided to supplement information in the Brick curriculum where needed.

  3. Small Group Sessions – will occur on a daily basis. Their goal is to develop your problem-solving skills in all aspects of the module content. They are designed to increase your understanding in 3 areas: 1) neuroanatomical structures and pathways, 2) to help you understand the content in the Bricks more fully, and 3) to help you apply your knowledge to clinical situations. Materials available to help you include a brain museum, lab manual with instruction for each session, an outstanding collection of stained cross sections of nervous tissue created at UB, and radiological images. The lab manual, cross sections, and radiological images are all accessed from the module web site.
    • Location: 8 virtual, small group rooms accessed by zoom

    • Format: Small group sessions will begin at 10 AM and end at 12 PM. You will work in teams of 3 (mostly) or 2 on the activities. Each session will be divided into 3 sections: laboratory, content discussion, case application. These are required sessions that play an important role in your understanding because they will go beyond information in the Bricks.
      • Laboratory Section Small group sessions will begin with a quiz requiring you to identify structures learned from the laboratory manual activities you prepared prior to the session. This will be followed by additional activities to review the specific sensory or motor pathway being studied.

      • Content Discussion Using breakout sessions, you will develop answers to questions based on key aspects of the Brick readings prepared prior to the session.

      • Case Application Using breakout sessions, you will develop answers to patient cases that involve the topics being studied, with the goal of applying your knowledge to clinical situations.

  4. Faculty-Facilitated Case Sessions – There are 5 sessions where you will have an opportunity to work with Neurologists and Neurosurgeons on neurological cases. These cases are more complex than the typical morning problem solving sessions. They involve the topics of neuroimaging, neuropathy, cervical radiculomyelopathy, tumors, and stroke.
    • Timing: Sessions will begin at 8 AM in breakout rooms to allow you to compose your answers to your assigned question. Discussion with faculty facilitators will begin at 8:30 AM. The session will end at 10 AM.

    • Format: In each session, a case history will be provided along with a list of questions. The goal is for you to talk about the information you have learned so you can demonstrate your understanding, develop verbal communication skills, and promote group discussion.
      • Each case contains 8 questions that explore different aspects of the disorder.
      • You are expected to review the cases with your team and prepare answers for the 8 questions ahead of time.
      • On the morning of the session, the questions (8) will be assigned randomly to the 8 teams in each room.
      • You will have 30 min to compose your answer to the assigned question before rejoining the room for discussion.
      • When you present your answer you should: 1) indicate the source used for your research, 2) discuss the answer in your own words without use of powerpoint tools, but whiteboard diagrams can be helpful for some explanations, 3) allow each team member to participate in the presentation.
      • Case answers will be available after the session. Be aware that it is unprofessional and defeating to your learning experience to use answer handouts from previous years for your case discussion.

  5. 4th year medical students will be teaching assistants who will facilitate the lab and small group discussion sessions. Fourth-year students have participated in this module for many years. They provide a unique learning opportunity for peer teaching. Your learning will be more effective due to the help of TAs who have experienced the same learning environment as you and have also added clinical experience to deepen their understanding and application of information.

  6. Weekend Practice Questions – Questions from the ScholarRX question bank will be assigned each weekend to practice application of the week’s material. Questions will be assigned on Friday and due by Sunday night. You are required to complete these practice quizzes each weekend. Questions will appear in tutor mode so that answers are available to you. No grade will be assigned for this activity. You should realize that even though you might not have had time to review the week’s material by the weekend, it is still beneficial for you to complete these practice questions. They provide an alternative means to study module topics and they will reveal important aspects of these topics for you to keep in mind when you have time to review. Since I consider this an important way to practice application of module material, some of these questions will appear on each module exam.

9. OPPORTUNITIES FOR SELF-DIRECTED LEARNING

Using the ScholarRX Bricks will allow you to develop an understanding of module content on your own before you discuss it with others. The module web site tutorials page contains multiple tutorials to help you learn nervous system pathways, blood supply, the ventricular system, and to help you review for exams. The Atlas page contains a complete collection of stained cross sections that can be selected from a brain diagram, spinal cord cross sections, a labelled MRI atlas, and labelled diagrams of sensory structures. This material was developed by Dr Cohan and previous students specifically for this module to help you. The lab and small group sessions provide time for you to work independently with your team.

10. EXAMINATIONS, WEIGHTING, FORMAT

There are four scheduled examinations during the module. The spacing of these examinations is based on continuity of topics. Final grades will be calculated based on the following weighting:

Exam 1 (neurology) 22 %
Exam 2 (neurology) 23 %
Exam 3 (neurology) 30 %
Exam 4 (psychiatry) 25 %

Examinations 1, 2, and 3 are based on the Neurology component of the module, while exam 4 is based on the Psychiatry component. Exams 1-3 will consist of a practical portion (20%), based on laboratory material (sections and gross), and a written portion (80%) composed of multiple choice questions (examsoft), case problem solving, and anatomical drawing based upon lectures, notes, and readings. Case problem solving requires drawing a representative area of the nervous system to localize the site of a lesion causing the patient symptoms.

Examinations will depend upon cumulative information about each functional pathway that will enable you to solve case studies and localize lesions.

Questions almost exclusively will be USMLE format using case scenarios to test your understanding of concepts and your ability to apply information to diagnose neurological problems. These questions place less emphasis on smaller details of systems, which may be important for your overall understanding, but will not be included in exams. Consequently, your strategy for studying should reflect this emphasis. All questions are uniform in style and emphasis to ensure that they are fair, accurate, and unambiguous. Green boards are available for note-taking.

11. GRADING POLICY

Grades are rounded to the nearest tenth of a point.
Pass ≥ 69.5
Fail < 69.5

To pass this module, you are required to show competency in both the Neurology and Psychiatry components. Therefore, to receive a grade of Pass, you must achieve a weighted average grade of at least 69.5% in the Neurology component AND a grade of at least 69.5% in the Psychiatry component. If you achieve less than 69.5% in either component (even though your combined grade may be greater than 69.5%), you will receive an Unsatisfactory for the module. A passing grade also assumes that you attended the small group and laboratory sessions.

Reporting of Exam Grades Students will receive their grades on each exam and/or quiz through the Examsoft portal. An individual’s scores and grades will be accessible only to that individual student.

Reporting of Final Grades Students will receive final grades in the course via email and/or on the myUB HUB system. Final course grades will not be released to the student until he/she completes the course evaluations on MedHub or within four weeks of the course end date.

12. LEARNING RESOURCES (list of textbooks, sites, software programs, etc.)

See web site pages: Resources/Links, Tutorials, Atlas
Textbook: Neuroscience online

13. COURSE SCHEDULE - https://ubneuro-ccohan.webapps.buffalo.edu/NBsched.pdf

Please see the module web site for the course schedule. Any changes will be made there and students will be notified as early as possible. Please note, that some last minute changes may occur due to unforeseen circumstances such as weather or an instructor cancellation.

14. SUPPORT SERVICES AVAILABLE

Personal Support Services
Counseling Services are available both on and off campus. Please see the website for more information.

Academic Support
The Academic Support Program offers workshops, interactive learning sessions and individual academic counseling for exploring content, processes and thinking skills to maximize student success. Please see the website for more information.

In addition, students seeking support with course content are encouraged to contact the course director.

Student Health Services
Student Health Services provides high-quality medical services and patient education for all UB students. Our team of health care providers — including board-certified physicians, physician assistants, nurse practitioners, registered nurses and medical support staff — offers primary care, preventative treatment and specialty services designed to meet the needs of our students. If you are a UB student who is currently registered for classes, you can be seen by Student Health Services regardless of the type of health insurance plan you have. You do not need to be insured through one of UB’s health insurance plans to utilize Student Health Services.

http://www.buffalo.edu/studentlife/who-we-are/departments/health.html
Phone: (716) 829-3316
Location: Michael Hall, South Campus

Library Services
University at Buffalo Libraries provide access to Access Medicine, ClinicalKey, UpToDate, PubMed, and many more databases, books, and journals. Go to the Health Sciences Library website to search and browse materials. Log in with your UBIT name and password for offsite access. Take advantage of the Libraries’ free request service, Delivery+, if there is something you need that the Libraries do not have. HUBNET is a collection of clinical resources provided by UB and area hospitals. Access HUBNET on campus or from any of our affiliated hospitals. Create an account using your UB credentials for remote access.

The library in Jacobs School is open to student card access 24/7. It is staffed by a Health Sciences librarian at the hours below:

Monday 9:00 – 5:00
Tuesday 1:00 – 5:00
Wednesday 9:00 – 5:00
Thursday – Friday 9:00 – 5:00

OMC
The OMC can assist with your Jacobs School Account, Calendar Suture, printing, and Computer Lab needs.

Phone: (716) 829-2106
Email: omc-req@buffalo.edu

UBIT
UB Information Technology can assist with your UBIT name and password, connecting to the Internet, file storage through UBbox, downloading and purchasing software, and UBlearns technical support.

UBIT Help Center:
(716) 645-3542
https://www.buffalo.edu/ubit/get-help/help-center.html

15. COURSE POLICIES

ExamSoft/Examplify
The medical school is using the ExamSoft/Examplify exam management system. This course will utilize the system for exams. Questions will be tagged to categories to provide a customized report for your review. You will be able to use the reports to identify strengths and weaknesses. You are encouraged to use them to reflect, self-assess, and develop your own self-directed learning plans. You are responsible for the operation of your computer for exams including successfully downloading and uploading the exam in the allotted time. Exams must be uploaded, and “green screens” shown to faculty/proctors upon exiting the exam. Support is available online at https://examsoft.force.com/etcommunity/s/, by phone (866) 429-8889, or chat. You can also contact Kevin Hittle in the Office of Medical Curriculum at kevinhit@buffalo.edu or 829-5838.

TopHat
Per UB policy, each student is required to purchase a license for TopHat. This will be used for active learning and review sessions throughout the course and students are responsible for bringing a compatible device (computer, tablet, or phone) and having an active license to be able to participate. Please refer to the UBIT page for instructions on purchasing a license, downloading, and using the software.

For help you can contact TopHat or Kevin Hittle in the Office of Medical Curriculum.

Course Failure and Remediation
Students who earn an Unsatisfactory grade in this course will be notified via email by the course director. The student will then be contacted by the Office of Student and Academic Affairs to determine the next steps based on the Academic Status Policy. If remediation is recommended, it will take the form of a six-week course immediately following the completion of the second year. Students are required to pass six weekly exams and achieve and average grade of 70% or above to successfully complete the remediation. The material covered and the rigor of the examinations are equivalent to that of the original module. Students have full access to the same learning material and to most instructors as experienced during the regular module. The resulting grade will be listed on the transcript as a U with the remediation grade also indicated.

Accessibility Resources
If you require classroom or testing accommodations due to a disability, please contact Accessibility Resources: http://www.buffalo.edu/studentlife/who-we-are/departments/accessibility.html. If accommodations are recommended, the Accessibility Resources office will give you an official document stating the accommodation needs. The student is responsible for communicating any accessibility needs with the Office of Medical Curriculum, including submitting a copy of the document from Accessibility Resources.

Absence and Attendance
Students may be justifiably absent from required sessions due to religious observances, illness, public emergencies, documented personal or family emergencies, and conflicts with University sanctioned activities. University sanctioned activities include, but are not limited to, presentations and other official representation at professional meetings and conferences.

The student is responsible for notifying the course director and the course coordinator in writing with as much advance notice as possible of required absences, preferably at the beginning of the course. It is recognized that absences, especially for illness and emergencies, may not be known at the beginning of the course. Students should contact the course director and course coordinator as soon as possible for absences due to these circumstances. Absences for illness may require medical documentation at the discretion of the course director.

Students must be excused from classes for needed diagnostic, preventive, and therapeutic health services. The student should make an effort to select an appointment time that minimizes the time lost from required activities, if available. If an appointment time outside of the required activities is not available, then students must be excused to receive these services.

For justifiable absences, course directors may provide reasonable alternatives to students. Students are responsible for the prompt completion of any alternative assignments that may be given by the course director. Unexcused absences from a graded/points bearing activity may result in not achieving the stated points/credit.

Attendance is mandatory at exams, patient presentations, and designated small group activities and active learning sessions. The required sessions will be indicated in the course syllabus. Attendance at lecture is not mandatory, but highly encouraged. Students may watch lectures via the recordings on UBLearns, however students should be aware that because technology is not always reliable, these recordings are not guaranteed.

Course Evaluation
MedHub is the Jacobs School tool for evaluating courses, clerkships, and other experiences. Results from the questions can help both the faculty and the curriculum committee identify changes to improve students’ experience and learning outcomes. Students are expected to participate fully in this important process. Students are reminded to be professional in their comments and that specific constructive criticism drives improvement. Final course grades will not be sent to a student until he or she has completed the evaluations or until 3 weeks have passed since the end of the course. Student responses are completely anonymous.
Academic Integrity and Professional Conduct

The University has a responsibility to promote academic honesty and integrity and to develop procedures to deal effectively with instances of academic dishonesty. Students are responsible for the honest completion and representation of their work, for the appropriate citation of sources, and for respect for others’ academic endeavors. By placing their name or student identifier on assignments, quizzes, examinations, and sign-in sheets, students certify that the work is theirs and theirs alone. Students may not refer to any material or look at other student's papers during quizzes or examinations. Students observed so doing will receive a grade of zero for that quiz or examination. As students in a health professions school, students are expected to display conduct consistent with their status as entering members of the profession. Incidents of academic dishonesty and/or professional misconduct will be addressed as described in the University at Buffalo Student Code of Conduct and the Jacobs School of Medicine and Biomedical Sciences Code of Professional Conduct.

Learning Environment and Discrimination and Harassment Policies
The purpose of this policy is to define student mistreatment and provide mechanisms for reporting violations of this policy. The Jacobs School of Medicine and Biomedical Sciences recognizes that preparation for a career in medicine demands the acquisition of a large fund of knowledge and a host of special skills. It also demands the strengthening of those virtues that undergird the doctor–patient relationship and that sustain the profession of medicine as a moral enterprise. This Policy serves both as a pledge and as a reminder to teachers and learners that their conduct in fulfilling their mutual obligations is the medium through which the profession inculcates its ethical values. Details of this policy can be found here. Students can report violations through the outlines measured in the policy, which includes the University at Buffalo anonymous system. The Jacobs School of Medicine and Biomedical Sciences also follows the University at Buffalo Discrimination and Harassment Policy.



BOOKS

During the module we will use an excellent online textbook. It is easy to access, up to date, and contains animations to aid understanding. In addition, any of the textbooks listed below, including older editions, are helpful. Many are available on loan from Dr. Cohan for the module. Check the web site resources page for others (links).

1. USEFUL TEXTBOOKS Neuroscience textbooks cover anatomical, physiological, and neurological components with varying detail. Strengths and weaknesses of selected neuroscience texts appear below.

  1. Basic Clinical Neuroscience, 2nd Ed., by P.A.Young, P.H.Young, and D.L.Tolbert, LippincottWW 2008. - a very concise text with a strong clinical emphasis and adequate coverage of topics.
  2. The Human Brain, by J. Nolte, any Ed., Mosby, 2002-16 - this book is easy to read and understand and it contains good pictures with some 3D reconstructions. It combines both anatomy, physiology and clinical information. It also has a study guide containing summaries of the book chapters.
  3. Essential Neuroscience, by A. Siegel and H.N.Sapru, LippincottWW, 2006, - a concise, but very complete text covering many topics and with excellent pictures. Each chapter contains example cases and Board-style questions.
  4. Clinical Neurology, D.A. Greenberg, M.J.Aminoff, R.P. Simon, 6th Ed., Appleton and Lange, 2005 - an excellent reference for Neurology and a clinical companion for many of the module topics. This book also is used for the Neurology clekship. (available online)
  5. Neuroscience, by D.Purves, GJ Augustine, D Fitzpatrick, et al., ed., 5th Ed., Sinauer, 2012 - this is a comprehensive text that covers neuroanatomy and neurophysiology. It has beautiful illustrations, but there is less emphasis on clinical examples.
  6. Lippincott´s Illustrated Review of Neuroscience, by C.Krebs, J.Weinberg, E.Akesson, LippincottWW, 2012 – a new text - concise, excellent pictures, and board-style questions in each chapter.
  7. Neuroanatomy Through Clinical Cases, H.Blumenfeld, Sinauer Assoc, MA, 2002. - This comprehensive text has a clear, clinical focus throughout each chapter. It uses many clinical cases to illustrate neuroanatomical concepts.
  8. Clinical Neuroanatomy, by S.G.Waxman, ed., 25th Ed., McGraw Hill, 2003 - a very concise book that´s easy to read. It covers many topics, has many clinical examples and cases, and has a great appendix with much useful information on peripheral nerves, muscles, and body distribution.

2. ATLAS: (You may find it helpful) Can be borrowed from Dr Cohan.

Neuroanatomy, D.E.Haines, 8th Ed., Urban and Schwartzenberg, 2011 (other editions OK) - contains much information including stained cross sections, excellent gross pictures, blood supply, unstained horizontal and parasagittal brain slices with MRIs, and pathway diagrams. The newer editions have many improvements. Haines figures are referenced in the lab manual. However, other atlases are also adequate and can be substituted.