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Course Director Name: Chris Cohan PhD Office Location: 4103B JSMBS Department: PAS Phone: 829-3081 Email: ccohan@buffalo.edu Office Hours: Mon/Fri 3 PM |
Assistant Director David Freedman, PhD 4208 Jacobs School PAS 829-5282 daf23@buffalo.edu |
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Administrative Details Course Designation: Phase 1 Course Type: Required Year/Semester: 2nd, Fall Credit Hours: 12 Grading Schema: P/F |
4. COURSE START AND END DATES
Oct 7, 2024 – Dec 20, 2024
5. COURSE DESCRIPTIONThis 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 MAPMD 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 |
- Revised tutorials on Neuroo web site
- Increased anatomical review during Review of Topics sessions
- Increased practice on Pathology topics for Step 1 reinforcement
- Added AI-related questions to cases to provide familiarity with ChatGPT use in medicine
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 Camp.
- Format for the Neurology Component
- Module Content – The ScholarRX Bricks curriculum in Neurology provides the foundation for learning content in the module. Bricks emphasize self-directed learning that you complete outside of class time in preparation for subsequent discussion. Brick readings are comprehensive, but concise. It takes time to understand their content, so please adjust your schedules to provide enough time to read through and learn the material. Neuroanatomy content will be provided primarily through our Neuroanatomy Guide and lectures.
- Lecture activities – a 1 hour lecture is provided each day to supplement information in the Bricks curriculum and to highlight important information.
- Small Group Sessions – occur every morning. Their goal is to develop your problem-solving skills in all aspects of the module content. They are designed to: 1) increase your understanding of neuroanatomical structures and pathways, 2) help you apply your new knowledge to clinical disorders, and 3) continue development of your communication skills. Materials available to help you are listed below under Learning Resources and are all accessed from the module web site.
- Location: 8 small group rooms within the Jacobs School
- Format: Small group sessions will begin at 10 AM and end by 11:20 AM. You will work in teams of 2-3 on the activities. Each session will be divided into 2 sections: Neuroanatomy review and case application. These are required sessions.
- Neuroanatomy Review Understanding the basis of neurological disorders requires knowledge of the structure of the nervous system. Small group sessions will begin with a quiz requiring you to identify structures learned from the Neuroanatomy Guide that you prepared prior to the session. This is followed by additional activities to review neuroanatomical structures and concepts. Consistent reviewing aids remembering.
- Case Application Working with your team-mates, you will develop answers to patient cases related to topics being studied, with the goal of applying your knowledge to clinical situations. Multiple cases are provided each day so you have a wide perspective of the types of clinical applications that relate to each topic. Subsequently, you will present your answers to others in your room for discussion. Strive to make these sessions informal, enjoyable, and productive.
- Review of Topics the morning will conclude with answers to questions you post about topics. This ensures clarity and consistency between small group discussions. Post any unanswered questions from your activities to the Muddiest Points Google Doc for discussion.
- 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, and stroke.
- Timing: Sessions will begin at 8 AM to allow you to compose answers to your assigned question. Discussion with faculty facilitators will begin at 8:30 AM. The session ends 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 discuss the information you have learned so you can demonstrate your understanding, develop verbal communication skills, and promote group discussion.
- Each case contains 7 questions that explore different aspects of the disorder.
- You are expected to review the cases with your team and prepare answers for the 7 questions ahead of time.
- On the morning of the session, the questions will be assigned randomly to the 7 teams in each room.
- You will have 30 min to compose your answer to the assigned question before room 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.
- 4th year medical students will be teaching assistants who will facilitate the small group sessions. Fourth-year students have participated in this module for many years. They provide a unique learning opportunity for peer teaching. TAs experienced the same learning environment as you and now they have added clinical experience to deepen their understanding and application of information to help you.
- 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 should be completed 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 is assigned for this activity. These questions do not require previous review of material. They prompt you to retrieve information from memory, helping to identify your strengths and weaknesses, and indicating which topics need review.
This module requires mandatory, daily attendance for small group activities. Attendance will be recorded by facilitators at these activities. We recognize that this requires additional effort from you, but we also want to make this manageable for you. Therefore, we will require attendance 4 out of 5 days per week, allowing you to miss 1 small group session per week, if necessary, for issues that may arise in your schedule. Lack of missed days is not an accumulating feature. This policy applies ONLY to 1) IMC 606, 2) Neurology component, 3) Fall semester, 4) small group sessions. The policy DOES NOT apply to faculty-facilitated sessions nor to any other module. This exception to the Jacobs School attendance policy was granted by the curriculum committee.
10. OPPORTUNITIES FOR SELF-DIRECTED LEARNINGUsing 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. Small group sessions provide time for you to work independently with your team. This material was developed by Dr Cohan and previous students specifically for this module to help you. The small group sessions provide time for you to work independently with your team. A video guide to the web site is available at the Tutorials Tab.
11. EXAMINATIONS, WEIGHTING, FORMATThere 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 the Neuroanatomy Guide (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 a patient’s 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.
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 problem-solving sessions.
Reporting of Exam Grades
Students will receive their grades on each exam through the Examsoft portal. An individual’s scores and grades will be accessible only to that student.
Reporting of Final Grades
Students will receive final module grades via email and/or on the myUB HUB system. Final module grades will not be released to a student until the course evaluation on MedHub is completed within four weeks of the course end date.
NOTE: Your final grade for this module appears only for IMC610. According to UB policy, a grade of “Z” is used for IMC606 because only 1 final grade can appear for a course.
See web site pages: Resources/Links, Tutorials, Atlas
Textbook: Neuroscience online
A Brain Museum contains gross brain specimens, whole and dissected, to illustrate nervous system structures. A Neuroanatomy Guide provides the material for learning structures and pathways of the central nervous system.
14. COURSE SCHEDULE - https://ubneuro-ccohan.webapps.buffalo.edu/NBsched.pdfPlease see the module web site for the most current 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.
15. SUPPORT SERVICES AVAILABLEPersonal 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
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 Sarah Crissy in the Office of Medical Curriculum at scrissy@buffalo.edu or 829-5838.
Course Failure and Remediation
Students who receive an Unsatisfactory grade in this course will be notified via email by the course director. The student may be contacted by the Office of Student and Academic Affairs to determine the next steps based on the Academic Status Policy. Students should notify Dr Cohan to arrange a schedule for the remediation.
If remediation is recommended, it will occur following the completion of the second year. Students are required to remediate sections of the module in which they received unsatisfactory grades. Students must attain an average grade of 70% or above to successfully complete the remediation. The material covered and the difficulty of the examinations are equivalent to that of the original module. Students have full access to the same learning material that was used 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
Please refer to the following links for absence and attendance policy information:
https://medicine.buffalo.edu/offices/ome/current/policies/absence-attend.html
https://medicine.buffalo.edu/faculty-council/policies/academic-status.html#title_395839540
https://medicine.buffalo.edu/faculty-council/policies/academic-status.html#title_432830091
Attendance is mandatory at exams, patient presentations, and designated small group activities and active learning sessions. 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
1. USEFUL TEXTBOOKS Neuroscience textbooks cover anatomical, physiological, and neurological components with varying detail. Strengths and weaknesses of selected neuroscience texts appear below. Many are available online from the Abbott library (links below) or can be borrowed from Dr Cohan for the semester.
- Neuroscience Online, - This is the recommended text. It is easy to access, up to date, and contains animations to aid understanding.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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: Helpful for identifying structures
Neuroanatomy, D.E.Haines, 10th Ed., Urban and Schwartzenberg, 2021 (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.