Online teaching of clinical skills in neurology: Experience from a teaching institution during the Covid-19 pandemic

Background Medical education was completely online during the lockdown caused by the Covid-19 pandemic. This introduced new challenges in teaching clinical skills to medical students virtually. We describe the methods used by a tertiary teaching hospital to teach clinical skills in neurology to final year medical students and present the qualitative analysis of the feedback received from the students. Methods Clinical teaching was broadly divided into background clinical knowledge, history taking, clinical examination, and decision making leading to a diagnosis. To facilitate background clinical knowledge, the students created a virtual class notebook using OneNote. History taking skills were taught by using simulated patients, patients’ relatives with consent, faculty and peers to provide mock history. Clinical examination was taught by live streaming of clinical demonstration, home examination videos created by the students, and by pictures and videos of abnormal clinical signs. Clinical decision making and diagnosis were taught by using an online quiz with case scenarios where the students had to localize the lesion. Anonymous feedback was received from the students, and the themes from these were analysed. Results A higher percentage (36.9%, n=38) of students were confident in performing neurological examination and taking history independently compared to the students who were not confident (28.1%, n=29). The need for more clinical teaching was emphasized by the students. The students appreciated the OneNote compilation. The students also stated the difficulty in understanding without a real patient. Conclusion Teaching clinical skills in neurology through an online platform is challenging. The online platform can be used to strengthen the students understanding and background knowledge. It can be used to teach normal examination techniques and standardize teaching. However it is not a replacement for skills learnt by hands-on teaching.