Teaching the Neurologic Examination: A Prospective Controlled Study to Compare a Blended Learning Approach With Face-to-Face Instruction

Background and Objectives

To compare a blended learning approach with traditional face-to-face instruction in terms of their individual effectiveness in imparting neurologic examination (NE) skills in medical students.


We conducted a prospective controlled study of 4th-year medical students (n = 163) who were pseudorandomly distributed into 2 groups. Group A (n = 87) was subjected to a traditional teaching method comprising 2 face-to-face sessions. Group B (n = 76) underwent blended learning, which consisted of an individual preparation period using a course handbook and videoclips, plus a single face-to-face session. NE skill acquisition was assessed by an objective structured clinical examination (OSCE). Questionnaires were used for evaluation.


Comparison of mean OSCE scores in groups A vs B revealed that NE skill acquisition was better in group B (blended learning), with a moderate effect size, a smaller OSCE score variance, and fewer students performing poorly than in group A (face-to-face instruction). Student evaluation revealed that both teaching approaches were well accepted, but a higher level of satisfaction was associated with the blended learning approach. This method also provided more time for practice and feedback.


The blended learning approach is a highly efficacious and valued method for teaching NE skills. It offers instructors and faculty the advantage of successful skill acquisition in students despite the considerably reduced attendance time.

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