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Navigating the online galaxy for up-to-date evidence-based knowledge in clinical neurology can be a challenge. Practical Neurology is a noted and popular online clinical resource,1 which according to its website is "…practical in the sense of being useful for everyone who sees neurological patients and who want to keep up to date, and safe, in managing them." As UK-based neurology trainees, we have been fortunate to have automatic access to Practical Neurology during our training. We found that the articles adequately covered most elements in our syllabus and were ideal reference material for our department. This accords with the recent readership survey: for almost 80% of readers, the journal impacts positively on their clinical work, contains reliable information and reflects real-life clinical neurology practice.2 Therein lay an opportunity to address the challenge of how to navigate online resources for high-standard reference material: that is, by using Practical Neurology as a standard knowledge base.
We set about arranging all the articles from the journal since its inception in 2001 into clinically focused sections, using the structure of our curriculum as an initial categorisation framework. We are grateful for the opportunity now to introduce and share our article-mapping project as an online resource with the readers of Practical Neurology: it is available as a reference table on the journal’s non-beta homepage (pn.bmj.com) under the ‘UK Curriculum’ section.
During the tabulation process, we excluded articles that were less relevant to clinical neurology, such as Book Club and ‘Carphology’. Articles selected by one neurology trainee were independently cross-checked by another trainee against the table of contents of the respective issue to ensure no relevant articles were missed. We tabulated the first author, title and year of final selected articles against the relevant curriculum item in an edited form of the 2010 syllabus, and categorised each as either ‘Review’ or ‘non-Review’. For example, ‘Powell 2012. Acute Symptomatic Seizures’ was tabulated as a ‘Review’ next to ‘Knowledge of the differential diagnosis of paroxysmal and transient events’ under item 2.6 ‘Epilepsy and Loss of Consciousness’ of the syllabus (figure 1).
We encountered challenges during the article tabulation process that we addressed as follows. If there was difficulty in allocating a category, two trainees would discuss the article to decide where to tabulate it; for example, ‘Johnston 2004. Neurological Disease at 30,000 Feet’ was eventually mapped to ‘Adopt assessments and interventions that are...patient-centred’ under item 1.4 of the syllabus. Similarly, with articles that spanned many categories, two trainees would discuss it and then tabulate it under the section for which it had narrowest scope; for example, we placed ‘Lim 2014. Postpartum Headache: Diagnostic Considerations’ under syllabus item 1.12 ‘Special Interest Groups: Women and Pregnancy’, rather than under the headache or stroke categories.
Since early 2015, after completing the initial retrospective phase of tabulating articles, we have populated the table as each new issue of Practical Neurology is published, to benefit the readers. We found that the easily retrievable references in the table enhanced the work-based learning in our department; for instance, by having Gozzard et al’s 2010 article easily accessible when confronted with a case of paraneoplastic syndrome on a recent ward round.
Future prospects for the Practical Neurology reference table include:
Making it completely web-based to allow interlinking with electronic portfolios, and therefore record every download as evidence of ‘reflective practice’ for continuing medical education;
Enhancing its online cross-referencing for articles that span many categories;
Identifying sparse areas, such as ‘evaluation of mental competency’ in figure 1, to commission relevant articles in the future;
Developing it into a mobile application, or ‘app’, for more rapid access during clinical decision making;3
Supplementing templates for neurology training. The structure and content of the UK neurology curriculum is similar to neurology curricula from other countries such as the USA. Just as the decade-old ‘Residents and Fellows Section’ in the Neurology journal supports US residents, the above reference table can provide support within and even beyond the UK; as such, it is already being used to fashion a future postresidency neurology fellowship at a university hospital in Kenya.
The Practical Neurology table contributes to the increasing trend of neurology education harnessing information and communication technologies to improve learning and professional development.4 We envisage it will continue to develop into a more comprehensive learning and reference tool and offer it to readers as a useful online resource.
DS thanks his former colleagues Dr Dan Blackburn and Dr Gary Dennis (training programme director) at the Department of Clinical Neurology, Sheffield Teaching Hospitals NHS Foundation Trust for their supervision of the project. We are all grateful to James Smallbone and his team from the BMJ Publishing Executive for linking each article in the table to the respective HTML file.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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