title: Medical students' experience of emotions and success in neurological studies - What do they tell us?
abstract: BACKGROUND
  There is a need to develop effective educational experience in neurology to improve the students' skills in diagnosing and managing patients with neurological symptoms or disease. The aim of this study was to investigate the medical students' attitudes and emotions towards neurology before and after the four week clinical course at two Finnish Universities in order to find elements to improve effective learning by decreasing the emotional stress in medical studies.
  
  
  METHODS
  In this two-stage study, 58 medical students participated in an internet survey with open-ended questions after completing a clinical neurology course. In the content analysis of this survey 20 students (35%) were identified with negative anticipation towards neurology before undertaking the clinical neurology course. In the second phase of the study, the narrative analysis method was used to analyse the face-to-face interviews. Two of these interviews are described in this paper and represent cases who expressed negative emotions in both online survey and narrative interview.
  
  
  RESULTS
  According to the content analysis, the principal emotions that were experienced at the beginning of the clinical neurology course were insecurity about personal performance (n = 19, 95%) anxiety (n = 9, 45%) and fear (n = 6, 30%). During the course the combined negative emotions (insecurity, anxiety, and fear) decreased in 80% of students (16/20 cases), remained unchanged in 15% (3/20) and could not be evaluated in 1 (5%) case. The main reasons for the observed negative anticipation were the complexity of neurology and challenges in the interpretation of clinical findings. Based on content analysis and narratives, elements that were evaluated as the most significant contributors in reducing this included small group teaching with real patients, teachers' expertise and the increase in self-confidence.
  
  
  CONCLUSIONS
  Teaching with appropriate didactic methodology and feedback, and plenty of practical training can improve effective learning in neurology. We suggest that the pedagogic competence of the clinical teacher influences a student's motivation and proficiency and reduce stress in neurology-related learning tasks.
authors.affiliation: Research Unit of Clinical Neuroscience, University of Oulu, B.O.X. 5000, 90014, Oulu, Finland. hanna.ansakorpi@oulu.fi.|Oulu University Hospital, B.O.X. 5000, 90014, Oulu, Finland. hanna.ansakorpi@oulu.fi.
authors.forename: Hanna
authors.initials: H
authors.lastname: Ansakorpi
authors.affiliation: School of Medicine, University of Tampere, 33014, Tampere, Finland.
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Sumelahti
authors.affiliation: Faculty of Education, University of Oulu, B.O.X. 2000, 90014, Oulu, Finland.
authors.forename: Raimo
authors.initials: R
authors.lastname: Kaasila
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D004644:Emotions; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009462:Neurology / Q000193:education*; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*
keywords: Clinical teaching; Medical education; Neurology; Qualitative; Undergraduate