Introduction

Neurophobia, a perceived fear of neurology, exists amongst medical students and physicians alike but less is known about its prevalence in veterinary medicine. Neurological emergencies make up a significant proportion of small animal emergency and critical care caseload. The aim of our study was to investigate clinical confidence levels of ECC clinicians (ECC) managing neurological emergencies as well as to identify opportunities for improved collaboration and neurological training of ECC.

Methods

An online survey was distributed via specialty colleges’ mailing lists and discussion forums to ECC and neurology (NEUR) specialists and residents to assess self-reported and NEUR perceived competence of ECCs’ management of neurological emergencies. Questions covered respondents’ demographics, stress levels when managing neurological emergencies, and confidence with aspects of the neurological examination and neuroanatomical localization. Chi-square and Mann-Whitney-U tests were used to compare multiple categorical responses and continuous confidence scores between groups. P-values of <0.05 were considered significant.

Results

Responses from 192 ECC and 104 NEUR were analyzed. Fifty-two percent of ECC respondents found neurological emergencies to be slightly challenging, whereas 85% of NEUR respondents felt such emergencies to be moderately to extremely challenging for ECC (p<0.0001). ECCs’ median self-reported confidence score in performing a neurologic examination on a scale of 0–100 was 75 (IQR 58–85), while NEUR respondents reported a median ECC competence of 44 (IQR 30–51) (p<0.0001). ECC respondents rated their confidence in localizing intracranial, spinal, and neuromuscular disease as 67 (IQR 41–81), 88 (IQR 73–94), and 60 (IQR 43–80), which were significantly higher than NEUR respondents’ estimates of ECC competence of 35 (IQR 20–58), 51 (IQR 40–71), and 18 (10–30), respectively (p<0.0001). Following case transfer, only 37% of ECC sought out and received NEUR feedback in >75% of cases.

Conclusions

Noticeable discrepancies exist between ECC and NEUR perceptions of ECCs’ clinical confidence with neurological emergencies. Consistent favorable estimation of competence rather than the expected neurophobia was found amongst ECC. Increased interactions between the two specialties, such as joint rounds and frequent feedback after case transfer should be encouraged to further ECC exposure to neurological cases as well as NEURs’ understanding of challenges faced by ECC.

Disclosures

No disclosures to report.