Examine the effect of ANSWER (Analogy, Switch to clinical, Embody the signs and Recall learning), a multi-modal undergraduate neurology teaching intervention, on knowledge acquisition and attitudes towards neurology in final year medical students.

Final year medical students were randomly distributed into two groups; an intervention group (ANSWER teaching) and a control group (usual teaching). A crossover design was used. Baseline test and trait anxiety measured using validated State-Trait Anxiety Inventory (STAIT-5) and Test Anxiety Inventory (TAI-5). Knowledge was assessed via multiple-choice-question examination (MCQE). Neurophobia (fear of neurology) was assessed via a validated scale Neuro-Combined Measure (NCM). 

Seventy-seven final-year medical students participated. In the intervention arm,  post-intervention MCQE scores (M =13.7, SD = 2.6) were significantly higher than baseline (M =11.4, SD = 2.5) (Z = 4.818 , p = 0.000). There was a significant reduction in median NCM score from baseline (m = 30, IQR = 26, 33) to post-intervention (m = 26, IQR = 24, 31) ( Z = -2.869, p = 0.004). Both MCQE (Z = 3.508, p = 0.005) and NCM (Z = -3.637, p = 0.003) changes were maintained post washout period in the intervention arm. In the control arm, there was no significant change in MCQE  pre (M = 11.4, SD = 3.3) and post-usual teaching (M = 12.3, SD =3.3) (Z = 1.782, p = 0.074) or NCM pre (m = 28.5, IQR 25,33) and post usual teaching (m = 28.5, IQR 25,31) (Z = -1.098 , p = 0.272).