Comprehensive Summary
This review, written by Cavalcanti, emphasizes the importance of improving upon current neurology education by integrating philosophical domains such as epistemology, ethics, and philosophy of mind in an age where neurotechnology and artificial intelligence are rising as critical tools in the field. They highlight how epistemology refines diagnostic reasoning, ethics emphasizes integrity in complex moral dilemmas, and philosophy of mind addresses clinical decision-making, especially in cases of neurological conditions, in which the boundaries between identity, agency, and consciousness are blurred. Cavalcanti insists upon the use of Kern’s 6-step curriculum development model as an organizing framework to embed each domain into neurology training and evaluate how the program can be improved. The first and second steps are to identify the problem and conduct a needs assessment. If students encounter difficulties in navigating complex clinical situations, it is important to identify this gap and provide more structured guidance in ethical reasoning skills, navigating uncertainty, and reflection while engaging with each philosophical domain. The third step is to create measurable goals and learning objectives aligned with competency-based assessment frameworks such as the ACGME Milestones. The fourth step is to integrate philosophical content into existing programs using interdisciplinary and case-based approaches. In regard to epistemology, structured approaches are proposed, such as uncertainty rounds and metacognitive workshops to build skills in epistemic humility and adaptive decision-making, though faculty training and institutional culture remain barriers. Integrating case-based seminars, simulations, and narrative reflection into core training would help to foster better ethical judgment and prepare clinicians to navigate both traditional dilemmas and emerging challenges such as end-of-life care, surrogate decision-making, and neurotechnology use. Furthermore, incorporating conceptual debriefings and narrative case analyses to explore cases in which questions of consciousness, identity, and agency impact prognosis supports dignity-centered care and equips clinicians to better conceptualize these situations. The fifth and sixth steps emphasize phased implementation, ongoing evaluation, and documentation of improvements in reasoning, ethical integrity, and patient-centered practice.
Outcomes and Implications
Integrating philosophy into medical education is critical, especially in regard to the field of neurology, through its growing technological advancements. This framework decenters a reductionist approach in favor of a more humanistic approach to understanding and treating neurological disorders. Clinically, incorporating these philosophical domains could foster better physician–patient communication, allow for shared decision-making, and aid with the interpretation of clinical findings within the context of each patient’s lived experiences. This proposal remains theoretical and requires long-term adjustments and continual phased integration rounds prior to more widespread implementations. The ideal approach would be to create a pilot curriculum launched across two clinical rotations, likely neurological, alongside regular philosophical integration sessions with feedback and adjustments as needed. Nevertheless, adopting such a framework in medical education and specialty training has the potential to significantly enhance the quality and depth of patient care.