On education: teaching the neurology-psychiatry interface using a flexible quadrant model

Objective: The emerging field of neuropsychiatry theoretically offers trainees the opportunity to synthesize the core competencies of neurology and psychiatry in managing patients with brain dysfunction. However, there is limited practical evidence to guide trainees on how to achieve this integrative approach in diverse clinical settings. Method: We describe a clinical training model involving "flexible quadrants", which interweaves the subject material of neurology and psychiatry in a learner-focused, case-based manner, and applies it to general medicine. In this model, N denotes a traditionally neurologic, and P a traditionally psychiatric, approach; patients require different admixtures of each approach at different timepoints, based on their current complaints and the course of their underlying neuropsychiatric conditions. Results: Several cases are presented in which mindful application of the quadrant model assisted trainees in clinical decision-making and resulted in positive outcomes for both patients and families. Conclusions: Further research should involve larger groups of neuropsychiatry trainees and supervisors and examine their perceptions of the quadrant model's efficacy as a framework for improving clinical reasoning and patient- centered care. Key words: flexible quadrants, education