Neurosurgeon as educator: a review of principles of adult education and assessment applied to neurosurgery

Jensen, Randy L.; Alzhrani, Gmaan; Kestle, John R. W.; Brockmeyer, Douglas L.; Lamb, Sara; Couldwell, William T.

doi:10.3171/2017.3.jns17242

Cited by 4 publications

(5 citation statements)

References 92 publications

(123 reference statements)

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“…Evaluation of trainees' progress and feedback is done via an in-house NETS-SAS scoring system for task-based training that is similar to video OSATS. 1,25,26 Experts are posted on-site and review video footage of the various training modules. Personalized tips on how to improve, technical demonstrations by experts on various modules, and supervised performance of tasks provide a holistic learning experience to the residents during their routine training.…”

Section: Discussionmentioning

confidence: 99%

“…in neurosurgery as well as the higher stakes of the most minuscule errors makes the traditional implementation of the Halsted model inefficient. [1][2][3][4] Hence, nontraditional, or "out of OR" simulation-based training, is essential for neurosurgery. [5][6][7] Currently, this need is higher due to multiple factors such as an increase in the number of residents, work hour restrictions, the number of postresidency trainees, financial and ethical constraints, neurosurgical subspecialization, and focus on using technology to improve patient outcomes at the cost of learning opportunities for trainees.…”

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confidence: 99%

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Interval assessment using task- and procedure-based simulations: an attempt to supplement neurosurgical residency curriculum

Sharma

Katiyar

Narwal

et al. 2022

Neurosurgical Focus

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OBJECTIVE The longer learning curve and smaller margin of error make nontraditional, or "out of operating room" simulation training, essential in neurosurgery. In this study, the authors propose an evaluation system for residents combining both task-based and procedure-based exercises and also present the perception of residents regarding its utility. METHODS Residents were evaluated using a combination of task-based and virtual reality (VR)–based exercises. The results were analyzed in terms of the seniority of the residents as well as their laboratory credits. Questionnaire-based feedback was sought from the residents regarding the utility of this evaluation system incorporating the VR-based exercises. RESULTS A total of 35 residents were included in this study and were divided into 3 groups according to seniority. There were 11 residents in groups 1 and 3 and 13 residents in group 2. On the overall assessment of microsuturing skills including both 4-0 and 10-0 microsuturing, the suturing skills of groups 2 and 3 were observed to be better than those of group 1 (p = 0.0014). Additionally, it was found that microsuturing scores improved significantly with the increasing laboratory credits (R2 = 0.72, p < 0.001), and this was found to be the most significant for group 1 residents (R2 = 0.85, p < 0.001). Group 3 residents performed significantly better than the other two groups in both straight (p = 0.02) and diagonal (p = 0.042) ring transfer tasks, but there was no significant difference between group 1 and group 2 residents (p = 0.35). Endoscopic evaluation points were also found to be positively correlated with previous laboratory training (p = 0.002); however, for the individual seniority groups, the correlation failed to reach statistical significance. The 3 seniority groups performed similarly in the cranial and spinal VR modules. Group 3 residents showed significant disagreement with the utility of the VR platform for improving surgical dexterity (p = 0.027) and improving the understanding of surgical procedures (p = 0.034). Similarly, there was greater disagreement for VR-based evaluation to identify target areas of improvement among the senior residents (groups 2 and 3), but it did not reach statistical significance (p = 0.194). CONCLUSIONS The combination of task- and procedure-based assessment of trainees using physical and VR simulation models can supplement the existing neurosurgery curriculum. The currently available VR-based simulations are useful in the early years of training, but they need significant improvement to offer beneficial learning opportunities to senior trainees.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Interval assessment using task- and procedure-based simulations: an attempt to supplement neurosurgical residency curriculum

Sharma

Katiyar

Narwal

et al. 2022

Neurosurgical Focus

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“…A purposive sample of senior consultant trainers per country was surveyed. On the basis of standard curriculum guidelines per country, as well as their perception of several models of learning that are relevant to neurosurgical education, 24 these consultants were asked to describe the neurosurgical training environment and educational curricula in their country. The free-text responses that they provided were analyzed and summarized in accordance with qualitative content analysis techniques.…”

Section: Qualitative Data Analysismentioning

confidence: 99%

“…Residents may start off assisting in surgery and, as they progress, begin to perform on their own according to the type of case and difficulty index. The 4 levels of neurosurgical competency, based on a modification of the Miller pyramid, 24,57 provide the foundation of neurosurgical training.…”

Section: Indonesiamentioning

confidence: 99%

The state of neurosurgical training and education in East Asia: analysis and strategy development for this frontier of the world

Ferraris

Matsumura

Wardhana

et al. 2020

Neurosurgical Focus

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OBJECTIVEThe authors, who are from Indonesia, Japan, Malaysia, the Philippines, and Taiwan, sought to illustrate the processes of training neurosurgeons in their respective settings by presenting data and analyses of the current state of neurosurgical education across the East Asian region.METHODSThe authors obtained quantitative data as key indicators of the neurosurgical workforce from each country. Qualitative data analysis was also done to provide a description of the current state of neurosurgical training and education in the region. A strengths, weaknesses, opportunities, and threats (SWOT) analysis was also done to identify strategies for improvement.RESULTSThe number of neurosurgeons in each country is as follows: 370 in Indonesia, 10,014 in Japan, 152 in Malaysia, 134 in the Philippines, and 639 in Taiwan. With a large neurosurgical workforce, the high-income countries Japan and Taiwan have relatively high neurosurgeon to population ratios of 1 per 13,000 and 1 per 37,000, respectively. In contrast, the low- to middle-income countries Indonesia, Malaysia, and the Philippines have low neurosurgeon to population ratios of 1 per 731,000, 1 per 210,000, and 1 per 807,000, respectively. In terms of the number of training centers, Japan has 857, Taiwan 30, Indonesia 7, Malaysia 5, and the Philippines 10. In terms of the number of neurosurgical residents, Japan has 1000, Taiwan 170, Indonesia 199, Malaysia 53, and the Philippines 51. The average number of yearly additions to the neurosurgical workforce is as follows: Japan 180, Taiwan 27, Indonesia 10, Malaysia 4, and the Philippines 3. The different countries included in this report have many similarities and differences in their models and systems of neurosurgical education. Certain important strategies have been formulated in order for the system to be responsive to the needs of the catchment population: 1) establishment of a robust network of international collaboration for reciprocal certification, skills sharing, and subspecialty training; 2) incorporation of in-service residency and fellowship training within the framework of improving access to neurosurgical care; and 3) strengthening health systems, increasing funding, and developing related policies for infrastructure development.CONCLUSIONSThe varied situations of neurosurgical education in the East Asian region require strategies that take into account the different contexts in which programs are structured. Improving the education of current and future neurosurgeons becomes an important consideration in addressing the health inequalities in terms of access and quality of care afflicting the growing population in this region of the world.

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“…2-6 Much of the neurosurgical education literature concentrates on systematic improvements, pilot studies, educational theory, or highlighting gaps in training. 7-14 However, there is no centralized repository of tangible opportunities for those interested in becoming neurosurgical educators. Our letter aims to outline resources that residents and fellows as well as junior and senior faculty can join to improve their skills and practice as surgical educators.…”

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confidence: 99%

Letter: Neurosurgical Educators

et al. 2023

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To the Editor:We recently read with excitement the Neurosurgical Focus volume titled Education Methodology and Metrics in the Training of Neurosurgical Residents. 1 The Focus volume drew attention to a number of innovative educational initiatives including simulation, virtual reality, milestone evaluations, intraoperative autonomy assessments, and subintern curriculum reforms. [2][3][4][5][6] Much of the neurosurgical education literature concentrates on systematic improvements, pilot studies, educational theory, or highlighting gaps in training. 7-14 However, there is no centralized repository of tangible opportunities for those interested in becoming neurosurgical educators. Our letter aims to outline resources that residents and fellows as well as junior and senior faculty can join to improve their skills and practice as surgical educators. Neurosurgeons who share this interest will be offered a landscape of the current institutional and national certificate programs, medical education degrees, target journals, and medical education conferences.Certificate programs remain a common and practical means of obtaining a short-term, high-yield primer for medical education. Many institutions have outstanding local programs (Table ). At a national level, Harvard Macy Institute remains a pillar for medical education training, offering 6 courses. Two of these are particularly important to highlight: for residents and fellows, the Program for Post-Graduate Trainees: Future Academic Clinician-Educators (PGME) is a 3-day (currently virtual) foundational course in medical education; for faculty, the Program for Educators in Health Professions runs over the course of a year and includes Fall and Spring 3-day sessions intermixed with monthly CORRESPONDENCE

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Neurosurgeon as educator: a review of principles of adult education and assessment applied to neurosurgery

Cited by 4 publications

References 92 publications

Interval assessment using task- and procedure-based simulations: an attempt to supplement neurosurgical residency curriculum

Interval assessment using task- and procedure-based simulations: an attempt to supplement neurosurgical residency curriculum

The state of neurosurgical training and education in East Asia: analysis and strategy development for this frontier of the world

Letter: Neurosurgical Educators

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