The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

Abstract

Personalized care models are dominating modern medicine. These models are rooted in teaching future physicians the skill set to keep up with innovation. In orthopedic surgery and neurosurgery, education is increasingly influenced by augmented reality, simulation, navigation, robotics, and in some cases, artificial intelligence. The postpandemic learning environment has also changed, emphasizing online learning and skill- and competency-based teaching models incorporating clinical and bench-top research. Attempts to improve work–life balance and minimize physician burnout have led to work-hour restrictions in postgraduate training programs. These restrictions have made it particularly challenging for orthopedic and neurosurgery residents to acquire the knowledge and skill set to meet the requirements for certification. The fast-paced flow of information and the rapid implementation of innovation require higher efficiencies in the modern postgraduate training environment. However, what is taught typically lags several years behind. Examples include minimally invasive tissue-sparing techniques through tubular small-bladed retractor systems, robotic and navigation, endoscopic, patient-specific implants made possible by advances in imaging technology and 3D printing, and regenerative strategies. Currently, the traditional roles of mentee and mentor are being redefined. The future orthopedic surgeons and neurosurgeons involved in personalized surgical pain management will need to be versed in several disciplines ranging from bioengineering, basic research, computer, social and health sciences, clinical study, trial design, public health policy development, and economic accountability. Solutions to the fast-paced innovation cycle in orthopedic surgery and neurosurgery include adaptive learning skills to seize opportunities for innovation with execution and implementation by facilitating translational research and clinical program development across traditional boundaries between clinical and nonclinical specialties. Preparing the future generation of surgeons to have the aptitude to keep up with the rapid technological advances is challenging for postgraduate residency programs and accreditation agencies. However, implementing clinical protocol change when the entrepreneur–investigator surgeon substantiates it with high-grade clinical evidence is at the heart of personalized surgical pain management.

Bibliometric analysis of global scientific literature on the application and implementation of artificial intelligence in higher education

“…Within the bibliometric analysis, the presence of Malaysia and Taiwan also stands out, providing evidence of academic leadership, possibly with technological roots (Shi, 2023), by Asian countries. This is not disconnected from the rapid progress of their industries and the strong support from their governments, which has narrowed the gap between their scienti c production and that traditional powers (Lewandrowski et al, 2023). It is also important to note that, although the United States has the most diversi ed co-authorship network, its collaboration with Germany, Saudi Arabia, the United Kingdom, and Spain is still in its early stages.…”

Enhancing microsurgical skills in neurosurgery residents of low-income countries: A comprehensive guide

“…The increasing use of virtual reality research, virtual meetings, online education initiatives, and telehealth, initially introduced out of necessity during the COVID-19 pandemic, represent interesting tools to expand their knowledge and research among low-income country residents. [ 1 , 17 , 21 , 24 , 31 , 40 ] By networking and exchanging knowledge with experts in the field, low-income hospitals can enhance their microsurgical training opportunities and stay updated with the latest advancements.…”

On the balance beam: facing the challenges of neurosurgical education in the third millennium

“…In other words, while it is crucial to enhance the educational process, it is equally vital to uphold and maintain expert proficiency. [ 16 ] It is, therefore, essential to find an optimal balance between the integration of innovative training methods and the preservation of the time-tested principles and practices of neurosurgery. Neurosurgical education in the third millennium faces new, unprecedented challenges that require reshaping our current didactical methods, especially when considering the different scenarios of high- and low- and middle-income countries (LMICs).…”