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Kumarapuram S, Sreenivasan S, Mathivanan A, Manchiraju P, Khuroo M, Sundararajan S, Nanda A, Roychowdhury S, Gupta G. Network analysis of neurosurgical literature: an increased focus on training during the COVID-19 pandemic. Neurosurg Rev 2023; 46:178. [PMID: 37466764 DOI: 10.1007/s10143-023-02069-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/10/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023]
Abstract
The COVID-19 pandemic led to stringent guidelines to restrict the conduct of non-emergent surgical procedures. Consequently, neurosurgery departments experienced a decline in case volumes and greater educational time being spent on virtual research projects. In our report, we reveal how neurosurgical research has changed during the pandemic compared to the pre-pandemic phase. The WebOfScience database was searched for neurosurgical articles published between 2012-2019 (pre-pandemic) and 2020-2022 (pandemic). From this data, the keywords, terms, and countries were analyzed using networks formed by the VOS Viewer software. In addition, the analysis was repeated for neurosurgical articles specific to COVID-19. Network analyses of terms and keywords revealed an increased popularity of virtual research projects, including case reports, meta-analyses, reviews, surveys, and database studies. Additionally, there was increased interest in research pertaining to neurosurgical education during the post-pandemic era, including topics regarding virtual training modalities, mental health, and telemedicine. Our bibliometrics analysis suggests that the impact of COVID-19 restrictions on hospital systems affected neurosurgical training programs. Future investigations should explore the effects of the trainee experience during the COVID-19 pandemic on the outlook for neurosurgical education.
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Affiliation(s)
- Siddhant Kumarapuram
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Sanjeev Sreenivasan
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Akanksha Mathivanan
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Pranav Manchiraju
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Mohammad Khuroo
- Department of Neurosurgery, Rice University, Houston, TX, USA
| | - Srihari Sundararajan
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Anil Nanda
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Sudipta Roychowdhury
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Gaurav Gupta
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA.
- Rutgers RWJ Barnabas Healthcare System, Rutgers Robert Wood Johnson Medical School, 10 Plum Street, 5th floor, # 548, New Brunswick, NJ, 08903-2601, USA.
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Santyr B, Abbass M, Chalil A, Vivekanandan A, Krivosheya D, Denning LM, Mattingly TK, Haji FA, Lownie SP. High-fidelity, simulation-based microsurgical training for neurosurgical residents. Neurosurg Focus 2022; 53:E3. [DOI: 10.3171/2022.5.focus22188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/16/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Simulation is increasingly recognized as an important supplement to operative training. The live rat femoral artery model is a well-established model for microsurgical skills simulation. In this study, the authors present an 11-year experience incorporating a comprehensive, longitudinal microsurgical training curriculum into a Canadian neurosurgery program. The first goal was to evaluate training effectiveness, using a well-studied rating scale with strong validity. The second goal was to assess the impact of the curriculum on objective measures of subsequent operating room performance during postgraduate year (PGY)–5 and PGY-6 training.
METHODS
PGY-2 neurosurgery residents completed a 1-year curriculum spanning 17 training sessions divided into 5 modules of increasing fidelity. Both perfused duck wing and live rat vessel training models were used. Three modules comprised live microvascular anastomosis. Trainee performance was video recorded and blindly graded using the Objective Structured Assessment of Technical Skills Global Rating Scale. Eleven participants who completed the training curriculum and 3 subjects who had not participated had their subsequent operative performances evaluated when they were at the PGY-5 and PGY-6 levels.
RESULTS
Eighteen participants completed 106 microvascular anastomoses during the study. There was significant improvement in 6 measurable skills during the curriculum. The mean overall score was significantly higher on the fifth attempt compared with the first attempt for all 3 live anastomotic modules (p < 0.001). Each module had a different improvement profile across the skills assessed. Those who completed the microvascular skills curriculum demonstrated a greater number of independent evaluations during superficial surgical exposure, deep exposure, and primary maneuvers at the PGY-5 and PGY-6 levels.
CONCLUSIONS
High-fidelity microsurgical simulation training leads to significant improvement in microneurosurgical skills. Transfer of acquired skills to the operative environment and durability for at least 3 to 4 years show encouraging preliminary results and are subject to ongoing investigation.
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Affiliation(s)
- Brendan Santyr
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Mohamad Abbass
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Alan Chalil
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Amirti Vivekanandan
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Daria Krivosheya
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
- Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio
| | - Lynn M. Denning
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Thomas K. Mattingly
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
- Department of Neurosurgery, University of Rochester, Rochester, New York
| | - Faizal A. Haji
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
- Division of Neurosurgery, Department of Surgery, Queen’s University, Kingston, Ontario, Canada; and
| | - Stephen P. Lownie
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future. Indian J Surg 2022; 84:131-138. [PMID: 34149230 PMCID: PMC8197597 DOI: 10.1007/s12262-021-02964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 05/19/2021] [Indexed: 01/07/2023] Open
Abstract
The COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and 'face-to-face' clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions.
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Uche EO, Sundblom J, Iloabachie I, Ozoh II, Alalade A, Revesz D, Sandvik U, Olsson M, Mezue WC, Tisell M, Ryttlefors M. Pilot application of Lecture-Panel-Discussion Model (LPDM) in global collaborative neurosurgical education: a novel training paradigm innovated by the Swedish African Neurosurgery Collaboration. Acta Neurochir (Wien) 2022; 164:967-972. [PMID: 35059854 PMCID: PMC8776360 DOI: 10.1007/s00701-021-05071-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/14/2021] [Indexed: 11/29/2022]
Abstract
Background Disruptions in global surgery educational routines by the COVID-19 pandemic have elicited demands for alternative formats for rendering qualitative neurosurgical education. This study presents application of a novel model of online neurosurgical course, the Lecture-Panel-Discussion Model (LPDM). Methods This is a cross-sectional survey of participants who attended the Swedish African Neurosurgery Collaboration (SANC)-100A course. Participants evaluated the course through an online self-administered questionnaire using a 5-point Likert scale ranging from very poor—1, poor—2, average (fair)—3, good—4, to excellent—5. SANC-100A comprises a tripod of Lectures, Panel review, and interactive case Discussion. This model (LPDM) was innovated by SANC and applied at the Enugu International Neurosurgery course in February 2021. Results There were 71 attendees, 19 were course faculty, while 52 were participants. Thirty-five attended from Nigeria, 11 from Sweden, 3 from Malawi, 2 from Senegal, and 1 from the UK. Among 44 participants who completed the questionnaire, there were 9 fellows and 35 residents. The overall median course Likert rating was 4.65 ± 0.1. The median overall rating for course events was similar between day 1 (Likert score = 4.45) and day 2 (Likert score = 4.55), U = 55, Z score = 1.10, P = 0.27. The median rating for lectures was 4.50 ± 0.2 and varied from 4.40 on day 1 to 4.55 on day 2. The median rating for panel review was 4.60 ± 0.1 and varied from 4.55 on day 1 to 4.65 on day 2. Interactive case discussions were rated 4.80 on both course days. There was a significant variability in the rating profiles of the course tripod: U = 24.5, P = 0.03. Fifty-one (98%) participants believe LPDM was COVID-19-compliant, while 90% believe the course was beneficial to training and practice. Conclusion Initial application of LPDM is rewarded with both high acceptance and high rating among participants.
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