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Haizel-Cobbina J, Balogun JA, Park KB, Haglund MM, Dempsey RJ, Dewan MC. An Overview of Global Neurosurgery. Neurosurg Clin N Am 2024; 35:389-400. [PMID: 39244311 DOI: 10.1016/j.nec.2024.05.001] [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] [Indexed: 09/09/2024]
Abstract
Until recently, surgery had been passed over in the domain of global health, historically being described as "the neglected stepchild of global health." Knowledge of the existing global disparities in neurosurgical care has led to neurosurgery capacity-building efforts especially in low-income and middle-income countries. While many global collaborative projects are currently undertaken with philanthropic support, sustainability and scalability are not likely without governmental adoption of neurosurgery-inclusive national surgical plans. Momentum grows for the global neurosurgery community to develop a global neurosurgery action plan outlining goals, a guiding framework, an execution plan, and indicators for monitoring and evaluation.
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Affiliation(s)
- Joseline Haizel-Cobbina
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James A Balogun
- Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Kee B Park
- Program in Global Surgery and Social Change, Harvard University, Boston, MA, USA
| | - Michael M Haglund
- Department of Neurosurgery, Division of Global Neurosurgery and Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Robert J Dempsey
- Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Michael C Dewan
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA.
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2
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Gupta S, Gomez MG, Johnston JM, Park KB. Global Partnerships in Neurosurgery: Mapping the Need. Neurosurg Clin N Am 2024; 35:489-498. [PMID: 39244321 DOI: 10.1016/j.nec.2024.05.011] [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] [Indexed: 09/09/2024]
Abstract
The field of global neurosurgery seeks to improve access to neurosurgery and reduce health disparities worldwide. This process depends on intensive collaboration between partners in high-income and low-to-middle income country (LMIC) settings. Several such collaborations have propelled global neurosurgery forward, and long-standing partnerships in particular have brought subspecialty care and training to new locations. Recently, there have been more reports of collaborations between LMICs themselves. In this narrative study, we summarize the state of collaboration in global neurosurgery and discuss how the field is likely to change moving forward.
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Affiliation(s)
- Saksham Gupta
- Program for Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Martina Gonzalez Gomez
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James M Johnston
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kee B Park
- Program for Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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3
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Koueik J, Meisner L, Rocque BG, Moser R, Dempsey RJ. Nongovernmental Organizations in Global Neurosurgery: Foundation for International Education in Neurological Surgery and Solidarity Bridge. Neurosurg Clin N Am 2024; 35:475-480. [PMID: 39244319 DOI: 10.1016/j.nec.2024.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Health care disparities between high-income countries (HICs) and low- and middle-income countries (LMICs) are well established. The focus of the surgical aspect of health was identified in the early twenty-first century, and efforts to provide safe surgical intervention require the shift of resources from HICs to LMICs with specialized surgeons, anesthesiologists, and equipment. This intervention may make a difference on the short run; however, to achieve a long-term self-sustaining surgical service in the region of need, education and training of local physicians is key.
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Affiliation(s)
- Joyce Koueik
- Department of Neurological Surgery, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA
| | - Lars Meisner
- Department of Neurological Surgery, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA
| | - Brandon G Rocque
- Division of Pediatric Neurosurgery, Department of Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 400, Birmingham, AL 35233, USA
| | - Richard Moser
- Department of Neurological Surgery, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Robert J Dempsey
- Department of Neurological Surgery, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.
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Civilla L, Dodier P, Palumbo MC, Redaelli ACL, Koenigshofer M, Unger E, Meling TR, Velinov N, Rössler K, Moscato F. Development and assessment of case-specific physical and augmented reality simulators for intracranial aneurysm clipping. 3D Print Med 2024; 10:30. [PMID: 39292343 PMCID: PMC11411828 DOI: 10.1186/s41205-024-00235-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 09/05/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Microsurgical clipping is a delicate neurosurgical procedure used to treat complex Unruptured Intracranial Aneurysms (UIAs) whose outcome is dependent on surgeon's experience. Simulations are emerging as excellent complements to standard training, but their adoption is limited by the realism they provide. The aim of this study was to develop and validate a microsurgical clipping simulator platform. METHODS Physical and holographic simulators of UIA clipping have been developed. The physical phantom consisted of a 3D printed hard skull and five (n = 5) rapidly interchangeable, perfused and fluorescence compatible 3D printed aneurysm silicone phantoms. The holographic clipping simulation included a real-time finite-element-model of the aneurysm sac, allowing interaction with a virtual clip and its occlusion. Validity, usability, usefulness and applications of the simulators have been assessed through clinical scores for aneurysm occlusion and a questionnaire study involving 14 neurosurgical residents (R) and specialists (S) for both the physical (p) and holographic (h) simulators by scores going from 1 (very poor) to 5 (excellent). RESULTS The physical simulator allowed to replicate successfully and accurately the patient-specific anatomy. UIA phantoms were manufactured with an average dimensional deviation from design of 0.096 mm and a dome thickness of 0.41 ± 0.11 mm. The holographic simulation executed at 25-50 fps allowing to gain unique insights on the anatomy and testing of the application of several clips without manufacturing costs. Aneurysm closure in the physical model evaluated by fluorescence simulation and post-operative CT revealed Raymond 1 (full) occlusion respectively in 68.89% and 73.33% of the cases. For both the simulators content validity, construct validity, usability and usefulness have been observed, with the highest scores observed in clip selection usefulness Rp=4.78, Sp=5.00 and Rh=4.00, Sh=5.00 for the printed and holographic simulators. CONCLUSIONS Both the physical and the holographic simulators were validated and resulted usable and useful in selecting valid clips and discarding unsuitable ones. Thus, they represent ideal platforms for realistic patient-specific simulation-based training of neurosurgical residents and hold the potential for further applications in preoperative planning.
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Affiliation(s)
- Lorenzo Civilla
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Philippe Dodier
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Maria Chiara Palumbo
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Alberto C L Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Markus Koenigshofer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
| | - Torstein R Meling
- Department of Neurosurgery, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - Nikolay Velinov
- Clinics of Neurosurgery, University Hospital Pirogov, Medical University of Sofia, Sofia, Bulgaria
| | - Karl Rössler
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria.
- Austrian Cluster for Tissue Regeneration, Vienna, Austria.
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5
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Spiriev T, Körner KM, Steuwe A, Wolf-Vollenbröker M, Trandzhiev M, Nakov V, Cornelius JF. Immersive Photorealistic Three-Dimensional Neurosurgical Anatomy of the Cerebral Arteries: A Photogrammetry-Based Anatomic Study. Oper Neurosurg (Hagerstown) 2024:01787389-990000000-01318. [PMID: 39254300 DOI: 10.1227/ons.0000000000001198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/28/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Neurosurgeons need a profound knowledge of the surgical anatomy of the cerebral arteries to safely treat patients. This is a challenge because of numerous branches, segments, and tortuosity of the main blood vessels that supply the brain. The objective of this study was to create high-quality three-dimensional (3D) anatomic photorealistic models based on dissections of the brain arterial anatomy and to incorporate this data into a virtual reality (VR) environment. METHODS Two formaldehyde-fixed heads were used. The vessels were injected with radiopaque material and colored silicone and latex. Before the dissections, the specimens were computed tomography scanned. Stratigraphical anatomic dissection of the neck and brain was performed to present the relevant vascular anatomy. A simplified surface scanning method using a mobile phone-based photogrammetry application was used, and the data were incorporated into a VR 3D modeling software for post-processing and presentation. RESULTS Fifteen detailed layered photorealistic and two computed tomography angiography-based 3D models were generated. The models allow manipulation in VR environment with sufficient photographic detail to present the structures of interest. Topographical relevant anatomic structures and landmarks were annotated and uploaded for web-viewing and in VR. Despite that the VR application is a dedicated 3D modeling platform, it provided all necessary tools to be suitable for self-VR study and multiplayer scenarios with several participants in one immersive environment. CONCLUSION Cerebral vascular anatomy presented with photogrammetry surface scanning method allows sufficient detail to present individual vessel's course and even small perforating arteries in photorealistic 3D models. These features, including VR visualization, provide new teaching prospects. The whole study was done with simplified algorithms and free or open-source software platforms allowing creation of 3D databases especially useful in cases with limited body donor-based dissection training availability.
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Affiliation(s)
- Toma Spiriev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, Bulgaria
| | - Kay M Körner
- Institute for Anatomy I, Medical Faculty & University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Steuwe
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael Wolf-Vollenbröker
- Institute for Anatomy I, Medical Faculty & University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Martin Trandzhiev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, Bulgaria
| | - Vladimir Nakov
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, Bulgaria
| | - Jan Frederick Cornelius
- Department of Neurosurgery, Medical Faculty & University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Precious Fadele K, M K, Chaurasia B. Influence of social media in attracting future neurosurgeons to neurosurgery. Ann Med Surg (Lond) 2024; 86:4969-4970. [PMID: 39238963 PMCID: PMC11374214 DOI: 10.1097/ms9.0000000000002405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 07/16/2024] [Indexed: 09/07/2024] Open
Affiliation(s)
| | - Kodeeswaran M
- Department of Neurosurgery, Govt Kilpauk Medical College, Chennai, India
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal
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7
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Adzeley Boi-Dsane NA, Venkatesh P, Tenkorang P, Omoba O, Limann B, Opara A, Osunjimi AA, Barrie U, Totimeh T, Emmanuel I, Banson M. African Women in Neurosurgery: An Exploration of Historical Perspectives, Current Realities, and Future Prospects. World Neurosurg 2024; 191:10-22. [PMID: 39067689 DOI: 10.1016/j.wneu.2024.07.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Gender disparities remain a significant issue, particularly impacting African women in the field of neurosurgery. METHODS Databases, articles, and perspectives were reviewed to identify challenges faced by African Women in Neurosurgery (AWIN), and explore solutions for recruitment, retention, and career advancement of AWIN. RESULTS In 1982, Africa saw its first female neurosurgeon, with the first female president of the World Federation of Neurosurgical Societies appointed 4 null decades later. Presently, the continent hosts 245 female neurosurgeons, with North Africa comprising the majority at 76.3%, with Algeria notably contributing 72.2% of this total. Southern Africa contributes 7.8%, while West Africa, East Africa, and Central Africa contribute 6.5%, 6.1%, and 3.3%, respectively. Thirteen countries lack neurosurgeons entirely and 30 out of the 54 African nations face shortages of female neurosurgeons, with distributions as follows: North Africa (1-country), Southern Africa (6-countries), West Africa (8-countries), East Africa (9-countries), and Central Africa (6-countries). Our analysis mapped the distribution of 245 AWIN across the African regions and examined the professional trajectories and achievements of 17 pioneering AWIN. Additionally, we compiled registries for: 1) 76 neurosurgical training programs across 26 African countries, 2) organizations tackling gender disparities in neurosurgery, and 3) recommendations to promote AWIN across governmental, community, and academic spheres. CONCLUSIONS To boost AWIN representation in neurosurgery, concerted and comprehensive efforts are vital. Collaboration among medical schools, training programs, and governments is key to fostering diversity and inclusivity in African neurosurgical settings.
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Affiliation(s)
| | - Pooja Venkatesh
- University of Texas Southwestern Medical Center Department of Neurological Surgery, Dallas, Texas, USA.
| | | | - Oluwaseun Omoba
- Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | | | - Amoge Opara
- University of Texas Southwestern Medical Center Department of Neurological Surgery, Dallas, Texas, USA
| | - Adurape A Osunjimi
- University of Texas Southwestern Medical Center Department of Neurological Surgery, Dallas, Texas, USA
| | - Umaru Barrie
- University of Texas Southwestern Medical Center Department of Neurological Surgery, Dallas, Texas, USA
| | | | - Ibironke Emmanuel
- University of Texas Southwestern Medical Center Department of Neurological Surgery, Dallas, Texas, USA
| | - Mabel Banson
- Department of Neurosurgery, Korle Bu Teaching Hospital, Accra, Ghana
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8
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Ismail FW, Ajani K, Baqir SM, Nadeem A, Qureshi R, Petrucka P. Challenges and opportunities in the uptake of simulation in healthcare education in the developing world: a scoping review. MEDEDPUBLISH 2024; 14:38. [PMID: 39257565 PMCID: PMC11384200 DOI: 10.12688/mep.20271.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2024] [Indexed: 09/12/2024] Open
Abstract
Background Simulation is increasingly being adopted by healthcare educators throughout the developed world as it offers a safe environment to practice skills. While there is literature on learning via simulation in healthcare in the developed world, more studies are required to investigate the factors influencing this approach in the developing world. Objective This scoping review highlights the key factors that act as deterrents as well as encouragement to the uptake of simulation as a teaching methodology in healthcare education in developing countries. Design The MEDLINE (via OVID, using keywords and MeSH in OVID), and PubMed (via NCBI using MeSH), and CINAHL databases were searched between January 2000 and January 2024 for research articles published in peer reviewed English language journals using a combination of keywords. Results A total of 48 articles were included in the final analysis. Challenges and opportunities were divided into professional, academic, and resource-based factors, and their individual sub-themes. The main challenges reported were the lack of a contextual curriculum, content heavy curricula, dearth of trained simulationists and cost of simulators. Performance anxiety was an important challenge reported by both trainers and trainees. Main opportunities were an interest in adopting simulation-based education from both trainers and trainees, and the opportunity to improve patient safety and quality of education. Other findings were that academic leadership and faculty show interest and urgency to adopt simulation in curricula and allocate funds for this. Facilitators need to be provided with protected time to become simulationists. Local manufacturers need to be sourced for simulators, and transfer of technology and expertise needs to be negotiated. Conclusion Simulation needs to be looked at from the lens of not only education, but more importantly of patient safety in developing countries to allow simulation-based education to be mainstreamed in health professions education in low- and middle-income contexts.
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Affiliation(s)
- Faisal W Ismail
- Centre for innovation and Medical Education, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Khairulnissa Ajani
- Department of Nursing, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Syed Mujtaba Baqir
- Department of Medicine, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Ahmed Nadeem
- Department of Medicine, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Rayyan Qureshi
- Medical College, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Pammla Petrucka
- Department of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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9
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Oyemolade TA, Mukumbya B, Oboh EN, Nischal SA, Ozobu I, Palla A, Ogundeji OD, Trillo-Ordonez Y, Nwaribe EE, Badejo OA, Okere OE, Malomo TA, Abu-Bonsrah N, Oboh EC, Seas A, Still MEH, Asemota I, Ugorji C, Reddy R, Rahman R, Waguia-Kouam R, Deng DD, von Isenburg M, Haglund MM, Fuller AT, Adeleye AO, Ukachukwu AEK. Profile of Pediatric Neurosurgery in Nigeria from 1962 to 2021: A Systematic Review. World Neurosurg 2024; 185:e143-e184. [PMID: 37939879 DOI: 10.1016/j.wneu.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE This study aims to provide a comprehensive overview of pediatric neurosurgery in Nigeria, since 1962, by assessing epidemiological data, management strategies, and case outcomes. METHODS A systematic bibliometric review of Nigerian neurosurgical literature was reported with the PRISMA guidelines. The Risk of Bias Assessment Tool was applied to all nonrandomized studies, and a descriptive analysis was performed for all variables. RESULTS We identified 12,295 pediatric patients from 196 published studies. Most publications (72.4%) occurred in the recent 2 decades, of which 40.3% were observational case reports/series. The patients were predominantly male (57.2%) and aged 0-18 years, with the majority (66.1%) belonging to the 0-5 age range. Most patients (63.4%) presented between 1-12 months. The most common presenting feature was altered consciousness (7.7%), with computed tomography (38.8%) being the most frequently utilized diagnostic imaging modality. The diagnoses with the greatest prevalence (60.2%) were congenital abnormalities such as hydrocephalus and neural tube defects. 57.5% of cases received surgical therapy, with ventriculoperitoneal shunt placement being the most noticeable procedure performed (36.4%). Complications were identified in 9.5% of cases, with a 4.5% death rate. The Glasgow Outcome Score (95.7%) was the primary outcome measure utilized, with positive outcomes reported in 59.3% of cases. CONCLUSIONS This review provides significant epidemiological data which emphasizes the country's enormous burden of pediatric neurosurgical cases. The findings can help guide clinical decisions as well as future research and policy development.
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Affiliation(s)
| | - Benjamin Mukumbya
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Global Health Institute, Durham, North Carolina, USA
| | - Ehita N Oboh
- Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Shiva A Nischal
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ifeanyichukwu Ozobu
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Ross University School of Medicine, Miramar, Florida, USA
| | - Adhith Palla
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | - Olaniyi D Ogundeji
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | - Yesel Trillo-Ordonez
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | | | - Oluwakemi A Badejo
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | | | - Toluyemi A Malomo
- Department of Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nancy Abu-Bonsrah
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ena C Oboh
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | - Andreas Seas
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Pratt School of Engineering, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA
| | - Megan E H Still
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Isaac Asemota
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | - Chiazam Ugorji
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | - Ramya Reddy
- University of Florida College of Medicine, Gainesville, Florida, USA
| | - Raphia Rahman
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | | | - Di D Deng
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | - Megan von Isenburg
- Duke University Medical Center Library and Archives, Durham, North Carolina, USA
| | - Michael M Haglund
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Global Health Institute, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA
| | - Anthony T Fuller
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Global Health Institute, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA
| | - Amos O Adeleye
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | - Alvan-Emeka K Ukachukwu
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA.
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10
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Ukachukwu AEK, Petitt Z, Usman B, Ekweogwu OC, Dawang Y, Ahmad MH, Ayodele OA, Badejo OA, Morgan E, Onyia CU, Orhorhoro OI, Oyemolade TA, Okere OE, Abu-Bonsrah N, Njeru PN, Oboh EC, Otun A, Nischal SA, Deng DD, Mahmud MR, Mezue WC, Malomo AO, Shehu BB, Shokunbi MT, Ohaegbulam SC, Chikani MC, Adeleye AO, Fuller AT, Haglund MM, Adeolu AA. The Status of Specialist Neurosurgical Training in Nigeria: A Survey of Practitioners, Trainers, and Trainees. World Neurosurg 2024; 185:e44-e56. [PMID: 37979680 DOI: 10.1016/j.wneu.2023.11.040] [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: 06/13/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE Despite the well-known neurosurgical workforce deficit in Sub-Saharan Africa, there remains a low number of neurosurgical training programs in Nigeria. This study sought to reassess the current status of specialist neurosurgical training in the country. METHODS An electronic survey was distributed to all consultant neurosurgeons and neurosurgery residents in Nigeria. Demographic information and questions relating to the content, process, strengths, and challenges of neurosurgical training were explored as part of a broader survey assessing neurosurgical capacity. Descriptive statistics were used for analysis. RESULTS Respondents identified 15 neurosurgical training centers in Nigeria. All 15 are accredited by the West African College of Surgeons, and 6 by the National Postgraduate Medical College of Nigeria. The average duration of core neurosurgical training was 5 years. Some identified strengths of Nigerian neurosurgical training included learning opportunities provided to residents, recent growth in the neurosurgical training capacity, and satisfaction with training. Challenges included a continued low number of training programs compared to the population density, lack of subspecialty training programs, and inadequate training infrastructure. CONCLUSIONS Despite the high number of neurosurgery training centers in Nigeria, compared to other West African countries, the programs are still limited in number and capacity. Although this study shows apparent trainee satisfaction with the training process and contents, multiple challenges exist. Efforts at improving training capacity should focus on continuing the development and expansion of current programs, commencing subspecialty training, driving health insurance to improve funding, and increasing available infrastructure for training.
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Affiliation(s)
- Alvan-Emeka K Ukachukwu
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
| | - Zoey Petitt
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Global Health Institute, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA
| | - Babagana Usman
- Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
| | - Ofodile C Ekweogwu
- Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Yusuf Dawang
- Department of Surgery, University of Abuja Teaching Hospital, Abuja, FCT, Nigeria
| | - Misbahu H Ahmad
- Department of Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Olabamidele A Ayodele
- Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Oluwakemi A Badejo
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | - Eghosa Morgan
- Department of Surgery, Babcock University Teaching Hospital, Ilishan Remo, Nigeria
| | | | - Omuvie I Orhorhoro
- Department of Surgery, Delta State University Teaching Hospital, Oghara, Nigeria
| | | | | | - Nancy Abu-Bonsrah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paula N Njeru
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Global Health Institute, Durham, North Carolina, USA
| | - Ena C Oboh
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | - Ayodamola Otun
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Shiva A Nischal
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Di D Deng
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA
| | | | - Wilfred C Mezue
- Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Bello B Shehu
- Regional Center for Neurosurgery, Usman DanFodio University Teaching Hospital, Sokoto, Nigeria
| | - Matthew T Shokunbi
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | | | - Mark C Chikani
- Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Amos O Adeleye
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | - Anthony T Fuller
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA; Duke University Global Health Institute, Durham, North Carolina, USA
| | - Michael M Haglund
- Duke University Division of Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA; Duke University Global Health Institute, Durham, North Carolina, USA
| | - Augustine A Adeolu
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
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11
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Corvino S, Piazza A, Spiriev T, Tafuto R, Corrivetti F, Solari D, Cavallo LM, Di Somma A, Enseñat J, de Notaris M, Iaconetta G. The Sellar Region as Seen from Transcranial and Endonasal Perspectives: Exploring Bony Landmarks Through New Surface Photorealistic Three-Dimensional Model Reconstruction for Neurosurgical Anatomy Training. World Neurosurg 2024; 185:e367-e375. [PMID: 38342178 DOI: 10.1016/j.wneu.2024.02.022] [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: 01/16/2024] [Accepted: 02/04/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Virtual reality-based learning of neuroanatomy is a new feasible method to explore, visualize, and dissect interactively complex anatomic regions. We provide a new interactive photorealistic three-dimensional (3D) model of sellar region microsurgical anatomy that allows side-by-side views of exocranial and endocranial surfaces to be explored, with the aim of assisting young neurosurgery residents in learning microsurgical anatomy of this complex region. METHODS Four head specimens underwent an endoscopic endonasal approach extended to the anterior and posterior skull base to expose the main bony anatomic landmarks of the sellar region. The same bony structures were exposed from a transcranial perspective. By using a photogrammetry method, multiple photographs from both endocranial and exocranial perspectives, different for angulations and depth, were captured, fused, and processed through dedicated software. RESULTS All relevant bony structures were clearly distinguishable in the 3D model reconstruction, which provides several benefits in neuroanatomy learning: first, it replicates bony structures with high degrees of realism, accuracy, and fidelity; in addition, it provides realistic spatial perception of the depth of the visualized structures and their anatomic relationships; again, the 3D model is interactive and allows a 360° self-guided tour of the reconstructed object, so that the learner can read the bones and their anatomic relationship from all desired points of view. CONCLUSIONS Detailed knowledge of key surgical landmarks representing keyholes and/or anatomic structures to not violate is mandatory for safer surgery, especially for a complex region such as the skull base. Highly accurate virtual and functional neurosurgical models, such as photogrammetry, can generate a realistic appearance to further improve surgical simulators and learn neuroanatomy.
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Affiliation(s)
- Sergio Corvino
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences, Program in Neuroscience, Università degli Studi di Napoli "Federico II", Naples, Italy; Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy
| | - Amedeo Piazza
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy; Division of Neurosurgery, "Sapienza" University of Rome, Rome, Italy
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria
| | - Roberto Tafuto
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy; Laboratory of Surgical Neuroanatomy, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Francesco Corrivetti
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy; Department of Neurosurgery, San Luca Hospital, Salerno, Italy
| | - Domenico Solari
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Alberto Di Somma
- Laboratory of Surgical Neuroanatomy, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; Departments of Neurological Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Joaquim Enseñat
- Departments of Neurological Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Matteo de Notaris
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy; Neurosurgical Clinic A.O.U. "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
| | - Giorgio Iaconetta
- Neurosurgical Clinic A.O.U. "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
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12
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Heo K, Cheng S, Joos E, Joharifard S. Use of Innovative Technology in Surgical Training in Resource-Limited Settings: A Scoping Review. JOURNAL OF SURGICAL EDUCATION 2024; 81:243-256. [PMID: 38161100 DOI: 10.1016/j.jsurg.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/23/2023] [Accepted: 11/03/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND There has been a rapid growth in interest in global surgery. This increased commitment to improving global surgical care, however, has not translated into an equal exchange of surgical information between high-income countries (HICs) and low-income countries (LMICs). In recent years, a greater emphasis has been placed on training local medical personnel in order to increase surgical capacity while simultaneously decreasing reliance on expatriate visitors. Virtual curricular models, simulators, and immersive technologies have been developed and implemented in order to maximize training opportunities in low-resource settings. This study aims to assess and summarize innovative technologies used for surgical training in low-resource settings. METHODS We conducted a scoping review of the literature from 2000 to 2021. We included both academic and grey literature on surgical education technologies. Searches were performed on Medline and Embase as well as on Google, iOS, and Android app stores. RESULTS Four main categories of surgical training platforms were identified: web-based platforms, app-based platforms, virtual and augmented reality, and simulation. The platforms were analyzed based on their content, effectiveness, cost, accessibility, and barriers to use. CONCLUSIONS Virtual learning platforms show potential in surgical training as they are easily accessible, not limited by geography, continuously updated, and evaluated for effectiveness. In order to provide access to educational resources for surgical trainees all around the world, particularly in low-resource settings, increased effort and resources should be dedicated to developing free, open-access surgical training programs . Doing so will promote sustainable and equitable development in global surgical care.
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Affiliation(s)
- Kayoung Heo
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samuel Cheng
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emilie Joos
- Division of General Surgery, Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shahrzad Joharifard
- Division of Pediatric Surgery, Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
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13
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Zaed I, Marchi F, Cannizzaro D, Cardia A. Improving neurosurgical research through a trainee-led research community. J Neurosurg Sci 2023; 67:773-774. [PMID: 37306619 DOI: 10.23736/s0390-5616.23.06078-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Ismail Zaed
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland -
| | - Francesco Marchi
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Delia Cannizzaro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Neurosurgery, IRCCS Humanitas Clinic, Rozzano, Milan, Italy
| | - Andrea Cardia
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
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14
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Efe IE, Çinkaya E, Kuhrt LD, Bruesseler MMT, Mührer-Osmanagic A. Neurosurgical Education Using Cadaver-Free Brain Models and Augmented Reality: First Experiences from a Hands-On Simulation Course for Medical Students. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1791. [PMID: 37893509 PMCID: PMC10608257 DOI: 10.3390/medicina59101791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/16/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Neurosurgery has been underrepresented in the medical school curriculum. Advances in augmented reality and 3D printing have opened the way for early practical training through simulations. We assessed the usability of the UpSurgeOn simulation-based training model and report first experiences from a hands-on neurosurgery course for medical students. Materials and Methods: We organized a two-day microneurosurgery simulation course tailored to medical students. On day one, three neurosurgeons demonstrated anatomical explorations with the help of life-like physical simulators (BrainBox, UpSurgeOn). The surgical field was projected onto large high-definition screens by a robotic-assisted exoscope (RoboticScope, BHS Technologies). On day two, the students were equipped with microsurgical instruments to explore the surgical anatomy of the pterional, temporal and endoscopic retrosigmoid approaches. With the help of the RoboticScope, they simulated five clipping procedures using the Aneurysm BrainBox. All medical students filled out a digital Likert-scale-based questionnaire to evaluate their experiences. Results: Sixteen medical students participated in the course. No medical students had previous experience with UpSurgeOn. All participants agreed that the app helped develop anatomical orientation. They unanimously agreed that this model should be part of residency training. Fourteen out of sixteen students felt that the course solidified their decision to pursue neurosurgery. The same fourteen students rated their learning experience as totally positive, and the remaining two rated it as rather positive. Conclusions: The UpSurgeOn educational app and cadaver-free models were perceived as usable and effective tools for the hands-on neuroanatomy and neurosurgery teaching of medical students. Comparative studies may help measure the long-term benefits of UpSurgeOn-assisted teaching over conventional resources.
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Affiliation(s)
- Ibrahim E. Efe
- Department of Neurosurgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Emre Çinkaya
- University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Facultad de Medicina, Universidad de Sevilla, 41004 Sevilla, Spain
| | - Leonard D. Kuhrt
- Department of Traumatology and Reconstructive Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Melanie M. T. Bruesseler
- Faculty of Medicine, Ludwig-Maximilians-University, 80539 Munich, Germany
- The GKT School of Medical Education, King’s College London, London WC2R 2LS, UK
| | - Armin Mührer-Osmanagic
- Department of Orthopaedics and Neurosurgery, Schulthess Klinik, 8008 Zurich, Switzerland
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15
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Moreno-Oliveras L, Rodriguez-Mena R, Nahoda H, Chisbert-Genoves P, Ali Haji M, Llacer-Ortega JL, Piquer-Belloch J. Global neurosurgery: Reflections on myelomeningocele in the Zanzibar archipelago (Tanzania). World Neurosurg X 2023; 20:100222. [PMID: 37502101 PMCID: PMC10368924 DOI: 10.1016/j.wnsx.2023.100222] [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: 09/06/2022] [Revised: 05/16/2023] [Accepted: 06/12/2023] [Indexed: 07/29/2023] Open
Abstract
Objective Our main goal was to describe the general characteristics and demographic data of myelomeningocele (MMC) patients at Mnazi Mmoja Surgical NED Institute (MMSNI) in Zanzibar and to assess the clinical characteristics and medium-term result-impact of the implemented health care measures. Methods This is a retrospective study on 41 MMC patients treated at the MMSNI in Zanzibar (Tanzania) from September 2016 to September 2018. Patient demographics, prenatal care, clinical and radiographic characteristics, surgical management and nursing care, and clinical outcomes were abstracted. Results The mean age of the patients was 6.1 ± 4.6 days, and 53.7% were males. A total of 51.2% came from Zanzibar, 39% to Pemba, and 9.8% from mainland Tanzania. Maternal ultrasound checkups revealed hydrocephalus in 18.7% of the cases. 85.4% of the newborns were operated on. Surgical wound infection was the most frequent complication (28.6%). A significantly higher risk of complications was observed in children from Pemba Island (p = 0.046) and those born by vaginal delivery (p = 0.694), particularly infections. During follow-up, 48.57% of the patients presented with infantile hydrocephalus and in the majority of them, a ventriculoperitoneal shunt was inserted. Conclusions Proper prenatal care with early diagnosis, together with the neurosurgical and nursing standard of care in a specialized institution, are all essential to increase the chances of successful treatment of newborns harboring MMC and is one of the main goals pursued in the MMSNI, as the only referral public health center with locally trained health personnel in Zanzibar archipelago.
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Affiliation(s)
- Luis Moreno-Oliveras
- Cátedra Neurociencia Global y Cambio Social NED VIU. Calle Pintor Sorolla 21, 46002, Valencia, Spain
| | - Ruben Rodriguez-Mena
- Cátedra Neurociencia Global y Cambio Social NED VIU. Calle Pintor Sorolla 21, 46002, Valencia, Spain
| | - Hadia Nahoda
- Neurosurgery Education and Development (NED) Institute, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Pilar Chisbert-Genoves
- Cátedra Neurociencia Global y Cambio Social NED VIU. Calle Pintor Sorolla 21, 46002, Valencia, Spain
| | - Mohamed Ali Haji
- Neurosurgery Education and Development (NED) Institute, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Jose L. Llacer-Ortega
- Cátedra Neurociencia Global y Cambio Social NED VIU. Calle Pintor Sorolla 21, 46002, Valencia, Spain
| | - Jose Piquer-Belloch
- Cátedra Neurociencia Global y Cambio Social NED VIU. Calle Pintor Sorolla 21, 46002, Valencia, Spain
- Neurosurgery Education and Development (NED) Institute, Mnazi Mmoja Hospital, Zanzibar, Tanzania
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16
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Pahwa B, Tayal A, Chowdhury D, Umana GE, Chaurasia B. Endoscopic versus microscopic discectomy for pathologies of lumbar spine: A nationwide cross-sectional study from a lower-middle-income country. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2023; 14:373-380. [PMID: 38268688 PMCID: PMC10805162 DOI: 10.4103/jcvjs.jcvjs_39_23] [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: 04/10/2023] [Accepted: 08/21/2023] [Indexed: 01/26/2024] Open
Abstract
Objective We conducted a cross-sectional study to assess the preference of spine surgeons between MD for microdiscectomy and endoscopic discectomy (ED) surgery for the management of lumbar pathologies in a lower-middle-income country (LMIC). Methodology An online survey assessing the preference of spine surgeons for various lumbar pathologies was developed and disseminated in "Neurosurgery Cocktail" a social media platform. Statistical analyses were performed using SPSS software with a level of significance <0.05. Results We received responses from 160 spine surgeons having a median experience of 6.75 years (range 0-42 years) after residency. Most of the spine surgeons preferred MD over ED, preference being homogeneous across all lumbar pathologies. In ED, the interlaminar approach was preferred more frequently than the transforaminal approach. The most commonly chosen contraindication for the interlaminar approach and transforaminal approach was ≥ 3 levels lumbar disc herniation (LDH) (n = 117, 73.1%) and calcified LDH (n = 102, 63.8%), respectively. There was no significant association between the type of approach preferred (MD vs. ED; and interlaminar vs. translaminar endoscopic approach) with the type of workplace and the level of experience. Conclusion Spine surgeons were inclined toward MD over ED, due to various reasons, such as a steep learning curve, lack of training opportunities, and upfront expenses. There is a pressing need for the upliftment of ED in LMICs which requires global action.
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Affiliation(s)
- Bhavya Pahwa
- Department of Neurosurgery, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Anish Tayal
- Department of Neurosurgery, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Dhiman Chowdhury
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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17
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Carrillo LA, Katyal T, Panchal NN, Sabharwal S. Pediatric Orthopaedic Observerships in North America for International Surgeons: A Qualitative Study Exploring Motivations, Relevance, and Alternate Learning Platforms. J Bone Joint Surg Am 2023; 105:1344-1353. [PMID: 37498985 DOI: 10.2106/jbjs.23.00321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Given the growing interest among international surgeons to participate in North American clinical observerships, it is essential to incorporate international surgeons' views to further enhance the program's applicability, value, and accessibility. In this qualitative follow-up study, we explored the motivations, relevance, and opinions about alternate learning platforms among the international surgeons who had participated in a pediatric orthopaedic clinical observership in North America. METHODS Using a semistructured interview guide, international surgeons who had participated in a North American pediatric orthopaedic observership during 2009 to 2019 were interviewed until data saturation and inductive thematic saturation were reached. Twenty-one international surgeons representing 15 different countries (1 from a low-income country, 10 from a lower middle-income country, 8 from an upper middle-income country, and 2 from a high-income country) were interviewed. RESULTS The most commonly cited motivations for doing a clinical observership were to advance clinical training and learn specific skills. The clinical and nonclinical skills gained during the observership, such as utilizing an integrated team approach and open communication style, were helpful to most interviewees; however, several respondents highlighted the critical need to adapt and modify surgical indications, techniques, and skills to suit their local environment and limited resource availability. Although respondents were interested in exploring virtual learning models to save time and expense, several preferred a hybrid model, including access to remote learning opportunities and sharing their own clinical experiences with the North American hosts. CONCLUSIONS Identifying the visiting surgeon's motivation for participation can allow North American hosts to align their clinical exposure more closely with the unique needs and aspirations of the international surgeons and enable a more relevant exchange of clinical and nonclinical skills. Use of a blended learning model, including in-person and virtual learning platforms, and the missed opportunity of having the international surgeons share their clinical experiences and skills with their North American counterparts should be explored further.
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Affiliation(s)
| | - Toshali Katyal
- University of California, San Francisco (UCSF), San Francisco, California
- UCSF Benioff Children's Hospital Oakland, Oakland, California
| | - Niel N Panchal
- University of California, San Francisco (UCSF), San Francisco, California
| | - Sanjeev Sabharwal
- University of California, San Francisco (UCSF), San Francisco, California
- UCSF Benioff Children's Hospital Oakland, Oakland, California
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18
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de Oliveira ADSB, Leonel LCPC, LaHood ER, Hallak H, Link MJ, Maleszewski JJ, Pinheiro-Neto CD, Morris JM, Peris-Celda M. Foundations and guidelines for high-quality three-dimensional models using photogrammetry: A technical note on the future of neuroanatomy education. ANATOMICAL SCIENCES EDUCATION 2023; 16:870-883. [PMID: 36934316 DOI: 10.1002/ase.2274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/05/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
Hands-on dissections using cadaveric tissues for neuroanatomical education are not easily available in many educational institutions due to financial, safety, and ethical factors. Supplementary pedagogical tools, for instance, 3D models of anatomical specimens acquired with photogrammetry are an efficient alternative to democratize the 3D anatomical data. The aim of this study was to describe a technical guideline for acquiring realistic 3D anatomic models with photogrammetry and to improve the teaching and learning process in neuroanatomy. Seven specimens with different sizes, cadaveric tissues, and textures were used to demonstrate the step-by-step instructions for specimen preparation, photogrammetry setup, post-processing, and display of the 3D model. The photogrammetry scanning consists of three cameras arranged vertically facing the specimen to be scanned. In order to optimize the scanning process and the acquisition of optimal images, high-quality 3D models require complex and challenging adjustments in the positioning of the specimens within the scanner, as well as adjustments of the turntable, custom specimen holders, cameras, lighting, computer hardware, and its software. MeshLab® software was used for editing the 3D model before exporting it to MedReality® (Thyng, Chicago, IL) and SketchFab® (Epic, Cary, NC) platforms. Both allow manipulation of the models using various angles and magnifications and are easily accessed using mobile, immersive, and personal computer devices free of charge for viewers. Photogrammetry scans offer a 360° view of the 3D models ubiquitously accessible on any device independent of operating system and should be considered as a tool to optimize and democratize the teaching of neuroanatomy.
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Affiliation(s)
- André de Sá Braga de Oliveira
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA
- Department of Morphology, Federal University of Paraíba, João Pessoa, Brazil
| | - Luciano César P C Leonel
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Edward R LaHood
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Hana Hallak
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J Link
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA
- Department of Otorhinolaryngology Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph J Maleszewski
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Carlos D Pinheiro-Neto
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA
- Department of Otorhinolaryngology Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Maria Peris-Celda
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA
- Department of Otorhinolaryngology Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Raffa G, Spiriev T, Zoia C, Aldea CC, Bartek Jr J, Bauer M, Ben-Shalom N, Belo D, Drosos E, Freyschlag CF, Kaprovoy S, Lepic M, Lippa L, Rabiei K, Schwake M, Stengel FC, Stienen MN, Gandía-González ML. The use of advanced technology for preoperative planning in cranial surgery - A survey by the EANS Young Neurosurgeons Committee. BRAIN & SPINE 2023; 3:102665. [PMID: 38021023 PMCID: PMC10668051 DOI: 10.1016/j.bas.2023.102665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 12/01/2023]
Abstract
Introduction Technological advancements provided several preoperative tools allowing for precise preoperative planning in cranial neurosurgery, aiming to increase the efficacy and safety of surgery. However, little data are available regarding if and how young neurosurgeons are trained in using such technologies, how often they use them in clinical practice, and how valuable they consider these technologies. Research question How frequently these technologies are used during training and clinical practice as well as to how their perceived value can be qualitatively assessed. Materials and methods The Young Neurosurgeons' Committee (YNC) of the European Association of Neurosurgical Societies (EANS) distributed a 14-items survey among young neurosurgeons between June 1st and August 31st, 2022. Results A total of 441 responses were collected. Most responders (42.34%) received "formal" training during their residency. Planning techniques were used mainly in neuro-oncology (90.86%), and 3D visualization of patients' DICOM dataset using open-source software was the most frequently used (>20 times/month, 20.34% of responders). Software for 3D visualization of patients' DICOM dataset was the most valuable technology, especially for planning surgical approach (42.03%). Conversely, simulation based on augmented/mixed/virtual reality was considered the less valuable tool, being rated below sufficiency by 39.7% of responders. Discussion and conclusion Training for using preoperative planning technologies in cranial neurosurgery is provided by neurosurgical residency programs. Software for 3D visualization of DICOM datasets is the most valuable and used tool, especially in neuro-oncology. Interestingly, simulation tools based on augmented/virtual/mixed reality are considered less valuable and, therefore, less used than other technologies.
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Affiliation(s)
- Giovanni Raffa
- Division of Neurosurgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem CityClinic Tokuda Hospital Sofia, Bulgaria
| | - Cesare Zoia
- Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cristina C. Aldea
- Department of Neurosurgery, Cluj County Emergency Hospital, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Jiri Bartek Jr
- Department of Clinical Neuroscience, Karolinska Institutet and Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Marlies Bauer
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Netanel Ben-Shalom
- Department of Neurosurgery, Rabin Medical Center, Belinson Campus, Petah Tikva, Israel
| | - Diogo Belo
- Neurosurgery Department, Centro Hospitalar Lisboa Norte (CHLN), Lisbon, Portugal
| | | | | | - Stanislav Kaprovoy
- Burdenko Neurosurgical Center, Department of Spinal and Peripheral Nerve Surgery, Department of International Affairs, Moscow, Russia
| | - Milan Lepic
- Clinic for Neurosurgery, Military Medical Academy, Belgrade, Serbia
| | - Laura Lippa
- Dept of Neurosurgery, ASST Ospedale Niguarda, Milano, Italy
| | - Katrin Rabiei
- Institution of Neuroscience & Physiology, Sahlgrenska Academy, Gothenberg, Sweden
- Art Clinic Hospitals, Gothenburg, Sweden
| | - Michael Schwake
- Department of Neurosurgery, University Hospital Muenster, Germany
| | - Felix C. Stengel
- Department of Neurosurgery and Spine Center of Eastern Switzerland, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Martin N. Stienen
- Department of Neurosurgery and Spine Center of Eastern Switzerland, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Maria L. Gandía-González
- Department of Neurosurgery, Hospital Universitario La Paz, Idipaz, Madrid, Spain
- University Autonomous of Madrid, Spain
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Brown KE, Flores MJ, MacKechnie MC, Rodarte P, O'Marr J, Shearer DW, Toogood P. Novel e-learning platform for orthopaedic training in LMICs: A descriptive review of the IGOT portal. Surg Open Sci 2023; 13:24-26. [PMID: 37351189 PMCID: PMC10282557 DOI: 10.1016/j.sopen.2023.04.003] [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: 03/15/2023] [Accepted: 04/08/2023] [Indexed: 06/24/2023] Open
Abstract
Background While e-learning has been written about extensively within the context of orthopaedics in the United States, there are few articles describing e-learning initiatives geared towards low-and middle-income countries (LMICs). The Institute for Global Orthopaedics and Traumatology (IGOT) at the University of California, San Francisco (UCSF) developed the IGOT Learning Portal to meet this need. Methods The IGOT Learning Portal was designed to address knowledge gaps in patient care by increasing access to high-quality orthopaedic education for surgeons and trainees worldwide. It offers 10 distinct, asynchronous courses, which are divided into a modular format. Course enrollment is free and accessible to any surgeon or trainee with a web-browsing capable device and internet connection. Results There are more than 2700 registered users and 300 active learners enrolled in IGOT Learning Portal courses. The Surgical Management and Reconstructive Training (SMART) program is the most commonly taken course. Learners represent 32 different countries across six continents. The IGOT portal also has surgical videos available on YouTube. The IGOT Portal YouTube channel has over 2000 subscribers and over 143,000 total views. Conclusions The IGOT Learning Portal is an innovative approach to address the global disparity in orthopaedic trauma care by improving access to high-quality surgical education for surgeons and trainees both in the US and internationally. The development of an interactive online forum may be a beneficial addition to the Portal. Future directions include assessing content retention, participant interaction, and expanding existing content to other orthopaedic subspecialties.
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Affiliation(s)
| | | | | | | | | | | | - Paul Toogood
- Corresponding author at: 2550 23rd Street, San Francisco, CA 94110, USA.
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21
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Ahmed R, Muirhead W, Williams SC, Bagchi B, Datta P, Gupta P, Salvadores Fernandez C, Funnell JP, Hanrahan JG, Davids JD, Grover P, Tiwari MK, Murphy M, Marcus HJ. A synthetic model simulator for intracranial aneurysm clipping: validation of the UpSurgeOn AneurysmBox. Front Surg 2023; 10:1185516. [PMID: 37325417 PMCID: PMC10264641 DOI: 10.3389/fsurg.2023.1185516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/17/2023] [Indexed: 06/17/2023] Open
Abstract
Background and objectives In recent decades, the rise of endovascular management of aneurysms has led to a significant decline in operative training for surgical aneurysm clipping. Simulation has the potential to bridge this gap and benchtop synthetic simulators aim to combine the best of both anatomical realism and haptic feedback. The aim of this study was to validate a synthetic benchtop simulator for aneurysm clipping (AneurysmBox, UpSurgeOn). Methods Expert and novice surgeons from multiple neurosurgical centres were asked to clip a terminal internal carotid artery aneurysm using the AneurysmBox. Face and content validity were evaluated using Likert scales by asking experts to complete a post-task questionnaire. Construct validity was evaluated by comparing expert and novice performance using the modified Objective Structured Assessment of Technical Skills (mOSATS), developing a curriculum-derived assessment of Specific Technical Skills (STS), and measuring the forces exerted using a force-sensitive glove. Results Ten experts and eighteen novices completed the task. Most experts agreed that the brain looked realistic (8/10), but far fewer agreed that the brain felt realistic (2/10). Half the expert participants (5/10) agreed that the aneurysm clip application task was realistic. When compared to novices, experts had a significantly higher median mOSATS (27 vs. 14.5; p < 0.01) and STS score (18 vs. 9; p < 0.01); the STS score was strongly correlated with the previously validated mOSATS score (p < 0.01). Overall, there was a trend towards experts exerting a lower median force than novices, however, these differences were not statistically significant (3.8 N vs. 4.0 N; p = 0.77). Suggested improvements for the model included reduced stiffness and the addition of cerebrospinal fluid (CSF) and arachnoid mater. Conclusion At present, the AneurysmBox has equivocal face and content validity, and future versions may benefit from materials that allow for improved haptic feedback. Nonetheless, it has good construct validity, suggesting it is a promising adjunct to training.
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Affiliation(s)
- Razna Ahmed
- Queen Square Institute of Neurology, University College London, London, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
| | - William Muirhead
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Simon C. Williams
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Biswajoy Bagchi
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Nanoengineered Systems Laboratory, Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Priyankan Datta
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Nanoengineered Systems Laboratory, Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Priya Gupta
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Nanoengineered Systems Laboratory, Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Carmen Salvadores Fernandez
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Nanoengineered Systems Laboratory, Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Jonathan P. Funnell
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - John G. Hanrahan
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Joseph D. Davids
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Institute of Global Health Innovation and Hamlyn Centre for Robotics Surgery, Imperial College London, London, United Kingdom
| | - Patrick Grover
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Manish K. Tiwari
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Nanoengineered Systems Laboratory, Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Mary Murphy
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Hani J. Marcus
- Queen Square Institute of Neurology, University College London, London, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
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22
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Sevgi UT, Erol G, Doğruel Y, Sönmez OF, Tubbs RS, Güngor A. The role of an open artificial intelligence platform in modern neurosurgical education: a preliminary study. Neurosurg Rev 2023; 46:86. [PMID: 37059815 DOI: 10.1007/s10143-023-01998-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/09/2023] [Accepted: 04/08/2023] [Indexed: 04/16/2023]
Abstract
The use of artificial intelligence in neurosurgical education has been growing in recent times. ChatGPT, a free and easily accessible language model, has been gaining popularity as an alternative education method. It is necessary to explore the potential of this program in neurosurgery education and to evaluate its reliability. This study aimed to show the reliability of ChatGPT by asking various questions to the chat engine, how it can contribute to neurosurgery education by preparing case reports or questions, and its contributions when writing academic articles. The results of the study showed that while ChatGPT provided intriguing and interesting responses, it should not be considered a dependable source of information. The absence of citations for scientific queries raises doubts about the credibility of the answers provided. Therefore, it is not advisable to solely rely on ChatGPT as an educational resource. With further updates and more specific prompts, it may be possible to improve its accuracy. In conclusion, while ChatGPT has potential as an educational tool, its reliability needs to be further evaluated and improved before it can be widely adopted in neurosurgical education.
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Affiliation(s)
- Umut Tan Sevgi
- Department of Neurosurgery, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Neurosurgery, Yeditepe University Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey
| | - Gökberk Erol
- Department of Neurosurgery, Yeditepe University Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey
- Department of Neurosurgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Yücel Doğruel
- Department of Neurosurgery, Yeditepe University Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey
- The Neurosurgical Atlas, Carmel, IN, USA
| | - Osman Fikret Sönmez
- Department of Neurosurgery, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Richard Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Anatomical Sciences, St. George's University, St. George's, West Indies, Grenada
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Abuzer Güngor
- Department of Neurosurgery, Yeditepe University Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey.
- Department of Neurosurgery, University of Health Sciences, Bakirkoy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, Istanbul, Turkey.
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23
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Conti A, Magnani M, Zoli M, Kockro RA, Tuleasca C, Peschillo S, Umana GE, Tew SW, Jallo G, Garg K, Spetzler RF, Lafuente J, Chaurasia B. Social Media for Global Neurosurgery. Benefits and limitations of a groundbreaking approach to communication and education. BRAIN & SPINE 2023; 3:101728. [PMID: 37383446 PMCID: PMC10293234 DOI: 10.1016/j.bas.2023.101728] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 06/30/2023]
Abstract
Introduction Social media have become ubiquitous and their role in medicine is quickly growing. They provide an open platform by which members share educational material, clinical experiences, and collaborate with educational equity. Research question To characterize the role of social media in neurosurgery, we analyzed metrics of the largest neurosurgical group (Neurosurgery Cocktail), collected relevant data about activities, impact and risks of this groundbreaking technology. Material and methods We extracted Facebook metrics from 60-day time sample, including users demographics and other platform-specific values such as active members and number of posts within 60 days. A quality assessment of the posted material (clinical case reports and second opinions) was obtained establishing four main quality-criteria: privacy violation; quality of imaging; clinical and follow up data. Results By December 2022, the group included 29.524 members (79.8% male), most (29%) between 35 and 44 years of age. Over 100 countries were represented. A total of 787 posts were published in 60 days with an average of 12.7 per day. In 173 clinical cases presented through the platform, some issue with privacy was recorded in 50.9%. The imaging was considered insufficient in 39.3%, clinical data in 53.8%; follow up data were missing in 60.7%. Discussion and conclusion The study provided a quantitative evaluation of impact, flaws and limitations of social medial for healthcare. Flaws were mostly data breach and insufficient quality of case reports. There are actions to correct these flaws that can be easily taken to provide a greater credibility and efficacy to the system.
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Affiliation(s)
- Alfredo Conti
- Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna Alma Mater Studiorum Università di Bologna, Via Altura 3, 40123, Bologna, Italy
| | - Marcello Magnani
- Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna Alma Mater Studiorum Università di Bologna, Via Altura 3, 40123, Bologna, Italy
| | - Matteo Zoli
- Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna Alma Mater Studiorum Università di Bologna, Via Altura 3, 40123, Bologna, Italy
| | - Ralf A. Kockro
- Centre for Microneurosurgery, Hirslanden Hospital, Zurich, Switzerland
| | - Constantin Tuleasca
- Lausanne University Hospital (CHUV), Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland
- University of Lausanne (UNIL), Faculty of Biology and Medicine (FBM), Switzerland
- Ecole Polytechnique Fédérale de Lausanne (EPFL, LTS-5), Lausanne, Switzerland
| | - Simone Peschillo
- Unicamillus—Saint Camillus International University of Health Sciences, Rome, Italy
| | - Giuseppe Emmanuele Umana
- Trauma Centre, Gamma Knife Centre, Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy
| | - Seow Wan Tew
- Department of Neurosurgery, National Neuroscience Institute, Singapore
| | - George Jallo
- Institute of Brain protection sciences, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Kanwaljeet Garg
- Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India
| | | | - Jesus Lafuente
- Department of Neurosurgery, Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal
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Boissonneau S, Dufour H, Pann A. Neurosurgery 3.0? Neurosurg Rev 2023; 46:65. [PMID: 36897511 DOI: 10.1007/s10143-023-01974-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023]
Affiliation(s)
- S Boissonneau
- Neurosurgical Department, Hospital La Timone - APHM, Aix-Marseille University, Marseille, France.
| | - H Dufour
- Neurosurgical Department, Hospital La Timone - APHM, Aix-Marseille University, Marseille, France
| | - A Pann
- Neurosurgical Department, Hospital La Timone - APHM, Aix-Marseille University, Marseille, France
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25
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El-Hajj VG, Gharios M. Letter to the Editor Regarding "The Perceived Utility of 3 Online Resources for Medical Student Neurosurgery Education". World Neurosurg 2023; 170:254-255. [PMID: 36782413 DOI: 10.1016/j.wneu.2022.10.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 02/10/2023]
Affiliation(s)
| | - Maria Gharios
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Newall N, Khan DZ, Hanrahan JG, Booker J, Borg A, Davids J, Nicolosi F, Sinha S, Dorward N, Marcus H. High fidelity simulation of the endoscopic transsphenoidal approach: Validation of the UpSurgeOn TNS Box. Front Surg 2022; 9:1049685. [PMID: 36561572 PMCID: PMC9764859 DOI: 10.3389/fsurg.2022.1049685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Endoscopic endonasal transsphenoidal surgery is an established technique for the resection of sellar and suprasellar lesions. The approach is technically challenging and has a steep learning curve. Simulation is a growing training tool, allowing the acquisition of technical skills pre-clinically and potentially resulting in a shorter clinical learning curve. We sought validation of the UpSurgeOn Transsphenoidal (TNS) Box for the endoscopic endonasal transsphenoidal approach to the pituitary fossa. Methods Novice, intermediate and expert neurosurgeons were recruited from multiple centres. Participants were asked to perform a sphenoidotomy using the TNS model. Face and content validity were evaluated using a post-task questionnaire. Construct validity was assessed through post-hoc blinded scoring of operative videos using a Modified Objective Structured Assessment of Technical Skills (mOSAT) and a Task-Specific Technical Skill scoring system. Results Fifteen participants were recruited of which n = 10 (66.6%) were novices and n = 5 (33.3%) were intermediate and expert neurosurgeons. Three intermediate and experts (60%) agreed that the model was realistic. All intermediate and experts (n = 5) strongly agreed or agreed that the TNS model was useful for teaching the endonasal transsphenoidal approach to the pituitary fossa. The consensus-derived mOSAT score was 16/30 (IQR 14-16.75) for novices and 29/30 (IQR 27-29) for intermediate and experts (p < 0.001, Mann-Whitney U). The median Task-Specific Technical Skill score was 10/20 (IQR 8.25-13) for novices and 18/20 (IQR 17.75-19) for intermediate and experts (p < 0.001, Mann-Whitney U). Interrater reliability was 0.949 (CI 0.983-0.853) for OSATS and 0.945 (CI 0.981-0.842) for Task-Specific Technical Skills. Suggested improvements for the model included the addition of neuro-vascular anatomy and arachnoid mater to simulate bleeding vessels and CSF leak, respectively, as well as improvement in materials to reproduce the consistency closer to that of human tissue and bone. Conclusion The TNS Box simulation model has demonstrated face, content, and construct validity as a simulator for the endoscopic endonasal transsphenoidal approach. With the steep learning curve associated with endoscopic approaches, this simulation model has the potential as a valuable training tool in neurosurgery with further improvements including advancing simulation materials, dynamic models (e.g., with blood flow) and synergy with complementary technologies (e.g., artificial intelligence and augmented reality).
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Affiliation(s)
- Nicola Newall
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, United Kingdom,Correspondence: Nicola Newall
| | - Danyal Z. Khan
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, United Kingdom
| | - John G. Hanrahan
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, United Kingdom
| | - James Booker
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, United Kingdom
| | - Anouk Borg
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Joseph Davids
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Federico Nicolosi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Siddharth Sinha
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, United Kingdom
| | - Neil Dorward
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Hani J. Marcus
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, United Kingdom
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27
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ZOIA C, RAFFA G, ALDEA CC, BARTEK Jr Jr. J, BEN-SHALOM N, BELO D, DROSOS E, FREYSCHLAG CF, KAPROVOY S, LEPIC M, LIPPA L, RABIEI K, SCHWAKE M, SPIRIEV T, STIENEN MN, GANDÍA-GONZÁLEZ ML. The EANS Young Neurosurgeons Committee's vision of the future of European Neurosurgery. J Neurosurg Sci 2022; 66:473-475. [DOI: 10.23736/s0390-5616.22.05802-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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28
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OGANDO-RIVAS E, CASTILLO P, BELTRAN JQ, ARELLANO R, GALVAN-REMIGIO I, SOTO-ULLOA V, DIAZ-PEREGRINO R, OCHOA-HERNANDEZ D, REYES-GONZÁLEZ P, SAYOUR E, MITCHELL D. Evolution and Revolution of Imaging Technologies in Neurosurgery. Neurol Med Chir (Tokyo) 2022; 62:542-551. [PMID: 36288973 PMCID: PMC9831622 DOI: 10.2176/jns-nmc.2022-0116] [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] [Indexed: 11/06/2022] Open
Abstract
We understand only a small fraction of the events happening in our brains; therefore, despite all the progress made thus far, a whole array of questions remains. Nonetheless, neurosurgeons invented new tools to circumvent the challenges that had plagued their predecessors. With the manufacturing boom of the 20th century, technological innovations blossomed enabling the neuroscientific community to study and operate upon the living brain in finer detail and with greater precision while avoiding harm to the nervous system. The purpose of this chronological review is to 1) raise awareness among future neurosurgeons about the latest advances in the field, 2) become familiar with innovations such as augmented reality (AR) that should be included in education given their ready applicability in surgical training, and 3) be comfortable with customizing these technologies to real-life cases like in the case of mixed reality.
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Affiliation(s)
- Elizabeth OGANDO-RIVAS
- Department of Neurosurgery, Brain Tumor Immunotherapy Program, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Paul CASTILLO
- Department of Pediatrics, UF Health Shands Children's Hospital, Gainesville, FL, USA
| | - Jesus Q. BELTRAN
- Unit of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City, Mexico
| | - Rodolfo ARELLANO
- Department of Neurosurgery, CostaMed Medical Group, Quintana Roo, Mexico
| | | | - Victor SOTO-ULLOA
- Emergency Department, Hospital General #48, Instituto Mexicano del Seguro Social, Mexico City, México
| | | | | | | | - Elias SAYOUR
- Department of Neurosurgery, Brain Tumor Immunotherapy Program, McKnight Brain Institute, University of Florida, Gainesville, FL, USA,Department of Pediatrics, UF Health Shands Children's Hospital, Gainesville, FL, USA
| | - Duane MITCHELL
- Department of Neurosurgery, Brain Tumor Immunotherapy Program, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
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Interactive Neurosurgery Lecture Series: A Global Education Platform of Tele-Teaching During the Coronavirus Disease 2019 Pandemic and Beyond. World Neurosurg 2022; 166:e731-e740. [PMID: 35926699 DOI: 10.1016/j.wneu.2022.07.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To explore the worldwide impact of a virtual neurosurgery-neuroscience lecture series on optimizing neurosurgical education with tele-teaching. METHODS A retrospective analysis was performed from our Zoom database to collect data from October 15, 2020, to December 14, 2020, and from September 27, 2021, to December 13, 2021. A comparative analysis of participants in the 2 different time frames was performed to investigate the impact of tele-teaching on neurosurgical education worldwide. To evaluate participant satisfaction, the yearly continuing medical education reports of 2020-2021 were analyzed. Data related to the distribution of lectures by subspecialties were also described. RESULTS Among the 11 lectures of the first period, 257 participants from 17 countries in 4 different continents were recorded, with a mean of 64 (standard deviation = 9.30) participants for each meeting; 342 attendees participated from 19 countries in 5 continents over the 11 lectures of the second part, with an average of 82.8 (standard deviation = 14.04) attendees; a statistically significant increase in participation between the 2 periods was identified (P < 0.001) A total of 19 (2020) and 21 (2021) participants submitted the continuing medical education yearly survey. More than 86.4% of overall responses considered the lectures "excellent." The main topics reported during lectures in 2020-2021 were related to brain tumors (33.7%) and education (22.1%). CONCLUSIONS The COVID-19 pandemic has increased the need to introduce new educational approaches for teaching novel ways to optimize patient care. Our multidisciplinary Web-based virtual lecture series could represent an innovative tele-teaching platform in neurosurgical training.
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Mokin M, Kan P. Balancing technical innovation and competence in the age of evidence-based medicine. J Neurointerv Surg 2022; 14:949-950. [DOI: 10.1136/jnis-2022-019579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/03/2022]
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31
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Dada OE, Bukenya GW, Konan L, Mbangtang CB, Ooi SZY, Makambo PDDN, Adrien TDE, Kenfack YJ, Senyuy WP, Abu-Bonsrah N, Karekezi C, Jokonya L, Alalade AF, Esene I, Kanmounye US. State of African Neurosurgical Education: An Analysis of Publicly Available Curricula. World Neurosurg 2022; 166:e808-e814. [PMID: 35926702 DOI: 10.1016/j.wneu.2022.07.106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Africa bears more than 15% of the global burden of neurosurgical disease; however, it has the lowest neurosurgical workforce density worldwide. The past decade has seen an increase in neurosurgery residency programs on the continent. It is unclear how these residency programs are similar or viable. This study highlights the current status and interdepartmental and regional differences, with the main objective of offering a template for improving the provision of neurosurgical education on the continent. METHODS PubMed and Google Scholar were searched using keywords related to "neurosurgery," "training," and "Africa" from database inception to October 13, 2021. The residency curricula were analyzed using a standardized and validated medical education curriculum viability tool. RESULTS Curricula from 14 African countries were identified. The curricula differed in resident recruitment, evaluation mode and frequency, curriculum content, and length of training. The length of training varied from 4 to 8 years, with a mean of 6 years. The Eastern African region had the highest number of examinations, with a mean of 8.5. Few curricula had correlates of viability: ensuring that the instructors are competent (64.3%), prioritization of faculty development (64.3%), faculty participation in decision making (64.3%), prioritization of resident support services (50%), creating a conducive environment for quality education (42.9%), and addressing student complaints (28.6%). CONCLUSIONS There are significant differences in the African postgraduate neurosurgical education curriculum warranting standardization. This study identifies areas of improvement for neurosurgical education in Africa.
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Affiliation(s)
- Olaoluwa Ezekiel Dada
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
| | - George William Bukenya
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Case Western Reserve School of Medicine, Cleveland, Ohio, USA
| | - Landry Konan
- Neurosurgery Department, University Felix Houphouet Boigny, Abidjan, Côte d'Ivoire
| | | | - Setthasorn Zhi Yang Ooi
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Cardiff University School of Medicine, Cardiff, United Kingdom
| | | | | | - Yves Jordan Kenfack
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
| | - Wah Praise Senyuy
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
| | - Nancy Abu-Bonsrah
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Claire Karekezi
- Neurosurgery Unit, Department of Surgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Luxwell Jokonya
- Neurosurgery Unit, Department of Surgery, University of Zimbabwe, Harare, Zimbabwe
| | - Andrew F Alalade
- Department of Neurosurgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
| | - Ignatius Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
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Lefevre E, Ganau M, Zaed I, de Macedo Machado-Filho G, Scibilia A, Mallereau CH, Bresson D, Todeschi J, Cebula H, Proust F, Vignes JL, Masquelet AC, Facca S, Livernaux P, Alfieri A, Ramos TCM, Magaldi M, Bruno C, Chibbaro S. Learning curve and influencing factors of performing microsurgical anastomosis: a laboratory prospective study. Neurosurg Rev 2022; 45:3271-3280. [PMID: 36066661 DOI: 10.1007/s10143-022-01856-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/28/2022] [Accepted: 08/27/2022] [Indexed: 11/29/2022]
Abstract
Despite being a critical component of any cerebrovascular procedure, acquiring skills in microsurgical anastomosis is challenging for trainees. In this context, simulation models, especially laboratory training, enable trainees to master microsurgical techniques before performing real surgeries. The objective of this study was to identify the factors influencing the learning curve of microsurgical training. A prospective observational study was conducted during a 7-month diploma in microsurgical techniques carried out in the anatomy laboratory of the school of surgery. Training focused on end-to-end (ETE) and end-to-side (ETS) anastomoses performed on the abdominal aorta, vena cava, internal carotid and jugular vein, femoral artery and vein, caudal artery, etc. of Wistar strain rats under supervision of 2 expert anatomical trainers. Objective and subjective data were collected after each training session. The 44 microsurgical trainees enrolled in the course performed 1792 anastomoses (1577 ETE, 88%, vs. 215 ETS, 12%). The patency rate of 41% was independent from the trainees' surgical background and previous experience. The dissection and the temporary clamping time both significantly decreased over the months (p < 0.001). Technical mistakes were independently associated with thrombosis of the anastomoses, as assessed by the technical mistakes score (p < 0.01). The training duration (in weeks) at time of each anastomosis was the only significant predictor of permeability (p < 0.001). Training duration and technical mistakes constituted the two major factors driving the learning curve. Future studies should try and investigate other factors (such as access to wet laboratory, dedicated fellowships, mentoring during early years as junior consultant/attending) influencing the retention of surgical skills for our difficult and challenging discipline.
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Affiliation(s)
- Etienne Lefevre
- Department of Neurosurgery, University Hospital "Pitié-Salpêtrière", Paris, France
| | - Mario Ganau
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France
| | - Ismail Zaed
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France.
| | | | - Antonino Scibilia
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France
| | - Charles-Henry Mallereau
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France
| | - Damien Bresson
- Department of Neurosurgery, University Hospital "Henri Mondor", Créteil, France
| | - Julien Todeschi
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France
| | - Helene Cebula
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France
| | - Francois Proust
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France
| | - Jean-Luc Vignes
- Microsurgery Laboratory of "Assistance Publique Hopitaux Paris", Fer a moulin, Paris, France
| | - Alain-Charles Masquelet
- Microsurgery Laboratory of "Assistance Publique Hopitaux Paris", Fer a moulin, Paris, France.,Department of Orthopedics, University Hospital "Saint-Antoine", Paris, France
| | - Sybille Facca
- Department of Orthopedics (Hand Surgery Unit), University Hospital "Hautepierre II", Strasbourg, France
| | - Philippe Livernaux
- Department of Orthopedics (Hand Surgery Unit), University Hospital "Hautepierre II", Strasbourg, France
| | - Alex Alfieri
- Department of Neurosurgery, Winterthur Hospital, Winterthur, Switzerland
| | - Taise Cruz Mosso Ramos
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France
| | - Marcelo Magaldi
- Department of Neurosurgery, "Hospital das Clinicas", Belo Horizonte, Brazil
| | - Carmen Bruno
- Neurosurgery Department, Bonomo Hospital, Andria, Italy
| | - Salvatore Chibbaro
- Department of Neurosurgery, University Hospital "Hautepierre", 1, Av. Moliere, 67098, Strasbourg, France
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Bowen I, Toor H, Zampella B, Doe A, King C, Miulli DE. Infrastructural Limitations in Establishing Neurosurgical Specialty Services in Liberia. Cureus 2022; 14:e29373. [PMID: 36284802 PMCID: PMC9584543 DOI: 10.7759/cureus.29373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/19/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Liberia recently employed the first neurosurgeon in the country’s history. In a country with a population of 4.7 million people and staggering rates of cranial and spine trauma, as well as hydrocephalus and neural tube defects, neurosurgery is considered a luxury. Our study documents the experience of a team of neurosurgeons, critical care nurses, scrub technicians, nurses, and biomedical engineers who carried out a series of neurosurgical clinics and complex brain and spine surgeries in Liberia. Specifically, we aim to highlight some of the larger obstacles, beyond staff and equipment, facing the development of a neurosurgical or any other specialty practice in Liberia. Methods Our institutions, in collaboration with the Korle-Bu Neuroscience Foundation, spent 10 days in Liberia, based in Tappita, and performed 18 surgeries in addition to seeing several hundred clinic patients. This is a retrospective review of the cases performed along with outcomes to investigate obstacles in providing neurosurgical services in the country. Results Before arriving in Liberia, we evaluated, planned, and supplied staff and materials for treating complex neurosurgical patients. Sixteen patients underwent 18 surgeries at a hospital in Tappita, Liberia, in November 2018. Their ages ranged from 1 month to 72 years (average 20 years). Five patients (28%) were female. Ten patients (56%) were under the age of 18. Surgeries included ventriculoperitoneal shunting (VP-shunt), lumbar myelomeningocele repair, encephalocele repair, laminectomy, and a craniotomy for tumor resection. Ten patients (55%) underwent VP-shunting. Two patients (11%) had a craniotomy for tumor resection. Three patients (17%) had laminectomy for lumbar stenosis. Two patients (11%) had repair of lumbar myelomeningocele. Conclusion After an aggressive and in-depth approach to planning, conducting, and supplying complex neurosurgical procedures in Liberia, the greatest limiting factor to successful outcomes lie in real-time is access to health care, which is largely limited by overall infrastructure. Our study documents the experience of a team of neurosurgeons, critical care nurses, scrub technicians, nurses, and biomedical engineers who carried out a series of neurosurgical clinics and complex brain and spine surgeries in Liberia. Specifically, we aim to highlight some of the larger obstacles, beyond staff and equipment, facing the development of a neurosurgical or any other specialty procedural practice in the country of Liberia. Most notably, we focus on infrastructure factors, including power, roads, water, education, and overall health care.
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Pascual JSG, Khu KJO. Resources for Operative Neurosurgical Education Among Trainees in the Philippines. World Neurosurg 2022; 165:e292-e297. [PMID: 35710096 DOI: 10.1016/j.wneu.2022.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Operative neurosurgical skills education is a vital part of neurosurgical training, and these skills are usually obtained through operating room experience and supplemented by textbooks and other resources. We aimed to determine the resources used by trainees in the Philippines, both prior to and after the onset of the coronavirus disease 2019 pandemic. METHODS An online survey was sent to neurosurgical trainees in the Philippines from January to March 2021. Data on demographics, educational resources used, and weekly hours spent on each were collected, for both the pre- and post-coronavirus disease 2019 periods. RESULTS A total of 37 neurosurgical trainees (60% response rate) participated in the survey. Most respondents were female (70%), in their senior levels (58%), and undergoing training in a public institution (65%). The main resources for operative neurosurgical education were operative experience, online academic resources, and neurosurgical textbooks. After the onset of the pandemic, the overall time spent decreased to 61.2 hours/week from 67.7 hours/week, with a significant reduction in the hours spent on operative experience (27.3 vs. 21.3 hours/week, P < 0.0001) and a significant increase in the time spent on webinars (0 vs. 3.2 hours/week, P < 0.0001) and online resources as a whole (14.9 vs. 16.4 hours/week, P = 0.0003). CONCLUSIONS Operative experience, online academic resources, and neurosurgical textbooks were the main resources for operative neurosurgical education among trainees in the Philippines. After the onset of the pandemic, the hours spent on operative experience decreased and online academic resources increased significantly. New avenues of neurosurgical education, particularly webinars, also became available locally.
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Affiliation(s)
- Juan Silvestre G Pascual
- Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Kathleen Joy O Khu
- Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
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Bongetta D, Zoia C. Editorial: Training and education in neurosurgery: Challenges and strategies for the next ten years. Front Surg 2022; 9:984208. [PMID: 36051704 PMCID: PMC9424647 DOI: 10.3389/fsurg.2022.984208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Cesare Zoia
- Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Correspondence: Cesare Zoia
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Bankole NDA, Ouahabi AE. Towards a collaborative-integrative model of education and training in neurosurgery in low and middle-income countries. Clin Neurol Neurosurg 2022; 220:107376. [PMID: 35878558 DOI: 10.1016/j.clineuro.2022.107376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Neurosurgery inequity between High-Income Countries and Low- and Middle-Income Countries is striking. Currently, several models of education and training are available each has advantages and limitations. Our goal is to suggest an integrative model of Education and Training with international collaboration which will assure the most cost-effective Training Model. MATERIALS AND METHODS The authors reviewed the literature narratively and examined in broad stroke the different existing models of international education and training programs to analyze their strengths, limitations, and cost-effectiveness in addressing the needs of Neurosurgery in Low and middle-Income Countries. RESULTS Several international institutions have been involved in Education and Training in Global Neurosurgery. The most common models for international education include short-term surgical mission and boot camps, a full residency training program in HICs, and a full residency training Program in Local or regional World Federation of Neurosurgical Societies (WFNS) reference centers in Low and Middle-Income Countries, and online education. In Africa, both Local residency training centers and WFNS reference centers are available and provide full training programs in Neurosurgery. Among them, WFNS Rabat Training Center is the first established center in Africa in 2002. This program is supported by the WFNS Foundation and by the Africa 100 Project. Some of these education models face currently challenges such as sustainability, financial support, and ethical issues. CONCLUSION Training neurosurgeons from Low and Middle-Income countries in local and regional WFNS Training centers might be the most cost-effective model of training that helps close the gap in neurosurgery. This training Model is duplicable and may be integrated into a global cohesive and collaborative model of education with international institutions.
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Affiliation(s)
- Nourou Dine Adeniran Bankole
- Department of Neurosurgery, Hôpital Des Spécialités, WFNS Rabat Training Center for young, African neurosurgeons, Faculty of Medicine, Mohamed V University, Rabat, Morocco.
| | - Abdessamad El Ouahabi
- Department of Neurosurgery, Hôpital Des Spécialités, WFNS Rabat Training Center for young, African neurosurgeons, Faculty of Medicine, Mohamed V University, Rabat, Morocco.
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Shlobin NA, Radwanski RE, Sandhu MRS, Rosseau G, Dahdaleh NS. Increasing Equity in Medical Student Neurosurgery Education Through Distance Learning. World Neurosurg 2022; 163:187-196.e8. [PMID: 35729820 DOI: 10.1016/j.wneu.2021.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Addressing equitable opportunities for medical student (MS) education is important for minimizing disparities in neurosurgical care. However, international MSs, particularly from low- and middle-middle income countries (LMICs) may lack access to educational opportunities compared with their contemporaries in high-income countries. We compare the usefulness of virtual neurosurgery training camps (VNTC) between U.S. and international MSs. METHODS A survey assessing demographics, baseline interests, and ratings of usefulness was sent to attendees after the VNTC. Ratings were compared between international and U.S. MSs. RESULTS Thirty-three (27.7%) of 119 attendees were international MSs, of whom 24 (72.7%) were from LMICs. International MSs were more likely to hold an advanced degree (P = 0.0009), more likely to be MS3/MS4s (P = 0.0111) or postdoctoral (P < 0.0001), and less likely to be MS1/MS2s (P = 0.0059). After the VNTC, international MSs reported greater increase in interest in neurosurgery in general (P = 0.0009) and subspecialties of spine (P = 0.0002), peripheral nerve (P = 0.002), vascular (P = 0.0468), functional/epilepsy (P = 0.001), pediatric (P = 0.0285), and trauma/neurocritical care (P = 0.0067). International MSs reported greater post-VNTC willingness to pursue a career in neurosurgery (P = 0.0001), likelihood of taking a year off during medical school (P = 0.0363), and preparedness for subinternships (P = 0.0003). International MSs reported greater increases in awareness of burnout (P = 0.0157) and work-life balance in neurosurgery (P = 0.0249). CONCLUSIONS International MSs experience prolonged periods of education before applying to residency and have unmet informational needs. Distance learning is useful for international MSs. MS neurosurgery education, through online platforms, represents a long-term strategy for addressing disparities in neurosurgical care worldwide.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA.
| | - Ryan E Radwanski
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
| | - Mani Ratnesh S Sandhu
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Nader S Dahdaleh
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
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Shlobin NA, Kortz MW, Radwanski RE, Dahdaleh NS. Distance Learning for Medical Students without a Neurosurgery Interest Group. World Neurosurg 2022; 163:197-204.e8. [PMID: 35729821 DOI: 10.1016/j.wneu.2021.09.033] [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: 07/08/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Interest groups for medical students (MSs) facilitate interest and engagement in neurosurgery. Students without interest groups are at a disadvantage as a result of greater barriers to exposure. We aimed to compare the usefulness of a virtual neurosurgery training camp for MSs with and without interest groups. METHODS A survey assessing demographics, interests, and ratings of informativeness and usefulness was sent to attendees of virtual neurosurgery training camps. Ratings were quantified on modified 7-point Likert scales. Data were compared between respondents with and without neurosurgery interest groups. RESULTS Students without an interest group were less likely to be MS1/MS2 (P = 0.0007) and more likely to be postdoctoral students (P = 0.0017). Students without an interest group were less likely to list breakout sessions as their primary reason for attendance (P = 0.0007), more likely to rate the resident panel as most useful (P = 0.0429), and less likely to rate the breakout session as most useful (P = 0.0231). Students without interest groups reported greater increases in interest in neurosurgery in general (P = 0.0284) and subspecialties of spine (P = 0.0003), peripheral nerve (P = 0.0054), and pediatric (P = 0.0137). There was no difference in willingness to pursue a neurosurgical career (P = 0.06), likelihood of taking a year off during medical school (P = 0.45), or preparedness for subinternships (P = 0.18) or residency application process (P = 0.43). CONCLUSIONS Distance learning increases both general and subspecialty-specific interest in neurosurgery among MSs without neurosurgery interest groups to a greater degree than among those with interest groups. Future initiatives seeking to benefit students without home programs should address the specific concerns of these students.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA.
| | - Michael W Kortz
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
| | - Ryan E Radwanski
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
| | - Nader S Dahdaleh
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
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Shlobin NA, Radwanski RE, Kortz MW, Rasouli JJ, Gibbs WN, Than KD, Baaj AA, Shin JH, Dahdaleh NS. Utility of Virtual Spine Neurosurgery Education for Medical Students. World Neurosurg 2022; 163:179-186. [PMID: 35729819 DOI: 10.1016/j.wneu.2021.07.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Distance learning has become increasingly important to expand access to neurosurgical spine education. However, emerging online spine education initiatives have largely focused on residents, fellows, and surgeons in practice. We aimed to assess the utility of online neurosurgical spine education for medical students regarding career interests, knowledge, and technical skills. METHODS A survey assessing the demographics and effects of virtual spine education programming on the interests, knowledge, and technical skills was sent to attendees of several virtual spine lectures. The ratings were quantified using 7-point Likert scales. RESULTS A total of 36 responses were obtained, of which 15 (41.7%) were from first- or second-year medical students and 18 (50.0%) were from international students. Most respondents were interested in neurosurgery (n = 30; 80.3%), with smaller numbers interested in radiology (n = 3; 8.3%) and orthopedic surgery (n = 2; 5.6%). The rating of utility ranged from 5.69 ± 1.14 to 6.50 ± 0.81 for career, 5.83 ± 0.94 to 6.14 ± 0.80 for knowledge, and 5.22 ± 1.31 to 5.83 ± 1.06 for clinical skills. Of the 36 respondents, 26 (72.2%) preferred virtual neurosurgical spine education via intermixed lectures and interactive sessions. The most common themes regarding the utility of virtual spine education were radiology by 18 (50.0%), anatomy by 12 (33.3%), and case-based teaching by 8 (22.2%) respondents. CONCLUSIONS Virtual distance learning for neurosurgical spine education is beneficial for students by enabling career exploration and learning content and clinical skills. Although the overall benefit was lowest for clinical skills, virtual programming could serve as an adjunct to traditional in-person exposure. Distance learning could also provide an avenue to reduce disparities in medical student neurosurgical spine education locally and globally.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA.
| | - Ryan E Radwanski
- Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Michael W Kortz
- Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA; Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Wende N Gibbs
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Khoi D Than
- Department of Neurosurgery, Duke University Hospital, Durham, North Carolina, USA
| | - Ali A Baaj
- Department of Neurological Surgery, University of Arizona, Banner University Medical Center, Phoenix, Arizona, USA
| | - John H Shin
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nader S Dahdaleh
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
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Hanalioglu S, Romo NG, Mignucci-Jiménez G, Tunc O, Gurses ME, Abramov I, Xu Y, Sahin B, Isikay I, Tatar I, Berker M, Lawton MT, Preul MC. Development and Validation of a Novel Methodological Pipeline to Integrate Neuroimaging and Photogrammetry for Immersive 3D Cadaveric Neurosurgical Simulation. Front Surg 2022; 9:878378. [PMID: 35651686 PMCID: PMC9149243 DOI: 10.3389/fsurg.2022.878378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Visualizing and comprehending 3-dimensional (3D) neuroanatomy is challenging. Cadaver dissection is limited by low availability, high cost, and the need for specialized facilities. New technologies, including 3D rendering of neuroimaging, 3D pictures, and 3D videos, are filling this gap and facilitating learning, but they also have limitations. This proof-of-concept study explored the feasibility of combining the spatial accuracy of 3D reconstructed neuroimaging data with realistic texture and fine anatomical details from 3D photogrammetry to create high-fidelity cadaveric neurosurgical simulations. Methods Four fixed and injected cadaver heads underwent neuroimaging. To create 3D virtual models, surfaces were rendered using magnetic resonance imaging (MRI) and computed tomography (CT) scans, and segmented anatomical structures were created. A stepwise pterional craniotomy procedure was performed with synchronous neuronavigation and photogrammetry data collection. All points acquired in 3D navigational space were imported and registered in a 3D virtual model space. A novel machine learning-assisted monocular-depth estimation tool was used to create 3D reconstructions of 2-dimensional (2D) photographs. Depth maps were converted into 3D mesh geometry, which was merged with the 3D virtual model’s brain surface anatomy to test its accuracy. Quantitative measurements were used to validate the spatial accuracy of 3D reconstructions of different techniques. Results Successful multilayered 3D virtual models were created using volumetric neuroimaging data. The monocular-depth estimation technique created qualitatively accurate 3D representations of photographs. When 2 models were merged, 63% of surface maps were perfectly matched (mean [SD] deviation 0.7 ± 1.9 mm; range −7 to 7 mm). Maximal distortions were observed at the epicenter and toward the edges of the imaged surfaces. Virtual 3D models provided accurate virtual measurements (margin of error <1.5 mm) as validated by cross-measurements performed in a real-world setting. Conclusion The novel technique of co-registering neuroimaging and photogrammetry-based 3D models can (1) substantially supplement anatomical knowledge by adding detail and texture to 3D virtual models, (2) meaningfully improve the spatial accuracy of 3D photogrammetry, (3) allow for accurate quantitative measurements without the need for actual dissection, (4) digitalize the complete surface anatomy of a cadaver, and (5) be used in realistic surgical simulations to improve neurosurgical education.
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Affiliation(s)
- Sahin Hanalioglu
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nicolas Gonzalez Romo
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Giancarlo Mignucci-Jiménez
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Osman Tunc
- BTech Innovation, METU Technopark, Ankara, Turkey
| | - Muhammet Enes Gurses
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Irakliy Abramov
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Yuan Xu
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Balkan Sahin
- Department of Neurosurgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ilkay Isikay
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ilkan Tatar
- Department of Anatomy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Berker
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Michael T. Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Mark C. Preul
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
- Correspondence: Mark C. Preul
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Pojskić M, Nguyen VN, Gienapp AJ, Arnautović KI. Step-by-Step Guide on How to Make a 2-Dimensional Operative Neurosurgical Video: Microsurgical Resection of a Right Lateral Ventricle Subependymoma by an Anterior Interhemispheric Transcallosal Approach. Oper Neurosurg (Hagerstown) 2022; 22:165-170. [PMID: 35042224 DOI: 10.1227/ons.0000000000000073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/13/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Digital video recordings are increasingly used across various medical and surgical disciplines with advances in computer hardware and software technologies. The creation of high-quality surgical video footage requires a basic understanding of key technical considerations, together with creativity and sound aesthetic judgment. Online operative videos have become a core resource within neurosurgical education. OBJECTIVE To provide a step-by-step description for making operative videos using a video from a real case as an example. METHODS We recorded an operative video of the microsurgical resection of a right lateral ventricle subependymoma performed by an anterior interhemispheric transcallosal approach. The patient consented to surgical resection of the subependymoma and to publication of this operative video. With the video, we explain the step-by-step process the authors used for developing the raw video into a publishable surgical video. RESULTS The patient depicted in our video tolerated the surgery well and made a complete recovery. The final video produced from the surgery illustrated elements that Operative Neurosurgery, Neurosurgery, and other journals require in surgical videos. CONCLUSION Although more than 1200 peer-reviewed (PubMed) neurosurgical operative videos have been published so far, there has not been a single publication that describes the step-by-step process of producing an operative video. To the best of our knowledge, this is the first published detailed description of editing of an educational operative video in neurosurgery and the first video case report of a microsurgical resection of subependymoma of the lateral ventricle in the peer-reviewed English literature.
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Affiliation(s)
- Mirza Pojskić
- Department of Neurosurgery, University of Marburg, Marburg, Germany.,Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
| | - Vincent N Nguyen
- Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Andrew J Gienapp
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
| | - Kenan I Arnautović
- Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Patel S, Shlobin NA. Letter to the Editor Regarding "Social Media Use Among Neurosurgery Trainees: A Survey of North American Training Programs". World Neurosurg 2021; 156:151. [PMID: 34802670 DOI: 10.1016/j.wneu.2021.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Saarang Patel
- Seton Hall University, South Orange, New Jersey, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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New neuroanatomy learning paradigms for the next generation of trainees: A novel literature-based 3D methodology. Clin Neurol Neurosurg 2021; 210:106948. [DOI: 10.1016/j.clineuro.2021.106948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/29/2022]
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A National Survey Evaluating the Impact of the COVID-19 Pandemic on Students Pursuing Careers in Neurosurgery. NEUROSCI 2021; 2:320-333. [PMID: 36091326 PMCID: PMC9457230 DOI: 10.3390/neurosci2040023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The COVID-19 pandemic has profoundly disrupted medical education and the residency application process. Methods: We conducted a descriptive observational study in April 2020 of medical students and foreign medical graduates considering or pursuing careers in neurosurgery in the United States to examine the impact of the pandemic. Results: A total of 379 respondents from 67 medical schools completed the survey. Across all participants, 92% (n = 347) stopped in-person didactic education, and 43% (n = 161) experienced basic science and 44% (n = 167) clinical research delays. Sixty percent (n = 227) cited a negative impact on academic productivity. Among first year students, 18% (n = 17) were less likely to pursue a career in neurosurgery. Over half of second year and third year students were likely to delay taking the United States Medical Licensing Examination Steps I and II. Among third year students, 77% (n = 91) reported indefinite postponement of sub-internships, and 43% (n = 53) were unsatisfied with communication from external programs. Many fourth-year students (50%, n = 17) were graduating early to participate in COVID-19-related patient care. Top student-requested support activities included access to student-focused educational webinars and sessions at upcoming conferences. Conclusions: Medical students pursuing careers in neurosurgery faced unique academic, career, and personal challenges secondary to the pandemic. These challenges may become opportunities for new initiatives guided by professional organizations and residency programs.
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45
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Chaurasia B, Umana GE, Scalia G, Barresi F, Yağmurlu K, Soldozy S, Deora H, Raudino G, Graziano F, Nicoletti GF, Cicero S, Maugeri R, Tomasi SO, Zileli M, Graffeo CS, Herrera RR, Shah A, Ha Y, Chaurasiya RK, Kim HS, Sameshima T, Borba L, Rotta JM, Chowdhury D, Chaurasia RK, Grotenhuis A, Linfante I, Sekhar LN. Largest neurosurgical social media group and its impact on communication and research. Br J Neurosurg 2021; 36:58-62. [PMID: 34236265 DOI: 10.1080/02688697.2021.1947978] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The use of social media to communicate and disseminate knowledge has increased exponentially, especially in the field of neurosurgery. 'Neurosurgery cocktail' (NC) was developed by a group of young neurosurgeons as a means of sharing didactic materials and clinical experiences via social media. It connects 35.000 neurosurgeons worldwide on multiple platforms, primarily Facebook and Twitter. Given the rising utilization of social media in neurosurgery, the popularity of NC has also increased since its inception. In this study, the authors surveyed the social media analytics of NC for both Facebook and Twitter. Besides, we reviewed the literature on the use of social media in neurosurgery. METHODS Facebook and Twitter metrics were extracted through each respective platform's analytics tools from December 2020 (earliest available date for data analysis) through January 2021. A literature search was conducted using PubMed (MEDLINE) and Scopus databases. RESULTS On Facebook, as of January 2021, the group had a total of 25.590 members (87.6% male), most commonly (29%) between 35 and 44 years of age with over 100 countries were represented. As of January 2021, they had amassed 6457 followers on Twitter. During the last 28 d between December 2020 and January 2021, the account published 65 tweets that garnered a total of 196,900 impressions. Twelve articles were identified in our literature review on the use of social media within the neurosurgical community. CONCLUSIONS NC is one of the most widely utilized neurosurgical social media resources available. Sharing knowledge has been broadened thanks to the recent social media evolution, and NC has become a leading player in disseminating neurosurgical knowledge.
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Affiliation(s)
- Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal
| | - Giuseppe Emmanuele Umana
- Department of Neurosurgery, Cannizzaro Hospital, Trauma Centre, Gamma Knife Centre, Catania, Italy
| | - Gianluca Scalia
- Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy
| | | | - Kaan Yağmurlu
- Department of Neuroscience and Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA
| | - Sauson Soldozy
- Department of Neuroscience and Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA
| | - Harsh Deora
- Department of Neurosurgery, National Institute of Mental Health and Neuroscience, Bangalore, India
| | | | - Francesca Graziano
- Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy.,Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone", Palermo, Italy
| | | | - Salvatore Cicero
- Department of Neurosurgery, Cannizzaro Hospital, Trauma Centre, Gamma Knife Centre, Catania, Italy
| | - Rosario Maugeri
- Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone", Palermo, Italy
| | | | - Mehmet Zileli
- Neurosurgery Department, Ege University, Izmir, Turkey
| | | | - Roberto R Herrera
- Neurosurgical Department, Belgrano Adventist Clinic, Buenos Aires, Argentina
| | - Abidha Shah
- Department of Neurosurgery, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, India
| | - Yoon Ha
- Department of Neurosurgery, Spine and Spinal cord Institute, Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea
| | | | - Hyeun-Sung Kim
- Department of Neurosurgery, Gangnam Nanoori Hospital, Seoul, Korea
| | - Tetsuro Sameshima
- Department of Neurosurgery, Hamamatsu University School of Medicine, University Hospital, Hamamatsu, Japan
| | - Luis Borba
- Department of Neurosurgery, Federal University of Parana, Curitiba, Brazil
| | - Jose Marcus Rotta
- Department of Neurosurgery, Hospital do Servidor Público Estadual, São Paulo, Brazil
| | - Dhiman Chowdhury
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Andre Grotenhuis
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Italo Linfante
- Interventional Neuroradiology, Endovascular Neurosurgery, Baptist Hospital, Miami, FL, USA
| | - Laligam N Sekhar
- Department of Neurosurgery, University of Washington, Seattle, WA, USA
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Newall N, Smith BG, Burton O, Chari A, Kolias AG, Hutchinson PJ, Alamri A, Uff C. Improving Neurosurgery Education Using Social Media Case-Based Discussions: A Pilot Study. World Neurosurg X 2021; 11:100103. [PMID: 33997763 PMCID: PMC8095172 DOI: 10.1016/j.wnsx.2021.100103] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The increasing shift toward a more generalized medical undergraduate curriculum has led to limited exposure to subspecialties, including neurosurgery. The lack of standardized teaching may result in insufficient coverage of core learning outcomes. Social media (SoMe) in medical education are becoming an increasingly accepted and popular way for students to meet learning objectives outside formal medical school teaching. We delivered a series of case-based discussions (CbDs) over SoMe to attempt to meet core learning needs in neurosurgery and determine whether SoMe-based CbDs were an acceptable method of education. METHODS Twitter was used as a medium to host 9 CbDs pertaining to common neurosurgical conditions in practice. A sequence of informative and interactive tweets were formulated before live CbDs and tweeted in progressive order. Demographic data and participant feedback were collected. RESULTS A total of 277 participants were recorded across 9 CbDs, with 654,584 impressions generated. Feedback responses were received from 135 participants (48.7%). Participants indicated an increase of 77% in their level of knowledge after participating. Of participants, 57% (n = 77) had previous CbD experience as part of traditional medical education, with 62% (n = 84) receiving a form of medical education previously through SoMe. All participants believed that the CbDs objectives were met and would attend future sessions. Of participants, 99% (n = 134) indicated that their expectations were met. CONCLUSIONS SoMe has been shown to be a favorable and feasible medium to host live, text-based interactive CbDs. SoMe is a useful tool for teaching undergraduate neurosurgery and is easily translatable to all domains of medicine and surgery.
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Key Words
- Brainbook
- CES, Cauda equina syndrome
- CM, Cervical myelopathy
- COVID-19, Coronavirus disease 2019
- CbD, Case-based discussion
- EDH, Extradural hematoma
- GBM, Glioblastoma
- HCP, Hydrocephalus
- LMICs, Low- and middle-income countries
- Medical education
- Neurosurgery
- Public engagement
- SAH, Subarachnoid hemorrhage
- SDH, Subdural hematoma
- Science dissemination
- SoMe, Social media
- Social media
- TBI, Traumatic brain injury
- TBI-CM, Traumatic brain injury–clinical management
- TBI-P, Traumatic brain injury–pathophysiology
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Affiliation(s)
- Nicola Newall
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom
- Brainbook, London, United Kingdom
| | - Brandon G. Smith
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital & University of Cambridge, Cambridge, United Kingdom
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Brainbook, London, United Kingdom
| | - Oliver Burton
- Warwick Medical School, University of Warwick, Warwick, United Kingdom
- Brainbook, London, United Kingdom
| | - Aswin Chari
- Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
- Brainbook, London, United Kingdom
| | - Angelos G. Kolias
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital & University of Cambridge, Cambridge, United Kingdom
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Brainbook, London, United Kingdom
| | - Peter J. Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital & University of Cambridge, Cambridge, United Kingdom
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Brainbook, London, United Kingdom
| | - Alexander Alamri
- Department of Neurosurgery, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
- Queen Mary University of London, London, United Kingdom
- Brainbook, London, United Kingdom
| | - Chris Uff
- Department of Neurosurgery, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
- Queen Mary University of London, London, United Kingdom
- Brainbook, London, United Kingdom
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47
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Carrillo LA, Sabharwal S. Pediatric Orthopaedic Observerships in North America for International Surgeons: Perceived Barriers and Opportunities for Visitors and Hosts. J Bone Joint Surg Am 2021; 103:00004623-990000000-00278. [PMID: 34191778 DOI: 10.2106/jbjs.21.00180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Despite recommendations for high-income countries to partner with low-income and middle-income countries to expand surgical access, little is known about the barriers that are faced by international surgeons (ISs) who participate in short-term clinical observerships in North America and the barriers that are encountered by their North American (NA) hosts. METHODS Surveys were distributed to ISs who participated in a pediatric orthopaedic observership in North America in 2009 to 2019 and their NA hosts to assess the perceived barriers that are faced by both partners and identify possible opportunities for improvement. RESULTS Responses were received from 181 ISs and 46 NA hosts. The ISs reported facing a variety of barriers prior to, during, and after completion of their NA observerships, including financial burden, language and cultural barriers, and challenges with local accommodations and transportation. Only 49% of ISs reported that their NA hosts had sought feedback from them. Barriers noted by the NA hosts included financial burden, logistical challenges with hosting, language barriers, and lack of support from their co-faculty/staff. At least 43% of NA hosts reported that their observership program was unfunded. Based on the survey responses, potential areas that may enhance the observership experience include funding support, creating a centralized data bank of pediatric subspecialty opportunities that are available at each sponsoring institution, a pre-visit orientation for the visiting surgeon, improving inclusivity by addressing language and cultural barriers, improving access to observing surgical procedures, obtaining post-visit feedback, and creating a virtual community of international visitors and NA hosts for an ongoing exchange of ideas and resources. CONCLUSIONS The ISs who participated in a pediatric orthopaedic clinical observership and their NA hosts identified limited funding as a major barrier. There are several opportunities for enhancing this unique learning experience and exploring the role of contextual remote learning for all participants. Additional studies are needed to investigate the value of clinical observerships for ISs, including the downstream impact of such opportunities on capacity-building, bidirectional learning, and improving patient care.
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Affiliation(s)
| | - Sanjeev Sabharwal
- UCSF Benioff Children's Hospital Oakland, Oakland, California
- University of California, San Francisco, San Francisco, California
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48
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Dechambenoit G, Moreau JJ, Roche PH, Cornu P. Sustainable neurosurgical training around the globe. A review and outline. Neurochirurgie 2021; 67:599-605. [PMID: 33753129 DOI: 10.1016/j.neuchi.2021.03.002] [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: 11/17/2020] [Revised: 01/25/2021] [Accepted: 03/06/2021] [Indexed: 11/19/2022]
Abstract
Sharing an equal and quality neurosurgical training across the globe without exclusion may seem utopian. However, such training is possible through educational opportunities and the ongoing digital revolution. The aim is to present the current state of neurosurgery training and education methods indicating strengths, weaknesses and opportunities. The thoughts, comments and suggestions of the authors are based on their academic experiences, training missions around the world and particularly in low- and middle-income countries by pointing out the French experience. The learning must be interactive and programmed over time, integrating varied courses and activities. Virtual reality and neurosurgical simulation need to be developed. The content of the teaching including e-learning must be evidence-based and peer-reviewed. Pedagogical training of trainers is fundamental. It is critical to evaluate the training under real working conditions. The optimization of human resources should create economies of scale that would attenuate the financial burden. The commitment of the teams, tutoring are success factors.
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Affiliation(s)
- G Dechambenoit
- Neurochirurgie, CMCO Côte d'Opale Route de Desvres, 62280 Saint Martin Boulogne, France.
| | - J-J Moreau
- Département Universitaire d'Enseignement Numérique en Santé, Faculté de Médecine, 2, rue Dr Marcland, 87025 Limoges cedex, France.
| | - P-H Roche
- Neurochirurgie Hôpital Nord, Pôle NEUROSCIENCES, Hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
| | - P Cornu
- Hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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49
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Kanmounye US, Sebopelo LA, Keke C, Zolo Y, Senyuy WP, Endalle G, Takoukam R, Sichimba D, Nguembu S, Ghomsi N. Mapping Global Neurosurgery Research Collaboratives: A Social Network Analysis of the 50 Most Cited Global Neurosurgery Articles. NEUROSURGERY OPEN 2021. [DOI: 10.1093/neuopn/okab006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
ABSTRACTSocial network analysis of bibliometric data evaluates the relationships between the articles, authors, and themes of a research niche. The network can be visualized as maps composed of nodes and links. This study aimed to identify and evaluate the relationships between articles, authors, and keywords in global neurosurgery. The authors searched global neurosurgery articles on the Web of Science database from inception to June 18, 2020. The 50 most cited articles were selected and their metadata (document coupling, co-authorship, and co-occurrence) was exported. The metadata were analyzed and visualized with VOSViewer (Centre for Science and Technology Studies, Leiden University, The Netherlands). The articles were published between 1995 and 2020 and they had a median of 4.0 (interquartile range [IQR] = 5.0) citations. There were 5 clusters in the document coupling and 10 clusters in the co-authorship analysis. A total of 229 authors contributed to the articles and Kee B. Park contributed the most to articles (14 publications). Backward citation analysis was organized into 4 clusters and co-occurrence analysis into 7 clusters. The most common themes were pediatric neurosurgery, neurotrauma, and health system strengthening. The authors identified trends, contributors, and themes of highly cited global neurosurgery research. These findings can help establish collaborations and set the agenda in global neurosurgery research.
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Affiliation(s)
| | - Lorraine Arabang Sebopelo
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Chiuyu Keke
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Faculty of Medicine, University of Zambia, Lusaka, Zambia
| | - Yvan Zolo
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Wah Praise Senyuy
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Genevieve Endalle
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Régis Takoukam
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Neurosurgery Department, Felix Houphouet Boigny University, Abidjan, Côte d'Ivoire
| | - Dawin Sichimba
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- School of Medicine, Copperbelt University, Kitwe, Zambia
| | - Stéphane Nguembu
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
| | - Nathalie Ghomsi
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Neurosurgery Department, Felix Houphouet Boigny University, Abidjan, Côte d'Ivoire
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50
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Teton ZE, Freedman RS, Tomlinson SB, Linzey JR, Onyewuenyi A, Khahera AS, Hendricks BK, Cohen-Gadol AA. The Neurosurgical Atlas: advancing neurosurgical education in the digital age. Neurosurg Focus 2021; 48:E17. [PMID: 32114553 DOI: 10.3171/2019.12.focus19820] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/16/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The advent of the internet and the popularity of e-learning resources has promoted a shift in medical and surgical education today. The Neurosurgical Atlas has sought to capitalize on this shift by providing easily accessible video and online education to its users on an international scale. The rising popularity of social media has provided new avenues for expanding that global reach, and the Atlas has sought to do just that. In this study, the authors analyzed user demographics and web traffic patterns to quantify the international reach of the Atlas and examined the potential impact of social media platforms on the expansion of that reach. METHODS Twitter, Facebook, and Instagram metrics were extracted using each respective service's analytics tool from the date of their creation through October 2019. Google Analytics was used to extract website traffic data from September 2018 to September 2019 and app data from January 2019 to October 2019. The metrics extracted included the number of platform users/followers, user demographic information, percentage of new versus returning visitors, and a number of platform-specific values. RESULTS Since the authors' previous publication in 2017, annual website viewership has more than doubled to greater than 500,000 viewing sessions in the past year alone; international users accounted for more than 60% of the visits. The Atlas Twitter account, established in August 2012, has more than 12,000 followers, primarily hailing from the United States, the United Kingdom, Canada, and Saudi Arabia. The Atlas Facebook account, established in 2013, has just over 13,000 followers, primarily from India, Egypt, and Mexico. The Atlas Instagram account (established most recently, in December 2018) has more than 16,000 followers and the highest percentage (31%) of younger users (aged 18-24 years). The Atlas app was officially launched in May 2019, largely via promotion on the Atlas social media platforms, and has since recorded more than 60,000 viewing sessions, 80% of which were from users outside the United States. CONCLUSIONS The Neurosurgical Atlas has attempted to leverage the many e-learning resources at its disposal to assist in spreading neurosurgical best practice on an international scale in a novel and comprehensive way. By incorporating multiple social media platforms into its repertoire, the Atlas is able to ensure awareness of and access to these resources regardless of the user's location or platform of preference. In so doing, the Atlas represents a novel way of advancing access to neurosurgical educational resources in the digital age.
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Affiliation(s)
- Zoe E Teton
- 1School of Medicine, Oregon Health & Science University, Portland, Oregon
| | | | - Samuel B Tomlinson
- 3School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Joseph R Linzey
- 4Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Alvin Onyewuenyi
- 5Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois
| | | | - Benjamin K Hendricks
- 7Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona; and
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