Current US neurosurgical resident involvement, interest, and barriers in global neurosurgery

Lundy, Paige; Miller, Christopher P.; Woodrow, Sarah

doi:10.3171/2019.12.focus19808

Cited by 12 publications

(9 citation statements)

References 22 publications

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“…Nowadays, international training for surgical residents is considered desirable for a complete neurosurgical education in this particular medical field ( 5 ). Unfortunately, after the COVID-19 pandemic outbreak, surgical activities and international exchange programs have been dramatically reduced ( 6 – 8 ).…”

Section: Introductionmentioning

confidence: 99%

Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents

et al. 2022

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BackgroundIn the recent years, growing interest in simulation-based surgical education has led to various practical alternatives for medical training. More recently, courses based on virtual reality (VR) and three-dimensional (3D)-printed models are available. In this paper, a hybrid (virtual and physical) neurosurgical simulator has been validated, equipped with augmented reality (AR) capabilities that can be used repeatedly to increase familiarity and improve the technical skills in human brain anatomy and neurosurgical approaches.MethodsThe neurosurgical simulator used in this study (UpSurgeOn Box, UpSurgeOn Srl, Assago, Milan) combines a virtual component and a physical component with an intermediate step to provide a hybrid solution. A first reported and evaluated practical experience on the anatomical 3D-printed model has been conducted with a total of 30 residents in neurosurgery. The residents had the possibility to choose a specific approach, focus on the correct patient positioning, and go over the chosen approach step-by-step, interacting with the model through AR application. Next, each practical surgical step on the 3D model was timed and qualitatively evaluated by 3 senior neurosurgeons. Quality and usability-grade surveys were filled out by participants.ResultsMore than 89% of the residents assessed that the application and the AR simulator were very helpful in improving the orientation skills during neurosurgical approaches. Indeed, 89.3% of participants found brain and skull anatomy highly realistic during their tasks. Moreover, workshop exercises were considered useful in increasing the competency and technical skills required in the operating room by 85.8 and 84.7% of residents, respectively. Data collected confirmed that the anatomical model and its application were intuitive, well-integrated, and easy to use.ConclusionThe hybrid AR and 3D-printed neurosurgical simulator could be a valid tool for neurosurgical training, capable of enhancing personal technical skills and competence. In addition, it could be easy to imagine how patient safety would increase and healthcare costs would be reduced, even if more studies are needed to investigate these aspects. The integration of simulators for training in neurosurgery as preparatory steps for the operating room should be recommended and further investigated given their huge potential.

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Section: Introductionmentioning

confidence: 99%

Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents

et al. 2022

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“…Unfortunately, numerous barriers to implementation or participation in these rotations exist including lack of program support or funding, fear of detrimental professional effects, and a reliance on adequate infrastructure at partnering sites. 39,40,84 The lack of formalized curricula may hamper the ability to systematically deliver targeted public health education in less-resourced…”

Section: Approaches and Challengesmentioning

confidence: 99%

Section: Public Health Education For Neurosurgeons: a Proposed Soluti...mentioning

confidence: 99%

Targeted Public Health Training for Neurosurgeons: An Essential Task for the Prioritization of Neurosurgery in the Evolving Global Health Landscape

et al. 2022

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The gap between the tremendous burden of neurological disease requiring surgical management and the limited capacity for neurosurgical care has fueled the growth of the global neurosurgical movement. It is estimated that an additional 23 300 neurosurgeons are needed to meet the burden posed by essential cases across the globe. Initiatives to increase neurosurgical capacity through systems strengthening and workforce development are key elements in correcting this deficit. Building on the growing interest in global health among neurosurgical trainees, we propose the integration of targeted public health education into neurosurgical training, in both high-income countries and low- and middle-income countries. This effort will ensure that graduates possess the fundamental skillsets and experience necessary to participate in and lead capacity-building efforts in the developing countries. This additional public health training can also help neurosurgical residents to achieve the core competencies outlined by accreditation boards, such as the Accreditation Committee on Graduate Medical Education in the United States. In this narrative review, we describe the global burden of neurosurgical disease, establish the need and role for the global neurosurgeon, and discuss pathways for implementing targeted global public health education in the field of neurosurgery.

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“…Physicians who trained in residency programs with formal global health pathways describe feeling more prepared to care for immigrants, refugees, and patients with non-English language preferences [ 17 ]. Demand for training in GH and on immigrant and refugee health is high among residents [ 8 , 18 , 19 ]. GH opportunities in residency also generate interest from highly-ranked fourth-year medical student candidates [ 16 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Underprepared: influences of U.S. medical students’ self-assessed confidence in immigrant and refugee health care

Stryker

Conway

Kaeppler

et al. 2023

Medical Education Online

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Background United States (U.S.) census data from 2017 indicates that the percentage of persons born outside of the U.S. is increasing. However, no studies describe the amount of class time focused on immigrant and refugee health during medical school in the U.S. nor on incoming residents’ confidence in providing culturally sensitive care. The objective of this study is to characterize final-year medical students’ exposure to immigrant and refugee health and their confidence in caring for these populations. Methods A voluntary, cross-sectional survey was sent electronically to fourth-year medical students at twelve U.S. medical schools in 2020, with 707 respondents (46% response rate). Questions addressed respondents’ curricular exposure to immigrant and refugee health care during medical school and their confidence in providing culturally sensitive care. Chi-square tests were used to assess relationships between categorical variables, and odds ratios were calculated for dichotomized variables. Results Most students (70.6%) described insufficient class time dedicated to culturally sensitive care, and many (64.5%) reported insufficient clinical exposure in caring for immigrants/refugees. The odds that incoming residents felt ‘usually’ or ‘always’ confident in their ability to provide culturally sensitive care to immigrants and refugees were higher in those with more class time on culturally sensitive care (OR 5.2 [3.6–7.4]), those with more clinical opportunities to care for immigrants and refugees (OR 7.2 [5.1–10.2]), and those who participated in a domestic low-resource or international elective (OR 1.4 [1.02–1.9]). More than half (55.3%) of respondents reported feeling ‘not at all’ or only ‘sometimes’ confident in their ability to provide culturally sensitive care to immigrants/refugees. Conclusions Most fourth-year U.S. medical students entering residency feel unprepared to deliver culturally sensitive care to immigrants and refugees. This may be mediated by increased exposure to didactic curricula class time and/or experiential clinical activities, as those factors are associated with improved student confidence

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Current US neurosurgical resident involvement, interest, and barriers in global neurosurgery

Cited by 12 publications

References 22 publications

Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents

Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents

Targeted Public Health Training for Neurosurgeons: An Essential Task for the Prioritization of Neurosurgery in the Evolving Global Health Landscape

Underprepared: influences of U.S. medical students’ self-assessed confidence in immigrant and refugee health care

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