Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
J Neurosurg. 2010 Jul;113(1):59-63. doi: 10.3171/2010.1.JNS091686.
Neurosurgical training is critical in providing residents with the skill set, knowledge, and confidence to perform challenging neurosurgical procedures. Radiosurgery, which neurosurgeons helped define and refine, differs from more traditional, open neurosurgical approaches. This study evaluates the opinions of residents on current radiosurgical training and the effect of a focused educational course on those residents.
The American Association of Neurological Surgeons sponsored a 3-day course focused on intracranial and spinal radiosurgery. Senior-level residents were nominated by US program directors to participate in the course. Twenty-eight residents from distinct training programs were surveyed before and after the course to discern current training practices in radiosurgery and the effect of the focused educational program. The median training level of the participants was postgraduate Year 5 (mean 5.3 years, range 3-7 years).
Two-thirds of residents reported that their training institutions had no formal radiosurgery rotation. Twenty-five percent planned to obtain postresidency fellowship training that would include radiosurgery. Before the course, 79% of the residents expected to include radiosurgery in their practice. However, prior to the course, those describing themselves as "very uncomfortable" with performing intracranial or spinal radiosurgery were 33.3 and 45.8%, respectively. After the course, mean self-assessment scores for understanding the indications and performing intracranial radiosurgery increased by 43 and 89%, respectively. The mean scores for understanding the indications and comfort with performing spinal radiosurgery increased by 79 and 200%, respectively. Following the course, there was a 12.3% increase in the number of residents planning to perform radiosurgery following residency.
Current neurosurgical residents appear uneasy about their grasp of radiosurgical indications and their ability to perform the procedure. Focused training courses sponsored by professional societies may improve resident education and training in this area of neurosurgery, which has a skill set and basis of knowledge different from traditional open neurosurgical procedures. Further evaluation of the radiosurgical training process for residents must be performed so as to ensure competency and sufficient workforce to meet expanding demands for neurosurgeons performing radiosurgery in a multidisciplinary climate.
神经外科培训对于为住院医师提供执行具有挑战性的神经外科手术所需的技能、知识和信心至关重要。放射外科是神经外科医师帮助定义和完善的，与更传统的开放式神经外科方法不同。本研究评估了住院医师对当前放射外科培训的看法，以及该培训对这些住院医师的影响。
美国神经外科学会（American Association of Neurological Surgeons）赞助了为期 3 天的课程，重点是颅内和脊柱放射外科。美国项目主任提名高级住院医师参加该课程。在课程前后，对来自不同培训项目的 28 名住院医师进行了调查，以了解他们在放射外科方面的培训实践情况，以及集中教育计划的效果。参与者的研究生培训水平中位数为第 5 年（平均 5.3 年，范围 3-7 年）。
三分之二的住院医师报告称，他们的培训机构没有正式的放射外科轮转。25%的人计划在住院医师培训后获得包括放射外科在内的 fellowship培训。在课程之前，79%的住院医师预计将在他们的实践中包括放射外科。然而，在课程之前，那些自认为在进行颅内或脊柱放射外科方面“非常不舒服”的住院医师分别为 33.3%和 45.8%。在课程之后，对颅内放射外科的适应证和手术理解的自我评估平均得分分别增加了 43%和 89%。对脊柱放射外科的适应证和舒适度的自我评估平均得分分别增加了 79%和 200%。课程之后，计划在住院医师培训后进行放射外科的住院医师人数增加了 12.3%。
目前的神经外科住院医师似乎对他们对放射外科适应证的掌握程度和进行该手术的能力感到不安。由专业协会主办的集中培训课程可能会改善住院医师在这一神经外科领域的教育和培训，因为该领域的技能和知识基础与传统的开放式神经外科手术不同。必须进一步评估住院医师的放射外科培训过程，以确保有足够的能力和足够的劳动力来满足在多学科环境下进行放射外科的神经外科医生的需求。
