Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
World Neurosurg. 2013 Nov;80(5):e27-31. doi: 10.1016/j.wneu.2012.09.007. Epub 2012 Sep 16.
The practice of neurosurgery requires fundamental knowledge base. Residency training programs and continuing medical education courses are designed to teach relevant neurosurgical principles. Nevertheless, knowledge gaps exist for neurosurgeons and may be different between cohorts of neurosurgeons. The Self-Assessment in Neurological Surgery (SANS) General Examination and Spine Examination are online educational tools for lifelong learning and maintenance of certification. This study examines the gaps in knowledge of spinal neurosurgeons and general neurosurgeons taking SANS.
From 2008 to 2010, a total of 165 spinal neurosurgeons completed the 243 available questions of the SANS Spine Examination. Over that same time frame, 993 general neurosurgeons completed the SANS General Spine Examination. Mean scores were calculated and assessed according to 18 major neurosurgical knowledge disciplines. Statistical analysis was carried out to evaluate for significant knowledge gaps among all users and significant differences in performance between spinal neurosurgeons and their general neurosurgeon counterparts.
The mean overall examination score was 87.4% ± 7.5% for spinal neurosurgeons and 71.5% ± 8.9% for general neurosurgeons (P < 0.001). Of the 18 major knowledge categories in SANS, spinal neurosurgeons (n = 165) answered questions incorrectly 15% or greater of the time in five of the categories. The categories of lower performance for spinal neurosurgeons were cerebrovascular, anesthesia and critical care, general clinical, tumor, and trauma. For general neurosurgeons (n = 993), the five knowledge categories with lowest performance were cerebrovascular, epilepsy, peripheral nerve, trauma, and radiosurgery. Although spinal neurosurgeons and general neurosurgeons shared some areas of decreased performance including trauma and cerebrovascular, spine neurosurgeons relatively underperformed in general clinical, anesthesia and critical care, and tumor.
The SANS Spine Examination demonstrated knowledge gaps in specific categories for spinal surgeons. The knowledge areas of diminished performance differed between spinal and general neurosurgeons. Identification of specific areas of deficiency could prove useful in the design and implementation of educational programs and maintenance of certification.
神经外科学的实践需要基础知识。住院医师培训计划和继续医学教育课程旨在教授相关的神经外科学原则。然而，神经外科医生之间存在知识差距，并且不同队列的神经外科医生之间的差距可能不同。自我评估神经外科学（SANS）一般检查和脊柱检查是在线学习和认证维护的教育工具。本研究检查了接受 SANS 的脊柱神经外科医生和普通神经外科医生的知识差距。
从 2008 年到 2010 年，共有 165 名脊柱神经外科医生完成了 SANS 脊柱检查的 243 个可用问题。在同一时间段内，993 名普通神经外科医生完成了 SANS 一般脊柱检查。根据 18 个主要神经外科学知识学科计算并评估了平均分数。进行了统计分析，以评估所有用户之间是否存在明显的知识差距以及脊柱神经外科医生与其普通神经外科医生对应方之间的表现差异。
脊柱神经外科医生的总体考试平均得分为 87.4%±7.5%，普通神经外科医生的平均得分为 71.5%±8.9%（P<0.001）。在 SANS 的 18 个主要知识类别中，脊柱神经外科医生（n=165）在五个类别中回答错误的问题占 15%或更多。脊柱神经外科医生表现不佳的类别为脑血管、麻醉和重症监护、一般临床、肿瘤和创伤。对于普通神经外科医生（n=993），表现最差的五个知识类别为脑血管、癫痫、周围神经、创伤和放射外科。尽管脊柱神经外科医生和普通神经外科医生在某些领域表现不佳，包括创伤和脑血管，但脊柱神经外科医生在一般临床、麻醉和重症监护以及肿瘤方面的表现相对较差。
SANS 脊柱检查显示了脊柱外科医生在特定类别中的知识差距。表现不佳的知识领域在脊柱和普通神经外科医生之间有所不同。确定特定的不足之处可能有助于设计和实施教育计划以及认证维护。
