Mansouri Alireza, Witiw Christopher D, Badhiwala Jetan H, Nassiri Farshad, McDonald Patrick J, Kulkarni Abhaya V, Zadeh Gelareh, Kondziolka Douglas
1Division of Neurosurgery,Toronto Western Hospital,University Health Network,Toronto,Ontario,Canada.
3Section of Neurosurgery,Children's Hospital Winnipeg,University of Manitoba,Winnipeg,Manitoba,Canada.
Can J Neurol Sci. 2017 Jan;44(1):51-58. doi: 10.1017/cjn.2016.314.
Despite the critical role played by neurosurgeons in performing radiosurgery, neurosurgery residents in Canada have limited exposure to radiosurgery during their training. A survey of neurosurgery residents and faculty along with radiation oncology faculty was conducted to analyze perspectives regarding incorporating formal radiosurgery training into the neurosurgery residency curriculum Methods: An online survey platform was employed. Descriptive statistics were used to summarize center and respondent characteristics. Categorical variables were compared using odds ratios and corresponding 95% confidence intervals. The chi-squared test was utilized to assess statistical significance. A value of p<0.05 was considered significant Results: The response rate was 31% (119/381); 87% (102/119) of respondents were from the neurosurgical specialty and 13% (17/119) from radiation oncology. Some 46% of residents (18/40) were "very uncomfortable" with radiosurgery techniques, and 57% of faculty (42/73) believed that dedicated radiosurgery training would be beneficial though impractical. No respondents felt that "no training" would be beneficial. A total of 46% of residents (19/41) felt that this training would be beneficial and that time should be taken away from other rotations, if needed, while 58% of faculty (42/73) and 75% (28/41) of residents believed that either 1 or 1-3 months of time dedicated to training in radiosurgery would suffice Conclusions: Canadian neurosurgeons are actively involved in radiosurgery. Despite residents anticipating a greater role for radiosurgery in their future, they are uncomfortable with the practice. With the indications for radiosurgery expanding, this training gap can have serious adverse consequences for patients. Considerations regarding the incorporation and optimal duration of dedicated radiosurgery training into the Canadian neurosurgery residency curriculum are necessary.
尽管神经外科医生在实施放射外科手术中发挥着关键作用,但加拿大的神经外科住院医师在培训期间接触放射外科手术的机会有限。对神经外科住院医师、教员以及放射肿瘤学教员进行了一项调查,以分析将正式的放射外科培训纳入神经外科住院医师课程的相关观点。方法:采用在线调查平台。描述性统计用于总结中心和受访者特征。分类变量使用优势比和相应的95%置信区间进行比较。采用卡方检验评估统计学意义。p<0.05的值被认为具有统计学意义。结果:回复率为31%(119/381);87%(102/119)的受访者来自神经外科专业,13%(17/119)来自放射肿瘤学专业。约46%的住院医师(18/40)对放射外科技术“非常不自在”,57%的教员(42/73)认为专门的放射外科培训虽有益但不切实际。没有受访者认为“不培训”会有益。共有46%的住院医师(19/41)认为这种培训有益,如有必要,应从其他轮转中抽出时间,而58%的教员(42/73)和75%的住院医师(28/41)认为专门用于放射外科培训1个月或1 - 3个月就足够了。结论:加拿大神经外科医生积极参与放射外科手术。尽管住院医师预计放射外科手术在他们未来的工作中会发挥更大作用,但他们对这种手术操作感到不自在。随着放射外科手术的适应证不断扩大,这种培训差距可能会给患者带来严重的不良后果。有必要考虑将专门的放射外科培训纳入加拿大神经外科住院医师课程以及确定最佳培训时长。