Dokponou Yao Christian Hugues, Nyalundja Arsene Daniel, Madjoue Arsene Desire Ossaga, Dossou Mèhomè Wilfried, Badirou Omar, Agada Nicaise, Lasssissi Katib, Adjovi Fritzell Marc, Lawson Laté Dzidoula, Bankole Nourou Dine Adeniran
Department of Neurosurgery, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco.
Department of Neurosurgery, Faculté de Médecine, Université Catholique de Bukavu, Democratic Republic of Congo, Université Catholique de Bukavu, South-Kivu, Democratic Republic of the Congo.
Surg Neurol Int. 2023 Mar 24;14:96. doi: 10.25259/SNI_68_2023. eCollection 2023.
This study looks at how COVID-19 affected the admission and training of neurosurgical residents worldwide.
From 2019 to 2021, we reviewed multiple databases (i.e., Google Scholar, Science Direct, PubMed, and Hinari) to evaluate the impact of the COVID-19 pandemic on neurosurgery resident training and admission in low middle-income countries (LMICs) and high-income countries (HICs). We then utilized a Wilcoxon signed-rank test to evaluate the difference between the two LMIC/HICs and employed Levene's test to assess the homogeneity of variances.
There were 58 studies that met our inclusion criteria; 48 (72.4%) were conducted in HIC and 16 (27.6%) in LMIC. The admission of new residents was mostly canceled in HIC (31.7%; = 13) and in LMIC (25%; = 4) from 2019 to 2021 due to COVID-19. Learning modalities changed to include predominantly video conferencing (i.e., 94.7% [ = 54] of cases). Further, neurosurgery was largely restricted to emergency cases alone (79.6% [ = 39]), with only 12.2% ( = 6) elective cases. The result was a marked reduction in resident surgical training (i.e., 66.7% [ = 10] in LMIC and 62.9% [ = 22] in HIC), despite increased workloads in (i.e., LMIC [37.4%; = 6] and HIC [35.7%; = 15]). This was attributed to the marked reduction in the number of surgical patients allotted to each resident (i.e., LMIC [87.5%; = 14] than HIC [83.3%; = 35]).
The COVID-19 pandemic markedly disrupted neurosurgical education globally. Although differences have been found between LMICs and HICs training, the reduction of neurosurgical case-loads and surgical procedures has significantly impacted neurosurgical training. The question remains, how can this "loss of experience" be redressed in the future?
本研究旨在探讨新型冠状病毒肺炎（COVID-19）如何影响全球神经外科住院医师的招录与培训。
2019年至2021年期间，我们检索了多个数据库（即谷歌学术、科学Direct、PubMed和Hinari），以评估COVID-19大流行对低收入和中等收入国家（LMICs）及高收入国家（HICs）神经外科住院医师培训和招录的影响。然后，我们使用Wilcoxon符号秩检验来评估两个LMIC/HIC组之间的差异，并采用Levene检验来评估方差的齐性。
有58项研究符合我们的纳入标准；48项（72.4%）在HIC进行，16项（27.6%）在LMIC进行。由于COVID-19，2019年至2021年期间，HIC（31.7%；n = 13）和LMIC（25%；n = 4）新住院医师的招录大多被取消。学习方式主要转变为视频会议（即94.7%[n = 54]的情况）。此外，神经外科手术在很大程度上仅局限于急诊病例（79.6%[n = 39]），择期病例仅占12.2%（n = 6）。结果是住院医师的外科手术培训显著减少（即LMIC为66.7%[n = 10]，HIC为62.9%[n = 22]），尽管（即LMIC[37.4%；n = 6]和HIC[35.7%；n = 15]）工作量有所增加。这归因于分配给每位住院医师的手术患者数量显著减少（即LMIC为87.5%[n = 14]，高于HIC的83.3%[n = 35]）。
COVID-19大流行显著扰乱了全球神经外科教育。尽管在LMICs和HICs培训之间发现了差异，但神经外科病例量和手术操作的减少对神经外科培训产生了重大影响。问题仍然存在，未来如何弥补这种“经验损失”？
