Visiting Professor's Corner
Daniel K. Resnick, MD
The Internet and Neurosurgical Education
Neurosurgery is a rapidly evolving field. Advances in surgical technology, molecular
biology and imaging science continue to change the way that patients with diseases
of the nervous system are treated. Practicing neurosurgeons must participate in
ongoing educational activities in order to stay abreast of these developments so
that they may continue to offer their patients high quality cutting edge care. It
is a fact of life, however, that neurosurgeons are extremely and increasingly busy.
The demands of trauma and emergency room coverage, clinic and operating room schedules,
and the need to see more patients due to decreased numbers of neurosurgeons and
declining reimbursement significantly limit the opportunity for practicing neurosurgeons
to close up shop for week long conferences on a regular basis.
The internet has evolved as a means of rapid communication and dispersal of information.
The internet is accessible from almost anywhere, and the contents are reviewable
at any time. The Congress of Neurological Surgeons has dedicated a substantial amount
of resources towards developing internet-based tools to provide valuable educational
opportunities for practicing neurosurgeons. The two most visible products are the
SANS (Self Assessment in Neurological Surgery) Lifelong Learning examination and
the CNS University of Neurosurgery.
SANS Lifelong Learning consists of a series of
multiple-choice questions related to clinical neurosurgery as well as the non-clinical
core competencies described by the Accreditation Council for Continuing Medical
Education. The learner answers the questions and is given immediate feedback regarding
the veracity of his/her response along with a detailed critique of the question
explaining the answer and providing peer reviewed references to support the “correct”
response. By participating in this process, the learner can both assess and measurably
increase his/her knowledge regarding common (and some not so common) neurosurgical
scenarios.
The CNS University of Neurosurgery offers a different
learning opportunity. Similar to a physical university, CNS University of Neurosurgery
offers courses that may be audited or taken for credit, libraries (with text, video,
and imaging databases), student resources (links to other educational activities
which have been endorsed by the CNS Education Committee as being worthwhile and
relevant for neurosurgery), interaction with faculty (through interactive lectures)
and other learners (through a wikipedia like “neuro-pedia”). Development of the
infrastructure (building the campus) was a formidable undertaking because of the
need for password protection of content, protection of financial records (when CME
credits are purchased), and documentation of educational activity for the awarding
of CME credits. Initial course offerings in the University are currently limited
to the Non-Clinical Core Competencies, a collaborative project with the Council
of State Neurosurgical Societies. New content is being developed and it is anticipated
that a full set of virtual practical courses will be available in the fall. With
the introduction of new CME requirements and the evolution of the Integrated Medical
Learning® (IML) paradigm, these courses and programs will blend with the Annual
Meeting to allow year round and lifelong learning opportunities that can be assessed
for efficacy.
What the real utility of these projects is in the long run remains to be seen. Some
neurosurgeons are very eager to participate in online educational activities in
order to fulfill local licensing and credentialing requirements without having to
travel across country and miss a week of practice. As technology and our understanding
of how to use technology increases, we will be able to improve the multidirectional
flow of information and interactivity if these tools. It is hoped that the advent
of internet-based learning will facilitate the ongoing and continuous education
of neurosurgeons.