Introduction: The Congress of Neurological Surgeons (CNS) Case of the Month (COTM) engages its members by allowing them to answer clinical management questions online regarding interesting and controversial neurosurgical cases. The CNS Web Committee sought to improve participation in this activity.
Methods: Between January 2002 and January 2011, 3 to 4 COTMs were posted yearly. Starting in February 2011, the COTM was updated monthly. Concurrently, the CNS announced new COTMs by emailing members monthly and by placing a COTM link on the rotating CNS.org homepage banner. User visits were recorded using Google Analytics from 2009 to the present.
Results: From February 2010 to February 2011, the COTM had 4,369 unique page views. From February 2011 to February 2012, the COTM had 12,939 unique page views, an increase of 196%. The average time spent on the COTM webpage also increased 15%. Approximately 90% of COTM visits occurred in the 3 days following the monthly email announcement of the new COTM. The most heavily visited months included cases of an atypical Hangman’s fracture (October, n = 1,815) and diffuse cervical spondylosis (July, n = 1,510). The fewest visits occurred in December and January (n = 776 and 667). The mean number of unique page views was 1,169 for spine cases and 867 for cranial cases (p = 0.20) and the mean average time spent on each page was 129s and 139s (p = 0.39) for spine and cranial cases, respectively.
Conclusions: Increasing user awareness with monthly emails and consistently updating web content resulted in dramatic improvement in COTM participation. Greater number of visits corresponded with the CNS annual meeting while fewer visits corresponded with the holiday season. Spine topics appear to be somewhat more popular than cranial topics. These methods and results could apply to any medical organization website striving to increase user participation.
Patient Care: This research can improve patient care by educating neurosurgeons, challenging neurosurgeons to critically analyze complex cranial and spine cases and make difficult clinical decisions, and allowing neurosurgeons to compare their responses with those of their peers. This research can also serve as a model to other medical organizations seeking to educate and engage their members.
Learning Objectives: 1) Describe the two key components to increase web-based user participation and 2) Understand the fluctuation in user participation based on external factors such as national meetings and holidays.