Implementation of Enhanced Recovery After Surgery in Neurosurgical Standardized Residency Training: Outcomes of...

Incorporating Enhanced Recovery After Surgery (ERAS) principles into clinical education offers a new direction for medical training reform. Especially in neurosurgery, the ERAS-based Standardized Residency Training (SRT) program is uncharted. This pilot study sought to design, implement, and evaluate an ERAS-based SRT program in neurosurgery.

This retrospective study analyzed 75 neurosurgery SRT trainees (ERAS group: n = 40; control: n = 35) at a tertiary center. The ERAS group received an ERAS protocol pathway utilizing small group discussions, case-based learning, protocol application, and mobile feedback. Controls received traditional training (lectures, demonstrations). Core competencies were assessed via a six-dimensional framework by supervising physicians; post-training exams evaluated knowledge and reasoning.

The demographics and baseline characteristics were similar between groups. Overall post-training exam scores were not significantly different (ERAS: 82 ± 7 vs. control: 79 ± 8, P > 0.05). However, the ERAS group excelled in case analysis (21.4 ± 2.9 vs. 19.9 ± 3.2, P = 0.04) and had more "Excellent" ratings (>85 points) (30% vs. 14.3%). They also outperformed in professional quality (P = 0.013), expertise capacity (P = 0.002), patient management (P = 0.022), and communication (P < 0.001), with communication consistently superior. No significant differences were noted in teaching ability (P = 0.616) or learning and improvement (P = 0.08).

This pilot study indicated that an ERAS-based SRT program in neurosurgery effectively matches traditional training in knowledge acquisition while significantly improving residents' clinical skills, especially in communication, patient management, professionalism, and expertise. Integrating the ERAS principles into SRT successfully links theory with practice, offering a solid foundation for competency-based residency education.