Implementation of a virtual curriculum for medical students completing clinical rotations in neurosurgery

There is currently no standardized curriculum for medical students completing rotations in neurosurgery. The authors assessed the impact of a virtual lecture series upon medical student competency during clinical neurosurgical rotations.

Neurosurgical residents (PGY3-6) prepared 10-25 min virtual lectures on the presentation and management of brain tumors, subarachnoid hemorrhage, cauda equina syndrome, and elevated intracranial pressure. Third-year medical students completing a neurosurgical clerkship (2 weeks) and fourth-year students completing a neurosurgical sub-internship (4 weeks) at our institution (1/14/22-9/20/24) were randomized to either receive or not receive the virtual lecture series. The authors distributed electronic pre- and post-rotation surveys assessing preparedness and operative skills, knowledge, interest, and perceptions of neurosurgery to all students. Propensity-score matching was performed by year of medical school, and responses were assessed with a 5-point Likert scale and compared with Wilcoxon matched pair signed rank tests. The results are reported from the propensity-score matched analysis.

Of the 44 respondents (mean age 27 years, 75% male), 25 received the lecture series and 19 did not. After propensity-score matching, there were 18 students in each group. The lecture group reported improvements in preparedness (median scores: 9/20 pre- vs. 13/20 post-rotation, p = 0.007) and understanding of neurosurgical concepts (10/20 vs. 12/20, p = 0.005), while interest and perception remained unchanged. Both the lecture and no-lecture groups reported improvement in knot tying after the rotation. Aside from this skill, the non-lecture group did not report significant gains in other operative skills assessed in the survey or in the understanding of the concepts covered in the lectures. All lecture recipients felt the series improved rotation readiness. 56% of non-lecture students expressed a desire for virtual didactics.

A virtual lecture series effectively improved medical students' perceived preparedness for rotations in neurosurgery and understanding of neurosurgical concepts. Future efforts to develop standardized curriculum may improve medical students' knowledge and comfort in early neurosurgical education.