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A 6-Session Case-Based Neurosurgery Curriculum Improves Medical Student Knowledge, Confidence, and Retention: A
Mercy H Mazurek1, Briana C Prager2, Kimie Han1
1Harvard Medical School, Boston, Massachusetts.
Background And Objectives:
Neurosurgical exposure in US medical schools is limited, and structured case-based curricula remain rare despite known benefits. We evaluated whether a 6-session case-based neurosurgery curriculum improves medical student knowledge, clinical confidence, and longitudinal retention.
Methods:
Medical students attended 6 optional resident- or attending-led case discussions (trauma, spine oncology, cranial trauma, epilepsy, posterior fossa lesions, spinal cord injury; August 2025-April 2026). Each session paired pre-/postsurveys with board-style questions, seven 0-to-5 Likert confidence items, and retention questions on prior content. Within-session change in knowledge was assessed with linear mixed-effects models; confidence domains used Holm-Bonferroni correction.
Results:
Thirty-seven students participated; 13 (35%) attended multiple sessions and none attended all 6. Twenty-five students contributed 37 paired pre-/postobservations. Pooled accuracy rose from 54.6% to 78.7% (+24.1 percentage points; mixed-effects p = 2.5 × 10⁻⁹). Per-session gains reached significance in 4 of 5 tested sessions. Self-rated confidence improved across all 7 domains (pooled 1.09-1.58; p < 10⁻¹³), with 5 retaining significance after correction. Interest in applying to neurosurgery rose modestly from 3.64 to 3.91 (p = 0.027). Across retention items, accuracy rose from 43% before teaching to 77% immediately after and 73% at follow-up. Accuracy on content unknown at baseline rose from 0% to 59% to 53%, indicating curriculum-attributable retention, while previously known content remained at 100% throughout.
Conclusions:
A recurring case-based neurosurgery curriculum produced within-session knowledge gains, confidence improvements, and longitudinal retention, and reinforced existing interest in neurosurgery. This reproducible approach requires modest resident and faculty time and adapts to other procedural specialties seeking earlier student exposure.
