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Neurosurgeons’ Socioeconomic Training Program Proves Successful

milestones and stethoscope

Most of us have been trained for a job at some point in our career, and likely, that training missed a thing or two.

Your manager may have overlooked teaching you skills like communicating with coworkers and clients effectively, or knowing the laws and regulations that pertain to your industry.

You learned eventually, through observation, intuition and determination, but wouldn’t some help along the way have been nice?

Department Chairman Dr. Robert A. Solomon and his faculty at the Department of Neurosurgery at Columbia University Medical Center/NewYork-Presbyterian Hospital knew of a new training requirement for neurosurgical residents:

The American Board of Neurological Surgery (ABNS) and the Accreditation Council for Graduate Medical Education (ACGME) expanded the training requirements of neurosurgical residents to include the socioeconomics of medicine–for example, navigating ethical challenges during patient care and using healthcare resources efficiently.

Recognizing this, Dr. Solomon, along with a group of researchers, decided to remedy the training in their own department.

The group consisted of Dr. Solomon, Vice Chairman of Academic Affairs, Dr. Jeffrey N. Bruce, Dr. Deborah Benzil, former chief residents Dr. Brad E. Zacharia (graduated 2014) and Dr. Zachary L. Hickman (graduated 2014), and current resident Dr. Brett E. Youngerman.*

During training, neurosurgical residents’ progress is evaluated using a set of milestones, which they must master to graduate from residency and become board certified. The ABNS and the ACGME set these milestones, most of which cover medical knowledge and patient care.

The rest of the milestones cover the recently added socioeconomic aspects of medicine—including the business, legal and managerial tasks of operating a practice, which, in a 2008 Council of State Neurosurgical Societies survey, neurosurgeons early in their careers felt they were unprepared to handle.

Up until now, some socioeconomic aspects were taught during residency, but without a formal curriculum. Because of this new residency program requirement, general socioeconomic aspects are now part of the required education in medical school in order to introduce these concepts early on.

But these aspects need to be retaught during residency because they are often learned best when the knowledge can be applied in a real-world setting. However, this new requirement doesn’t come with a set of customized courses or techniques to help weave the courses into residents’ already busy schedules. That falls to the individual residency programs.

To help these residents master their socioeconomic milestones, Dr. Bruce and his group of researchers, in consultation with Dr. Solomon, designed and implemented the first pilot program during the 2013-2014 academic year. The program consisted of 12 lectures, each 45 minutes long and covering a different topic, followed by 15 minutes of discussion. Topics included: where to work after residency; conflict of interest; and communicating with patients, colleagues, staff and the public, to list a few.

For the pilot program, once a month for the 2013-2014 academic year, Columbia neurosurgical residents attended a lecture and learned about a new topic. Spreading the program out in this way gave residents the opportunity to digest topics in small bites and then apply their new knowledge to situations outside the classroom.

The results of the study, published in the journal Neurosurgery, showed that the neurosurgical residents found the lectures tremendously effective. In course-evaluation surveys, residents gave high ratings for several aspects of the program: content, quality, relevance of lectures and overall value of the course.

The residents said the lectures filled in critical gaps in their medical school training and some lectures covered topics brand new to them, such as protecting one’s online reputation and the basics of tactful negotiation. But the residents simply couldn’t get enough—the most common feedback the residents gave about the pilot program was their desire to spend more time and go into greater depth on these topics and others.

Also, to measure the effectiveness of the program, residents were tested on topics before the lecture series and then after. Their improved test scores—along with their highly positive feedback—proved the program’s success.

Dr. Solomon and his team are expanding the format to 16 lectures given over two years. They will also make their program available nationwide so that other residency programs that have been lacking in this training can have access to it.

Because finding instructors with the necessary expertise and availability to teach these lectures may be a challenge at some institutions, Dr. Solomon and his team are exploring the possibility of recording the lectures or live streaming the program as it’s being held at Columbia.

In making these efforts, the authors hope to improve the training of future generations of neurosurgeons.

Learn more about Dr. Solomon on his bio page here.

Learn more about Dr. Bruce on his bio page here.

*Full list of authors:
Youngerman BE, Zacharia BE, Hickman ZL, Bruce JN, Solomon RA, Benzil DL

Photo Credit: © [shefkate]/Adobe Stock

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