Skip to main content
SpringerLink
Log in

Residency program trainee-satisfaction correlate with results of the European board examination in neurosurgery

  • Clinical Article - Neurosurgical Training
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Introduction

Substantial country differences in neurosurgical training throughout Europe have recently been described, ranging from subjective rating of training quality to objective working hours per week. The aim of this study was to analyse whether these differences translate into the results of the written and oral part of the European Board Examination in Neurological Surgery (EBE-NS).

Methods

Country-specific composite scores for satisfaction with quality of theoretical and practical training, as well as working hours per week, were obtained from an electronic survey distributed among European neurosurgical residents between June 2014 and March 2015. These were related to anonymous country-specific results of the EBE-NS between 2009 and 2016, using uni- and multivariate linear regression analysis.

Results

A total of n = 1025 written and n = 63 oral examination results were included. There was a significant linear relationship between the country-specific EBE-NS result in the written part and the country-specific composite score for satisfaction with quality of theoretical training [adjusted regression coefficient (RC) −3.80, 95 % confidence interval (CI) -5.43–7 -2.17, p < 0.001], but not with practical training or working time. For the oral part, there was a linear relationship between the country-specific EBE-NS result and the country-specific composite score for satisfaction with quality of practical training (RC 9.47, 95 % CI 1.47–17.47, p = 0.021), however neither with satisfaction with quality of theoretical training nor with working time.

Conclusion

With every one-step improvement on the country-specific satisfaction score for theoretical training, the score in the EBE-NS Part 1 increased by 3.8 %. With every one-step improvement on the country-specific satisfaction score for practical training, the score in the EBE-NS Part 2 increased by 9.47 %. Improving training conditions is likely to have a direct positive influence on the knowledge level of trainees, as measured by the EBE-NS. The effect of the actual working time on the theoretical and practical knowledge of neurosurgical trainees appears to be insignificant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. AlZhrani G, Alotaibi F, Azarnoush H, Winkler-Schwartz A, Sabbagh A, Bajunaid K, Lajoie SP, Del Maestro RF (2015) Proficiency performance benchmarks for removal of simulated brain tumors using a virtual reality simulator NeuroTouch. J Surg Educ 72:685–696

    Article  PubMed  Google Scholar 

  2. Babu MA, Nahed BV, Heary RF (2012) Investigating the scope of resident patient care handoffs within neurosurgery. PLoS One 7:e41810

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Babu R, Thomas S, Hazzard MA, Friedman AH, Sampson JH, Adamson C, Zomorodi AR, Haglund MM, Patil CG, Boakye M, Lad SP (2014) Worse outcomes for patients undergoing brain tumor and cerebrovascular procedures following the ACGME resident duty-hour restrictions. J Neurosurg 121:262–276

    Article  PubMed  PubMed Central  Google Scholar 

  4. Babu R, Thomas S, Hazzard MA, Lokhnygina YV, Friedman AH, Gottfried ON, Isaacs RE, Boakye M, Patil CG, Bagley CA, Haglund MM, Lad SP (2014) Morbidity, mortality, and health care costs for patients undergoing spine surgery following the ACGME resident duty-hour reform: clinical article. J Neurosurg Spine 21:502–515

    Article  PubMed  Google Scholar 

  5. Benzel EC (2010) Neurosurgery education: the pursuit of excellence. Clin Neurosurg 57:49–55

    PubMed  Google Scholar 

  6. Bina RW, Lemole GM, Jr., Dumont TM (2015) On resident duty hour restrictions and neurosurgical training: review of the literature. J Neurosurg 1–7

  7. Bohm PE, Arnold PM (2015) Simulation and resident education in spinal neurosurgery. Surg Neurol Int 6:33

    Article  PubMed  PubMed Central  Google Scholar 

  8. Brennum J (2000) European neurosurgical education–the next generation. Acta Neurochir (Wien) 142:1081–1087

    Article  CAS  Google Scholar 

  9. Brennum J, van Loon J (2016) Neurosurgical education in Europe. Acta Neurochir (Wien) 158:1–2

    Article  Google Scholar 

  10. Burkhardt JK, Zinn PO, Bozinov O, Colen RR, Bertalanffy H, Kasper EM (2010) Neurosurgical education in Europe and the United States of America. Neurosurg Rev 33:409–417

    Article  PubMed  PubMed Central  Google Scholar 

  11. Cappabianca P (2016) Reply to: “Neurosurgical resident education in Europe-results of a multinational survey”. Acta Neurochir (Wien)

  12. Chan S, Conti F, Salisbury K, Blevins NH (2013) Virtual reality simulation in neurosurgery: technologies and evolution. Neurosurgery 72(Suppl 1):154–164

    Article  PubMed  Google Scholar 

  13. Chowdhry SA, Spetzler RF (2014) Genealogy of training in vascular neurosurgery. Neurosurgery 74(Suppl 1):S198–S203

    Article  PubMed  Google Scholar 

  14. Dumont TM, Rughani AI, Penar PL, Horgan MA, Tranmer BI, Jewell RP (2012) Increased rate of complications on a neurological surgery service after implementation of the Accreditation Council for Graduate Medical Education work-hour restriction. J Neurosurg 116:483–486

    Article  PubMed  Google Scholar 

  15. EANS (accessed: February 29th, 2016) http://www.eans.org/pages/education/exams. Accessed 29 Feb 2016

  16. Gasco J (2014) Present and future of neurosurgery training and education. Malays J Med Sci 21:1–3

    PubMed  PubMed Central  Google Scholar 

  17. Gephart MH, Derstine P, Oyesiku NM, Grady MS, Burchiel K, Batjer HH, Popp AJ, Barbaro NM (2015) Resident away rotations allow adaptive neurosurgical training. Neurosurgery 76:421–425, discussion 425–426

    Article  PubMed  Google Scholar 

  18. Hoh BL, Neal DW, Kleinhenz DT, Hoh DJ, Mocco J, Barker FG 2nd (2012) Higher complications and no improvement in mortality in the ACGME resident duty-hour restriction era: an analysis of more than 107,000 neurosurgical trauma patients in the Nationwide Inpatient Sample database. Neurosurgery 70:1369–1381, discussion 1381–1362

    Article  PubMed  Google Scholar 

  19. Joswig H, Hock C, Hildebrandt G, Schaller K, Stienen MN (2016) Microscopic lumbar spinal stenosis decompression: is surgical education safe? Acta Neurochir (Wien) 158:357–366

    Article  Google Scholar 

  20. Kshettry VR, Mullin JP, Schlenk R, Recinos PF, Benzel EC (2014) The role of laboratory dissection training in neurosurgical residency: results of a national survey. World Neurosurg 82:554–559

    Article  PubMed  Google Scholar 

  21. Lister JR, Friedman WA, Murad GJ, Dow J, Lombard GJ (2010) Evaluation of a transition to practice program for neurosurgery residents: creating a safe transition from resident to independent practitioner. J Grad Med Educ 2:366–372

    Article  PubMed  PubMed Central  Google Scholar 

  22. Norby K, Siddiq F, Adil MM, Haines SJ (2014) The effect of duty hour regulations on outcomes of neurological surgery in training hospitals in the United States: duty hour regulations and patient outcomes. J Neurosurg 121:247–261

    Article  PubMed  Google Scholar 

  23. Oliveira MM, Araujo AB, Nicolato A, Prosdocimi A, Godinho JV, Valle AL, Santos M, Reis AB, Ferreira MT, Sabbagh A, Gusmao S, Del Maestro R (2015) Face, content, and construct validity of brain tumor microsurgery simulation using a human placenta model. Neurosurgery

  24. Omerhodzic I, Tonge M, Matos B, Musabeliu E, Raspanti C, Ferdinandov D, Galimova R, Muroi C, Balik V, Kursumovic A (2012) Neurosurgical training programme in selected European countries: from the young neurosurgeons’ point of view. Turk Neurosurg 22:286–293

    PubMed  Google Scholar 

  25. Parker SL, McGirt MJ, Asher AL, Selden NR (2015) Quality improvement in neurological surgery graduate medical education. Neurosurg Clin N Am 26(231–238):ix

    Google Scholar 

  26. Robison RA, Liu CY, Apuzzo ML (2011) Man, mind, and machine: the past and future of virtual reality simulation in neurologic surgery. World Neurosurg 76:419–430

    Article  PubMed  Google Scholar 

  27. Rosseau G, Bailes J, del Maestro R, Cabral A, Choudhury N, Comas O, Debergue P, De Luca G, Hovdebo J, Jiang D, Laroche D, Neubauer A, Pazos V, Thibault F, Diraddo R (2013) The development of a virtual simulator for training neurosurgeons to perform and perfect endoscopic endonasal transsphenoidal surgery. Neurosurgery 73(Suppl 1):85–93

    Article  PubMed  Google Scholar 

  28. Schaller K (2013) Neurosurgical training under European law. Acta Neurochir (Wien) 155:547

    Article  Google Scholar 

  29. Starke RM, Jane JA Jr, Asthagiri AR, Jane JA Sr (2015) International rotations and resident education. J Neurosurg 122:237–239

    Article  PubMed  Google Scholar 

  30. Stienen MN, Netuka D, Demetriades AK, Ringel F, Gautschi OP, Gempt J, Kuhlen D, Schaller K (2016) Neurosurgical resident education in Europe—results of a multinational survey. Acta Neurochir (Wien) 158:3–15

    Article  Google Scholar 

  31. Stienen MN, Netuka D, Demetriades AK, Ringel F, Gautschi OP, Gempt J, Kuhlen D, Schaller K (2016) Training and career aspects of female neurosurgical residents in Europe. J Neurosurg. doi:10.3171/2016.4.JNS16788

  32. Stienen MN, Netuka D, Demetriades AK, Ringel F, Gautschi OP, Gempt J, Kuhlen D, Schaller K (2016) Working time of neurosurgical residents in Europe—results of a multinational survey. Acta Neurochir (Wien) 158:17–25

    Article  Google Scholar 

  33. Sure U, Miller D, Bozinov O (2007) Neurosurgical training in Europe, problems and possible solutions. Surg Neurol 67:626–628, discussion 628–633

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Petra Koubova and Susie Hide from the European Association of Neurological Surgeons (EANS) for providing anonymous results of the EBE-NS.

Author information

Authors and Affiliations

  1. Department of Neurosurgery and Faculté de Médicine, University Hospital of Geneva, Geneva, Switzerland

    Martin N. Stienen, Oliver P. Gautschi & Karl Schaller

  2. Service de Neurochirurgie, Département des Neurosciences Cliniques, Hôpitaux Universitaires de Genève, Rue Gabrielle Perret-Gentil 4, 1205, Genève, Suisse

    Martin N. Stienen, Oliver P. Gautschi & Karl Schaller

  3. Department of Neurosurgery, Charles University, 1st Medical Faculty, Central Military Hospital, Prague, Czech Republic

    David Netuka

  4. Department of Neurosurgery, Western General Hospital, Edinburgh, EH4 2XU, UK

    Andreas K. Demetriades

  5. Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany

    Florian Ringel & Jens Gempt

  6. Department of Neurosurgery, Universitätsmedizin Mainz, Mainz, Germany

    Florian Ringel

  7. Department of Neurosurgery, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

    Dominique Kuhlen

Authors
  1. Martin N. Stienen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Netuka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andreas K. Demetriades
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Florian Ringel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Oliver P. Gautschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jens Gempt
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Dominique Kuhlen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Karl Schaller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin N. Stienen.

Ethics declarations

Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Table 1

(DOCX 87 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stienen, M.N., Netuka, D., Demetriades, A.K. et al. Residency program trainee-satisfaction correlate with results of the European board examination in neurosurgery. Acta Neurochir 158, 1823–1830 (2016). https://doi.org/10.1007/s00701-016-2917-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-016-2917-y

Keywords

Search

Navigation