Non-technical skills for neurosurgeons : an international survey

INTRODUCTION : Neurosurgery is considered a technically demanding specialty; nonetheless, it also requires non-technical skills (NTSs) to reach mastery. RESEARCH QUESTION : This study seeks to understand how important NTSs are perceived by neurosurgeons across diverse roles and socio-economic backgrounds. The objective is to identify key NTSs and explore their role in surgical precision, teamwork, and collaboration. MATERIAL AND METHOD : An international survey involving 372 neurosurgeons from various socio-economic and cultural contexts was conducted. The extensive sample and inclusive methodology provide a comprehensive perspective on the perceived importance of NTSs in neurosurgery. RESULTS : The survey results highlight the universal significance of NTSs among neurosurgeons. Attention to detail, humility, and self-awareness are considered essential for surgical precision, effective teamwork, and collaboration. The findings underscore the necessity for integrated training programs that combine NTSs with technical skills. DISCUSSION AND CONCLUSION : The study emphasizes the importance of effective training methods such as simulations, mentorship, and role-playing in equipping neurosurgeons to navigate the complexities of their profession. Future research should focus on optimizing teaching methods for NTSs, comparing traditional courses, online modules, and hybrid training programs. Addressing the global disparity in neurosurgical care, particularly in low- and middle-income countries, is crucial for improving patient outcomes worldwide.https://www.journals.elsevier.com/brain-and-spinehj2024SurgerySDG-03:Good heatlh and well-beingSDG-04:Quality Educatio

Estado actual de la psicocirugía en España

Con el objetivo de recoger el estado actual de la psicocirugía en España y la opinión de los neurocirujanos hacia la misma, se diseñó una encuesta dirigida a todos los neurocirujanos en activo en nuestro país. Respondió al menos un neurocirujano de cada uno los 74 centros neuroquirúrgicos existentes en España (tasa de respuesta=100%). Únicamente 6 neurocirujanos realizaron intervenciones de psicocirugía. En total, se practicaron 111 intervenciones psicoquirúrgicas entre 1999 y 2003. El 75,7% de las mismas se llevó a cabo en centros privados. La indicación más frecuente ha sido el trastorno obsesivo-compulsivo, y la técnica más frecuente la capsulotomía anterior, aunque existe diversidad de indicaciones y técnicas entre los diversos neurocirujanos que la practican. Los que no realizan psicocirugía aducen como motivos la falta de remisión de pacientes (54,4%) y la propia inexperiencia (36,8%). La sospecha de una posible falta de eficacia o los posibles efectos adversos no son planteados frecuentemente. La posibilidad del empleo de la estimulación cerebral profunda en la psicocirugía, junto con la experiencia de algunos neurocirujanos y la opinión favorable del resto, puede dar lugar en el futuro a un mayor número de intervenciones en nuestro país

Estudo da mortalidade de recém-nascidos internados na UTI neonatal do Hospital Geral de Caxias do Sul, Rio Grande do Sul Newborn mortality study in the neonatal intensive care unit of Caxias do Sul General Hospital, Rio Grande do Sul

OBJETIVOS: conhecer as causas e variáveis relacionadas com o óbito de recém-nascidos (RN) de uma UTI neonatal de referência na região Sul do Brasil. MÉTODOS: estudo descritivo envolvendo 2.247 RN acompanhados até a alta. Foram analisadas variáveis maternas, do RN e variáveis da gestação, parto e atendimento. Foi utilizada a análise univariada e a regressão logística múltipla para relacionar as variáveis estudadas com o óbito. RESULTADOS: ocorreram 184 óbitos, com uma letalidade de 8,2%. A mortalidade dos RN com peso < 1.500g foi de 29,3%, sendo de 61,3% abaixo de 1.000g e 5,6% acima de 1.000g. Os RN com baixo peso e os prematuros apresentaram um risco de morrer quatro vezes maior do que os RN com peso >2.500g ou a termo. As variáveis relacionadas ao óbito foram o peso < 2.000 gramas, o Apgar no 5' < 4, a ausência de pré-natal, a necessidade de reanimação em sala de parto e a ventilação mecânica durante a internação. As principais causas básicas de óbito foram as malformações (25,6%), hipertensão materna (17,9%) e as infecções maternas (12,0%). CONCLUSÕES: muitos óbitos ocorreram por falhas no atendimento da gestante e do RN, desafio que precisa ser enfrentado por neonatologistas, obstetras e o poder público.<br>OBJECTIVES: to determine causes and variables related to newborn deaths of a neonate intensive care unite (ICU) in the Southern region of Brazil. METHODS: a descriptive study involving 2.247 newborns followed up until discharge date. Maternal variables were analyzed, as well as of the newborn and pregnancy, delivery and medical assistance variables. Univariate analysis and multiple logistic regression were used to relate the variables studied with death occurrence. RESULTS: 184 deaths occurred, corresponding to a 8.2% lethality rate. Newborn mortality variables were the following: weight of <1.500g corresponding to 29.3%, with 61.3% under 1.000g and 5.6% over 1.000g. Low weight and premature newborns held a death risk four times higher than newborns weighing >2.500g or born at pregnancy term. Death related variables were weight of <2.000 grams, Apgar at 5' <4, no prenatal medical care, the need of delivery room resuscitation procedures and mechanic ventilation during hospitalization. Deaths basic causes were malformations (25.6%), maternal hypertension (17.9%) and maternal infections (12.0%). CONCLUSIONS: many of the deaths occurred because of the poor medical care offered to pregnant women and newborns, a challenge that need to be faced by neonatologists, obstetricians and the government

Non-technical skills for neurosurgeons: An international survey

Neurosurgery is considered a technically demanding specialty; nonetheless, it also requires non-technical skills (NTSs) to reach mastery. This study seeks to understand how important NTSs are perceived by neurosurgeons across diverse roles and socio-economic backgrounds. The objective is to identify key NTSs and explore their role in surgical precision, teamwork, and collaboration. An international survey involving 372 neurosurgeons from various socio-economic and cultural contexts was conducted. The extensive sample and inclusive methodology provide a comprehensive perspective on the perceived importance of NTSs in neurosurgery. The survey results highlight the universal significance of NTSs among neurosurgeons. Attention to detail, humility, and self-awareness are considered essential for surgical precision, effective teamwork, and collaboration. The findings underscore the necessity for integrated training programs that combine NTSs with technical skills. The study emphasizes the importance of effective training methods such as simulations, mentorship, and role-playing in equipping neurosurgeons to navigate the complexities of their profession. Future research should focus on optimizing teaching methods for NTSs, comparing traditional courses, online modules, and hybrid training programs. Addressing the global disparity in neurosurgical care, particularly in low- and middle-income countries, is crucial for improving patient outcomes worldwide. •Universal significance of NTSs: The survey results show that NTSs are essential for neurosurgery.•Integrated Training Programs: Teaching of NTSs alongside technical skills through simulations, mentorship and role-playing.•Curriculum: NTSs as means of selection criteria and included in neurosurgical training curricula