key: cord-0860055-x5lcocoz
authors: Sharif, Salman; Hafiz, Mehak
title: The Light at the End of the Tunnel: Neurosurgery Education During COVID
date: 2021-10-27
journal: World Neurosurg
DOI: 10.1016/j.wneu.2021.08.057
sha: 843c5fdb9a6dfcb4d4b5d9227b2cef1b18641d66
doc_id: 860055
cord_uid: x5lcocoz

nan

The Light at the End of the Tunnel: Neurosurgery Education During COVID

Beginning in China in December 2019, the novel coronavirus (COVID-19) spread to the world in a matter of months and a global pandemic was declared by the World Health Organization in March 2020. It affected almost all walks of life, and nearly all of the world's population had lockdowns at some point as multiple waves devastated different areas with the allusion of a new variant each time.

As the world underwent transformation, new norms of living began to emerge and things unheard of became the new reality. When lockdown started, the educational activities were not allowed. All fields of education were affected, but medicine was the most under pressure. People in all fields of medicine were dealing with the COVID-19 virus from the frontline, and many lost their lives. On the other hand, medical education suffered due to safety guidelines introduced by the World Health Organization.

During this pandemic, trainees and medical practitioners were asked to redeploy to the COVID area and perform only lifethreatening emergencies with protocol. This led to limited learning opportunities for young trainees. 1 All medical education including surgical training was affected globally. Training in subspecialties included neurosurgery, in which training time is already limited and sometimes inadequate. Managing patients and learning surgical skills became challenging.

In ambiguous times like this, the Pakistan Society of Neurosurgeons and Liaquat National Hospital took responsibility for training young neurosurgeons. This amazing adventure started with educating the trainees of 1 center under the leadership of Professor Salman Sharif, and it gradually spread among neurosurgeons from around the globe in a short time. His initiative and ideas were contagious, resulting in collaboration with the World Federation pf Neurosurgical Societies (WFNS) and a series of 54 International Pakistan Society of Neurosurgeons (PSN)/WFNS webinars. This provided a great opportunity to young and experienced neurosurgeons and played a vital role in educating trainees and neurosurgeons around the globe. With all the new norms and life modifications that the pandemic brought, e-learning was the greatest gift. 2 This was great help for the neurosurgery trainees and consultants who could not afford to travel or who did not have a culture of continuing medical education.

In the beginning, trainees from Pakistan and Asia were attending these sessions. The attendees included young neurosurgery trainees and also new and old neurosurgeons. With the increasing number of participation of learners and keen interest noted in mentors during the online sessions, new ideas were implied. Live questions and answers kept the participants interested. After every session, a virtual quiz was conducted to assess the performance and maintain interest during the session. The participants received a certificate of attendance and continuing medical education hours after filling a feedback form.

Along with international PSN/WFNS webinars, sessions were also conducted in association with the WFNS spine committee, WFNS trauma committee, WFNS neuroendoscopy/International Federation of Neuroendoscopy weekend sessions, and WFNS skull base sessions. Special sessions were conducted to learn neuroanatomy with the collaboration of the WFNS anatomy committee. With these exceptional webinars, "Rhoton Anatomy Modules," complicated neuroanatomy was simplified (Figure 1) .

A series of webinars on pediatric neurosurgery was conducted with the WFNS pediatrics committee. Two appreciation ceremonies were conducted on the 33rd webinar day, and a golden jubilee ceremony was held to appreciate all mentors of neurosurgery who helped to make International PSN/WFNS webinars a hit! During this journey, an amazing 150 world-class webinars were conducted with over 50,000 participants attending live via Zoom and over 100,000 attending via YouTube ( Figure 2) . Also during this time, a prospective study was conducted about the International PSN/WFNS webinars initiated in April 2020 by the PSN at the Neurosurgery Department, Liaquat National Hospital Karachi. It concluded that neurosurgery training and practice had been significantly influenced by e-learning during the pandemic. A total of 418 complete responses were collected; most of them were from residents, and 99% of the respondents reported that these webinars were beneficial to them and wished that the series would continue after the epidemic. 3 Later, the frequency of webinars was cut down to a couple a week to keep the participants' interest going.

With the implication of new government rules of lockdown and limited travels around the globe, the Internet played a major role in keeping everyone connected in times of calamity. In these dark times, the neurosurgery community bonded together and stayed strong. A 3-day virtual webinar (Figure 3 ) was conducted with the collaboration of WFNS and World Spinal Column Society (WSCS), joined together on this platform to promote neurosurgical training for 1600 international participants, giving everyone a message of "equal neurosurgery for all."

Three comments from participants are given as follows.

Adrian Caceres from Costa Rica extended the deepest gratitude to Professor Salman Sharif and his team for "allowing us to share our experience in pediatric and endoscopic surgery. This has been a great learning experience for everyone." Uchiwan from Nigeria said that he "enjoys these sessions and finds them informative." Furthermore, he said "we want Professor Sharif to continue with WFNS webinars that are making a great impact here in Africa. Superb learning!" Rajesh Kumar from the United Arab Emirates said he is grateful and highly acknowledge the efforts by PSN/WFNS for arranging such webinars during this COVID situation.

We have collaborated with WSCS for a certificate course, "pearls from OR," and with the WSCS and WFNS Spine committee for an neurosurgery. Together with all the great mentors on our board and with the help of all these societies, we aim to continue providing equal neurosurgical training globally.

The impact of COVID-19 on neurosurgeons and the strategy for triaging non-emergent operations: a global neurosurgery study

Virtual World Spine 2020: The First Online Conference during the COVID Pandemic

Virtual learning in neurosurgery during COVID-19 pandemic-is pedagogy transforming?

Eminent speakers participating in webinars from the World Federation of Neurosurgical Societies Spine Committee/Virtual World Spine