Background The adoption of electronic learning, such as surgical case modules, has shown to
be an effective tool for improving knowledge and skills for trainees in general surgery
and surgical subspecialties. However, the field of neurosurgery has largely yet to
develop and utilize surgical case modules as a part of surgical education. The goal
of the NEXUS project is to develop a comprehensive online library of neurosurgical
cases with intraoperative videos and/or photos to better prepare trainees for the
operating room. Such a program has potential to significantly improve trainee preparation,
knowledge, and surgical skills.
Methods The initial call for curated neurosurgical case modules occurred in February 2017.
Authors use a standardized template consisting of summary, case presentation, approach,
alternatives, incision, operation, post-op, outcome, pearls and pitfalls, discussion,
and links. Authors are encouraged to include video and/or photographs to detail the
surgical procedure. Cases undergo peer-review and revisions prior to being accepted
for online publication. On the NEXUS Web site, cases are assigned to the following
categories: spine, tumor, vascular, trauma, pediatric, functional/epilepsy, and pain.
Each category is further subdivided into several subcategories, for example, tumor:
skull base, pineal, dural-based, intrinsic, intraventricular, extra-axial, or intra-axial.
All cases are in the English language, and are formatted to be viewed on a variety
of platforms such as computer, tablet, and smartphone.
Results NEXUS has received 173 case submissions for online publication as of September 2017.
Submissions are from 48 unique institutions in the United States, Canada, and Brazil.
Cases have been submitted for each neurosurgical subdiscipline, with spine (75 cases),
and vascular (68 cases) receiving the most submissions. The number of cases in the
other categories are tumor (14), trauma (6), functional/epilepsy (6), pediatrics (2),
and pain (2). Cases are highly visual, and include pre- and post-op imaging, anatomic
figures, and intraoperative photos and/or videos. Thirty percent of cases include
intraoperative video, 43% include intraoperative photos, and 65% include intraoperative
photos, video, or both.
Conclusion Since its inception, NEXUS has successfully received cases spanning all neurosurgical
subdisciplines and from a variety of institutions. Yet, there is still a need for
additional pediatric and pain cases. Furthermore, as not all cases include intraoperative
videos or photos, new cases that include such valuable multimedia content would strengthen
the repository. Once launched publicly, the NEXUS online neurosurgical repository
has the potential to improve trainee preparation for the operating room. As neurosurgery
is currently behind other surgical disciplines in utilizing surgical case modules
in trainee education, NEXUS can fill an important gap in neurosurgical training. Due
to its online availability, NEXUS may also serve as an important resource for neurosurgeons
and trainees around the world.
