UNASSIGNED: From 2019 to 2021, we reviewed multiple databases (i.e., Google Scholar, Science Direct, PubMed, and Hinari) to evaluate the impact of the COVID-19 pandemic on neurosurgery resident training and admission in low middle-income countries (LMICs) and high-income countries (HICs). We then utilized a Wilcoxon signed-rank test to evaluate the difference between the two LMIC/HICs and employed Levene\'s test to assess the homogeneity of variances.
UNASSIGNED: There were 58 studies that met our inclusion criteria; 48 (72.4%) were conducted in HIC and 16 (27.6%) in LMIC. The admission of new residents was mostly canceled in HIC (31.7%; n = 13) and in LMIC (25%; n = 4) from 2019 to 2021 due to COVID-19. Learning modalities changed to include predominantly video conferencing (i.e., 94.7% [n = 54] of cases). Further, neurosurgery was largely restricted to emergency cases alone (79.6% [n = 39]), with only 12.2% (n = 6) elective cases. The result was a marked reduction in resident surgical training (i.e., 66.7% [n = 10] in LMIC and 62.9% [n = 22] in HIC), despite increased workloads in (i.e., LMIC [37.4%; n = 6] and HIC [35.7%; n = 15]). This was attributed to the marked reduction in the number of surgical patients allotted to each resident (i.e., LMIC [87.5%; n = 14] than HIC [83.3%; n = 35]).
UNASSIGNED: The COVID-19 pandemic markedly disrupted neurosurgical education globally. Although differences have been found between LMICs and HICs training, the reduction of neurosurgical case-loads and surgical procedures has significantly impacted neurosurgical training. The question remains, how can this \"loss of experience\" be redressed in the future?
■从2019年到2021年,我们审查了多个数据库(即,谷歌学者,科学直接,PubMed,和Hinari)评估COVID-19大流行对中低收入国家(LMICs)和高收入国家(HICs)神经外科住院医师培训和入学的影响。然后,我们使用Wilcoxon符号秩检验来评估两个LMIC/HIC之间的差异,并使用Levene检验来评估方差的同质性。
■有58项研究符合我们的纳入标准;48项(72.4%)在HIC中进行,16项(27.6%)在LMIC中进行。由于COVID-19,2019年至2021年,HIC(31.7%;n=13)和LMIC(25%;n=4)大多取消了新居民的入学。学习方式更改为主要包括视频会议(即,94.7%[n=54]的病例)。Further,神经外科手术主要限于急诊病例(79.6%[n=39]),只有12.2%(n=6)的选择性病例。结果是住院医师外科培训明显减少(即,LMIC为66.7%[n=10],HIC为62.9%[n=22]),尽管在(即,LMIC[37.4%;n=6]和HIC[35.7%;n=15])。这归因于分配给每个居民的手术患者数量显着减少(即,LMIC[87.5%;n=14]高于HIC[83.3%;n=35])。
■COVID-19大流行明显扰乱了全球神经外科教育。尽管LMIC和HIC培训之间存在差异,神经外科病例负荷和外科手术的减少对神经外科培训产生了重大影响。问题仍然存在,这种“经验的丧失”如何在未来得到纠正?