UCLA introduces digital and mobile technology to make more effective neurosurgical training

The neurosurgery residency training program at UCLA has successfully introduced digital and mobile technology—including tablet computers linked to a digital library of resources—to make neurosurgical training more effective and efficient, according to an article in the July issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Dr. Nestor R. Gonzalez and colleagues of University of California Los Angeles David Geffen School describe and evaluate an integrated system of mobile and digital support as part of their neurosurgery residency program. They present evidence that the digital enhancements have led to improved reading and study habits—and perhaps even to higher scores on standardized exams.

Digital Resources Integrated into Neurosurgical Training
The program provided residents with "digital and mobile educational resources" to support the extensive range of knowledge required for neurosurgeons in training. All trainees received tablet computers preinstalled with apps for management of documents, video, and interactive teaching tools. The tablets also provided remote access to a digital library of educational textbooks, articles, and collections of surgical pictures and videos.

A highlight of the digital library was "The 100 UCLA Subjects in Neurosurgery"—a video podcast collection of essential lectures from iTunes U on the iTunes App store. (The series—planned to include 100 lectures over a three-year period—can be viewed and downloaded free of charge at http://itunes.apple.com/us/itunes-u/ucla-100-subjects-in-neurosurgery/id434135906.) Developed by faculty members and trainees, the lectures were geared to the essential neurosurgery curriculum, delivering high-quality content equivalent to that published in major medical journals.

The program also included an important but decidedly 'low-tech' component: a mandatory weekly conference, geared to teaching "core competencies" required for neurosurgical education. The conferences were held during "protected time," including additional staffing to ensure that the residents' patient care duties were covered.

Changes Lead to Increased Study Time—Mainly on Tablets
In a survey of the first twelve participating residents, 92 percent said that the tablet and digital resources increased the time they spent studying outside the hospital. In the face of recent changes limiting the work hours of medical residents, increasing hours of study time was a key goal of the program.

Two-thirds of the residents used their tablet (rather than a home or hospital computer) as their main tool for accessing the digital library. All found the materials useful, and several had made their own contributions to the library.

There was even evidence that the program improved the residents' performance on a standard assessment of neurosurgical knowledge. Scores improved in 16 out of 17 topic areas on the test, with the gains being statistically significant in six areas.

There are several challenges facing neurosurgery residency training today, with an ever-increasing body of required knowledge coupled with limits on the time residents can spend in the hospital. Work-hour limits intended to limit the effects of fatigue have also reduced the time available for educational and clinical activities.

Dr. Gonzalez and colleagues believe the innovations have helped trainees to strike a balance between their educational and clinical activities. Providing residents with tablet devices for anytime, anywhere access to educational resources—along with structured weekly conferences and protect time to attend the meetings—have led to significant improvements in study habits and knowledge.

The authors discuss some additional enhancements to further improve the educational quality of the neurosurgery residency experience. They invite other training programs and doctors and trainees in other specialties—as well as interested members of the public—to access and view the "UCLA 100 Subjects" presentations on iTunes U.

Source: Neurosurgery