Non-technical skills for neurosurgeons: An international survey

Cavallo S.M. Pellencin E. Carone G. Castelli N. Ayadi R. Olldashi F. Al Anazi A. Kanaan I. Garcia Colmena F. Ajler P. Socolovsky M. Knosp E. Raftopoulos C. Rodrigues J.C., Jr. Enchev Y.P. Xu B. Chul-Kee P. Rotim K. Posti J. Meyer B. Shimamoto H. Makhambetov Y. Frosen J. Chandra S.P. Cappabianca P. Piatelli G. Genitori L. Germanò A. Sabatino G. Bernucci C. Giussani C. Olivi A. Locatelli D. Stefini R. Castrioto C. Mangiola A. Fontanella M.M. Tacconi L. Conti C. Skrap M. El Abbadi N. Sharma M.R. Shamim M.S. Sharif S. Farias J.P. Florian I.S. Gushcha A.O. Rasulic L. Vulekovic P. Ang B.T. Lagares A. Diez Valle R. Ensenat J. Ley Urzaiz L. Barcia Albacar J.A. Kupanur S.S. Regli L. Dunn I.F. Adelson D. Bederson J. Levi A.D. Alturky A.Y. Matula C. Cortes B. Xiang W. Li T. El-Ghandour N.M.F. Kanai R. Patir R. Misra B.K. Dwarakanath S. Servadei F. Tomasello F. Casali C. Unsgard G. Morcos J.J. Souhil T. Khoja I. Kehayov I. Vukic M. Ziebell M. Gulisano H.A. Tange M. Kurozumi K. Locatelli M. Garbossa D. Gomez Amador J.L. Rodriguez A.O. Ashkan K. Lim M. Maleki M. Agrawal A. Naik A. Sciubba D.M. Kim L.J. Spinner R.J. McDonald P. Pavesi G. Moiyadi A. Padayachy L. Meling T.R. Di Meco F. Perin A.
January 2024 Elsevier B.V.

Brain and Spine
2024 #4

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.

Education in medicine , Effective communications , Humility , Integrated training programs , Neurosurgery , Non-technical skills , Self-awareness , Simulations

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School of Neurosurgery, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico “C. Besta”, Milano, Italy
Neurosurgical Services, Department of Surgical Oncology, Tata Memorial Centre, Maharashtra, Mumbai, India
Department of Neurosurgery, Brain Tumor and Translational Neuroscience Centre, Faculty of Health Sciences, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa
Department of Pathophysiology and Transplantation, University of Milano, Milano, Italy
Department of Neurological Surgery, John Hopkins Medical School, Baltimore, MD, United States
Department of Life Sciences, University of Trieste, Trieste, Italy
Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico Nazionale “C. Besta”, Milano, Italy
Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
Department of Neurosurgery, University Hospital of Trauma, Tirana, Albania
Department of Neurosurgery, King Fahd Hospital of the University, Alkhobar College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Neurosurgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Clínica Privada Vélez Sarsfield, Córdoba, Argentina
Department of Neurosurgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Division of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
Department of Neurosurgery, Clinique Universitaires Saint Luc, Brussels, Belgium
Department of Neurosurgery, Heliopolis Hospital, São Paulo, Brazil
Department of Neurosurgery and ENT Diseases, Division of Neurosurgery, Medical University of Varna, Varna, Bulgaria
Department of Neurosurgery, Liaocheng Brain Hospital, No. 45 Huashan Road, Dongchangfu District, Shandong, Liaocheng, 252000, China
Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
Department of Neurosurgery, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Neurocenter, Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland
Department of Neurosurgery, School of Medicine and Health, Technical University of Munich, München, Germany
Shimamoto Neurosurgery Hospital, Fukuoka, Japan
Department of Vascular and Functional Neurosurgery, National Center for Neurosurgery, Astana, Kazakhstan
Department of Neurosurgery, Tampere University and Tampere University Hospital, Tampere, Finland
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
Department of Neurological Sciences, Division of Neurosurgery, Università Degli Studi Di Napoli Federico II, Naples, Italy
Pediatric Neurosurgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
Neurosurgery Department, Meyer Childrens Hospital IRCCS, Florence, Italy
Unit of Neurosurgery, AOU Policlinico G. Martino di Messina, Italy
Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Unit of Neurosurgery, H San Francesco, Nuoro, Italy
Neurosurgery Clinic, IRCCS Fondazione Ospedale San Gerardo Dei Tintori di Monza, Monza, Italy
Division of Neurosurgery, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di Circolo Fondazione Macchi, Varese, Italy
Department of Neurosurgery, ASST Ovest Milanese, Legnano, Milan, Italy
Division of Neurosurgery, S. Maria Della Misericordia Hospital, Piazzale Giorgio Menghini, Perugia, Italy
Department of Neurosciences, Imaging and Clinical Sciences, G. DAnnunzio University, Chieti, Italy
Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
Division of Neurosurgery, Azienda Sanitaria Universitaria Integrata di Trieste, University Hospital of Trieste, Trieste, Italy
Unit of Neurosurgery, ARNAS G. Brotzu, Cagliari, Italy
Neurosurgery Unit, Head-Neck and Neurosciences Department, Santa Maria Della Misericordia University Hospital, Udine, Italy
Department of Neurosurgery, Cheikh Zaid International Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco
Department of Neurosurgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
Department of Neurosurgery, Liaquat National Hospital & Medical College, Karachi, Pakistan
Department of Neurosurgery, Hospital Cuf Descobertas, Lisbon, Portugal
Department of Neurosurgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
Department of Neurosurgery, Research Center of Neurology, Moscow, Russian Federation
Department of Neurosurgery, University of Belgrade, Serbia
University Clinical Centre of Vojvodina, Novi Sad, Serbia
Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
Department of Neurosurgery, Hospital Universitario Doce de Octubre, Facultad de Medicina, Departamento de Cirugía, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid, Spain
Departamento de Neurocirugía, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
Department of Neurosurgery, Hospital Clinic of Barcelona, Barcelona, Spain
Department of Neurosurgery, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
Department of Neurosurgery, Hospital Clinico San Carlos, Madrid, Spain
Complutense University of Madrid, Madrid, Spain
Sapthagiri Institute of Medical Sciences and Research Center, Department of Pathology, Karnataka, India
Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse, Zurich, Switzerland
Department of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, United States
Neurosurgery, Phoenix Childrens Hospital, Phoenix, AZ, United States
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
Department of Adult Neurosurgery, King Fahad Medical City, Riyadh, Saudi Arabia
Department of Neurosurgery, Medical University of Vienna, Vienna Health Care Group, University Hospital Vienna, Austria
Souza Aguiar Municipal Hospital, Brazil
Hainan Women and Childrens Medical Center, Hainan Medical University, Haikou, China
Neurovascular Center, Henan Provincial Peoples Hospital, Henan Province, Zhengzhou, China
Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
Department of Neurosurgery, Eiju General Hospital, Tokyo, Japan
Department of Neurosurgery, Fortis Memorial Research Institute, GurugramI, India
Department of Neurosurgery, P D Hinduja National Hospital, Mumbai, India
Department of Neurosurgery, NIMHANS, Karnataka, Bangalore, India
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Humanitas Clinical Institute of Catania, Misterbianco, Catania, Italy
Norwegian University of Science and Technology, Trondheim, Norway
Department of Neurosurgery, University of Texas Health Huston, TX, United States
Neurosurgery Department, University of Abderrahmane Mira, Bejaia, Algeria
Medical Education Program, Syrian Virtual University, Damascus, Syrian Arab Republic
Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
Department of Neurosurgery, Sisters of Mercy University Hospital, Zagreb, Croatia
Department of Neurosurgery, Aalborg University Hospital, Aalborg, Denmark
Odense University Hospital, Odense, Denmark
Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Chuo-Ku, Shizuoka, Hamamatsu, Japan
Foundation IRCCS Ca Granda Ospedale Maggiore Policlinico, Neurosurgery Unit, Milan, Italy
Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, Turin, Italy
Neurosurgery Department, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
Neurosurgery Service of the University Hospital of Salamanca, Salamanca, Spain
Department of Neurosurgery, Kings College Hospital, Denmark Hill, London, United Kingdom
Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States
Department of Neurosurgery, McGill University Health Centre, Montreal, QC, Canada
Departments of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
Department of Neurosurgery, Barrow Neurological Institute, St. Josephs Hospital and Medical Center, Phoenix, 85013, AZ, United States
Department of Neurosurgery, Northwell Health, Donald and Barbara Zucker School of Medicine, Hempstead, NY, United States
Department of Neurological Surgery, University of Washington, Seattle, WA, United States
Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
Section of Neurosurgery, Department of Surgery, University of Manitoba, Manitoba, Winnipeg, Canada
Neurosurgery Unit, University Hospital of Modena, Modena, Italy

School of Neurosurgery
Department of Neurosurgery
Neurosurgical Services
Department of Neurosurgery
Department of Pathophysiology and Transplantation
Department of Neurological Surgery
Department of Life Sciences
Besta NeuroSim Center
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Neurosurgery
Clínica Privada Vélez Sarsfield
Department of Neurosurgery
Division of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery and ENT Diseases
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Neurocenter
Department of Neurosurgery
Shimamoto Neurosurgery Hospital
Department of Vascular and Functional Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurological Sciences
Pediatric Neurosurgery Unit
Neurosurgery Department
Unit of Neurosurgery
Department of Neurosurgery
Unit of Neurosurgery
Neurosurgery Clinic
Division of Neurosurgery
Department of Neurosurgery
Division of Neurosurgery
Department of Neurosciences
Division of Neurosurgery
Division of Neurosurgery
Unit of Neurosurgery
Neurosurgery Unit
Department of Neurosurgery
Department of Neurosurgery
Section of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
University Clinical Centre of Vojvodina
Department of Neurosurgery
Department of Neurosurgery
Departamento de Neurocirugía
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Complutense University of Madrid
Sapthagiri Institute of Medical Sciences and Research Center
Department of Neurosurgery
Department of Neurosurgery
Neurosurgery
Department of Neurosurgery
Department of Neurological Surgery
Department of Adult Neurosurgery
Department of Neurosurgery
Souza Aguiar Municipal Hospital
Hainan Women and Childrens Medical Center
Neurovascular Center
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Biomedical Sciences
Humanitas Clinical Institute of Catania
Norwegian University of Science and Technology
Department of Neurosurgery
Neurosurgery Department
Medical Education Program
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Odense University Hospital
Department of Neurosurgery
Foundation IRCCS Ca Granda Ospedale Maggiore Policlinico
Neurosurgery Unit
Neurosurgery Department
Neurosurgery Service of the University Hospital of Salamanca
Department of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Departments of Neurosurgery
Department of Neurosurgery
Department of Neurosurgery
Department of Neurological Surgery
Department of Neurosurgery
Section of Neurosurgery
Neurosurgery Unit

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