The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

被引：7

作者：

Lewandrowski, Kai-Uwe ^{[1
,2
]}

Elfar, John C. ^{[3
]}

Li, Zong-Ming ^{[3
,4
]}

Burkhardt, Benedikt W. ^{[5
]}

Lorio, Morgan P. ^{[6
]}

Winkler, Peter A. ^{[7
]}

Oertel, Joachim M. ^{[8
]}

Telfeian, Albert E. ^{[9
]}

Dowling, Alvaro ^{[10
]}

Vargas, Roth A. A. ^{[11
]}

Ramina, Ricardo ^{[12
]}

Abraham, Ivo ^{[13
]}

Assefi, Marjan ^{[14
]}

Yang, Huilin ^{[15
]}

Zhang, Xifeng ^{[16
]}

Ramirez Leon, Jorge Felipe ^{[17
]}

Alvim Fiorelli, Rossano Kepler ^{[18
]}

Pereira, Mauricio G. ^{[19
]}

Teixeira de Carvalho, Paulo Sergio ^{[20
]}

Defino, Helton ^{[10
]}

Moyano, Jaime ^{[21
,22
]}

Lim, Kang Taek ^{[23
]}

Kim, Hyeun-Sung ^{[24
]}

Montemurro, Nicola ^{[25
]}

Yeung, Anthony ^{[26
]}

Novellino, Pietro ^{[27
]}

机构：

[1] Ctr Adv Spine Care Southern Arizona, 4787 E Camp Lowell Dr, Tucson, AZ 85719 USA

[2] Fdn Univ Sanitas, Dept Orthopaed, Bogota 111321, Colombia

[3] Univ Arizona, Coll Med, Dept Orthopaed Surg, Tucson Campus,Hlth Sci Innovat Bldg HSIB,1501 N C, Tucson, AZ 85721 USA

[4] Univ Arizona, Coll Med Tucson Campus, Dept Biomed Engn, Tucson Campus,Hlth Sci Innovat Bldg HSIB,1501 N C, Tucson, AZ 85721 USA

[5] Hirslanden Klin Zurich, Wirbelsaulenzentrum Spine Ctr WSC, Witellikerstr 40, CH-8032 Zurich, Switzerland

[6] Adv Orthopaed, 499 E Cent Pkwy,Ste 130, Altamonte Springs, FL 32701 USA

[7] Charite Univ Med Berlin, Dept Neurosurg, D-13353 Berlin, Germany

[8] Univ Saarland, Klin Neurochirurg, Kirrberger Str 100, D-66421 Homburg, Germany

[9] Brown Univ, Rhode Isl Hosp, Warren Alpert Med Sch, Dept Neurosurg, Providence, RI 02903 USA

[10] Univ Sao Paulo, Orthopaed Surg, Brazilian Spine Soc SBC, BR-14071550 Ribeirao Preto, Brazil

[11] Fdn Hosp Ctr Med Campinas, Dept Neurosurg, BR-13083210 Campinas, Brazil

[12] Neurol Inst Curitiba, BR-80230030 Curitiba, Brazil

[13] Univ Arizona, Clin Translat Sci, Roy P Drachman Hall,Rm B306H, Tucson, AZ 85721 USA

[14] Univ N Carolina, Dept Biol, Nanobiol, Greensboro, NC 27413 USA

[15] Soochow Univ, Affiliated Hosp 1, Orthopaed Dept, 899 Pinghai Rd, Suzhou 215031, Peoples R China

[16] Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Orthopaed, Beijing 100853, Peoples R China

[17] Fdn Univ Sanitas, Minimally Invas Spine Ctr Bogota DC Colombia, Reina Sofia Clin Bogota DC Colombia, Dept Orthopaed, Bogota 0819, Colombia

[18] Fed Univ State Rio de Janeiro UNIRIO, Gaffree & Guinle Univ Hosp, Dept Gen & Specialized Surg, BR-20270004 Rio De Janeiro, Brazil

[19] Univ Brasilia, Fac Med, BR-70919900 Brasilia, DF, Brazil

[20] Gaffre & Guinle Univ Hosp, Pain & Spine Minimally Invas Surg Serv, BR-20270004 Rio De Janeiro, Brazil

[21] Soc Iberolatinoamer Columna SILACO, Quito 170521, Ecuador

[22] Ecuadorian Soc Orthopaed & Traumatol, Spine Comm, Quito 170521, Ecuador

[23] Good Doctor Teun Teun Spine Hosp, Anyang 14041, South Korea

[24] Nanoori Hosp, Dept Neurosurg, Seoul 06048, South Korea

[25] Univ Pisa, Dept Neurosurg, Azienda Osped Univ Pisana, I-56124 Pisa, Italy

[26] Desert Inst Spine Care, Phoenix, AZ 85020 USA

[27] Guinle & State Inst Diabet & Endocrinol, BR-20270004 Rio De Janeiro, Brazil

来源：

JOURNAL OF PERSONALIZED MEDICINE | 2023年 / 13卷 / 05期

关键词：

postgraduate residence training; orthopedic surgery; neurosurgery; technology advances; simulation; augmented reality; navigation; robotics; artificial intelligence; skill-based training; ARTIFICIAL-INTELLIGENCE; RESIDENT EDUCATION; MEDICAL-EDUCATION; SIMULATION; COVID-19; SPINE; SATISFACTION; PERCEPTIONS; EXPERIENCE; NAVIGATION;

D O I：

10.3390/jpm13050852

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Personalized care models are dominating modern medicine. These models are rooted in teaching future physicians the skill set to keep up with innovation. In orthopedic surgery and neurosurgery, education is increasingly influenced by augmented reality, simulation, navigation, robotics, and in some cases, artificial intelligence. The postpandemic learning environment has also changed, emphasizing online learning and skill- and competency-based teaching models incorporating clinical and bench-top research. Attempts to improve work-life balance and minimize physician burnout have led to work-hour restrictions in postgraduate training programs. These restrictions have made it particularly challenging for orthopedic and neurosurgery residents to acquire the knowledge and skill set to meet the requirements for certification. The fast-paced flow of information and the rapid implementation of innovation require higher efficiencies in the modern postgraduate training environment. However, what is taught typically lags several years behind. Examples include minimally invasive tissue-sparing techniques through tubular small-bladed retractor systems, robotic and navigation, endoscopic, patient-specific implants made possible by advances in imaging technology and 3D printing, and regenerative strategies. Currently, the traditional roles of mentee and mentor are being redefined. The future orthopedic surgeons and neurosurgeons involved in personalized surgical pain management will need to be versed in several disciplines ranging from bioengineering, basic research, computer, social and health sciences, clinical study, trial design, public health policy development, and economic accountability. Solutions to the fast-paced innovation cycle in orthopedic surgery and neurosurgery include adaptive learning skills to seize opportunities for innovation with execution and implementation by facilitating translational research and clinical program development across traditional boundaries between clinical and nonclinical specialties. Preparing the future generation of surgeons to have the aptitude to keep up with the rapid technological advances is challenging for postgraduate residency programs and accreditation agencies. However, implementing clinical protocol change when the entrepreneur-investigator surgeon substantiates it with high-grade clinical evidence is at the heart of personalized surgical pain management.

引用

页数：15