455 Implementation of a Virtual Curriculum Improves Understanding of Core Neurosurgical Principals for Medical Students Completing Clinical Rotations

INTRODUCTION: Early medical student education in neurosurgery is often limited to assisting in research with minimal standardized pre-clinical exposure to core neurosurgical topics prior to clinical rotations. METHODS: Neurosurgical residents (PGY3-6) prepared 10–25 minute virtual lectures on presentation and management of brain tumors, subarachnoid hemorrhage, cauda equina syndrome, and elevated intracranial pressure (ICP). Surgical skills were not covered in the lectures. We distributed the lectures to medical students before starting their neurosurgical clerkship or sub-internship at our institution (1/14/22-4/23/22). We utilized Qualtrics to distribute electronic pre- and 18-item post-rotation surveys (15-item and 18-item, respectively) assessing self-reported knowledge in managing these cases. Responses were assessed with a 5-point Likert scale, compared with Fisher’s exact tests. RESULTS: There were 25 respondents (26 ± 3 years, 36.3% female), including 12 (48%) second and third-year medical students completing a clerkship and 13 (52%) fourth-year medical students completing a sub-internship. Ninety-six percent agreed/strongly agreed that the clinical exposure improved their perception of neurosurgery and knot tying (18.2% vs. 68.8%, p = 0.018). Preparedness for neurosurgical skills, such as using the microscope, did not improve significantly. Following the course, a higher proportion of students understood the presentation and management of brain tumors (36.4% vs. 93.8%, p = 0.002), subarachnoid hemorrhage (45.5% vs. 93.8%, p = 0.009), and cauda equina syndrome (36.4% vs. 87.5%, p = 0.011). Understanding of the management of elevated ICP did not differ significantly before and after the course (54.6% vs. 75.0%, p = 0.411). CONCLUSIONS: Clinical rotations in neurosurgery improved students’ perceptions of the field and knot tying. While the majority of students had baseline understanding of elevated ICP, we observed improved competency in other neurosurgical fundamentals covered by our virtual lecture series. Future efforts to develop standardized curriculum may better improve medical students’ knowledge and comfort in early neurosurgical education.