Evaluating educational outcomes of a structured virtual neurosurgical teaching program: The foundations in neurosurgery education study

Background: Access to neurosurgical education remains limited by geographic, institutional, and financial barriers. Virtual education offers a scalable approach, yet robust evaluations of structured programs remain limited. Methods: This prospective observational study evaluated the foundations in neurosurgery education (FINE) 2025/26 program, a 4-month international virtual teaching series comprising nine structured sessions delivered under the auspices of the Surgical Interest Group of Africa Neurosurgery Division. Pre- and post-program surveys assessed participant confidence, career interest, and educational value using five-point Likert scales. Within-session confidence changes were analyzed using Wilcoxon signed-rank tests with Bonferroni correction; pre–post-series comparisons used Mann–Whitney U-tests. Qualitative feedback underwent thematic analysis. Results: A total of 213 participants completed the pre-series survey and 54 the post-series evaluation, with 518 session-level responses recorded. Within-session confidence improved significantly across all nine sessions (mean gain Δ = +1.29; all p < 0.001, Bonferroni-corrected). Pre- to post-series comparisons demonstrated significant improvements in confidence managing neurosurgical conditions (Δ = +2.01, p < 0.001), neurosurgical emergencies (Δ = +2.04, p < 0.001), and understanding of training pathways (Δ = +1.62, p < 0.001). Session ratings were consistently high across clarity, usefulness, and engagement. Of post-series respondents, 74.1% reported increased likelihood of pursuing a career in neurosurgery. Conclusion: A structured, longitudinal virtual neurosurgical program significantly improved learner confidence, perceived preparedness, and understanding of training pathways. This model represents an effective and scalable approach to enhancing neurosurgical education and addressing disparities in early specialty exposure globally.