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Mangham W, Parikh KA, Motiwala M, Gienapp AJ, Roach J, Barats M, Lillard J, Khan N, Arthur A, Michael LM. A Scoping Review of Professionalism in Neurosurgery. Neurosurgery 2024; 94:435-443. [PMID: 37819083 DOI: 10.1227/neu.0000000000002711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/10/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Accreditation Council for Graduate Medical Education's Milestones provides a foundation for professionalism in residency training. Specific professionalism concepts from neurosurgery could augment and expand milestones for the specialty. We reviewed the current literature and identified professionalism concepts within the context of neurosurgical practice and training. METHODS We used a scoping review methodology to search PubMed/MEDLINE and Scopus and identify English-language articles with the search terms "professionalism" and "neurosurgery." We excluded articles that were not in English, not relevant to professionalism within neurosurgery, or could not be accessed. Non-peer-reviewed and qualitative publications, such as commentaries, were included in the review. RESULTS A total of 193 articles were included in the review. We identified 6 professionalism themes among these results: professional identity (n = 53), burnout and wellness (n = 51), professional development (n = 34), ethics and conflicts of interest (n = 27), diversity and gender (n = 19), and misconduct (n = 9). CONCLUSION These 6 concepts illustrate concerns that neurosurgeons have concerning professionalism. Diversity and gender, professional identity, and misconduct are not specifically addressed in the Accreditation Council for Graduate Medical Education's Milestones. This review could be used to aid the development of organizational policy statements on professionalism.
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Affiliation(s)
- William Mangham
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Kara A Parikh
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Mustafa Motiwala
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Andrew J Gienapp
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis , Tennessee , USA
| | - Jordan Roach
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Michael Barats
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Jock Lillard
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Nickalus Khan
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - Adam Arthur
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - L Madison Michael
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
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Sandoval-Bonilla BA, la Cerda-Vargas MFD, Stienen MN, Nettel-Rueda B, Ramírez-Reyes AG, Soriano-Sánchez JA, Castillo-Rangel C, Mejia-Pérez S, Chávez-Herrera VR, Navarro-Domínguez P, Sánchez-Dueñas JJ, Ramirez-Cardenas A. Discrimination of residents during neurosurgical training in Mexico: Results of a survey prior to SARS-CoV-2. Surg Neurol Int 2022; 12:618. [PMID: 34992934 PMCID: PMC8720478 DOI: 10.25259/sni_813_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/24/2021] [Indexed: 01/15/2023] Open
Abstract
Background: Recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic represents an important negative impact on global training of neurosurgery residents. Even before the pandemic, discrimination is a challenge that neurosurgical residents have consistently faced. In the present study, we evaluated discriminatory conditions experienced by residents during their neurosurgical training in Mexico before the SARS-CoV-2 pandemic. Methods: An electronic survey of 18 questions was sent among residents registered in the Mexican Society of Neurological Surgery (MSNS), between October 2019 and July 2020. Statistical analysis was made in IBM SPSS Statistics 25. The survey focused on demographic characteristics, discrimination, personal satisfaction, and expectations of residents. Results: A response rate of 50% (132 of 264 residents’ members of MSNS) was obtained and considered for analysis. Median age was 30.06 ± 2.48 years, 5.3% (n = 7) were female and 16.7% (n = 22) were foreigners undergoing neurosurgical training in Mexico. Approximately 27% of respondents suffered any form of discrimination, mainly by place of origin (9.1%), by gender (8.3%) or by physical appearance (6.1%). About 42.9% (n = 3) of female residents were discriminated by gender versus 6.4% (n = 8) of male residents (P = 0.001); while foreign residents mentioned having suffered 10 times more an event of discrimination by place of origin compared to native Mexican residents (36.4% vs. 3.6%, P < 0.001). Conclusion: This manuscript represents the first approximation to determine the impact of discrimination suffered by residents undergoing neurosurgical training in Mexico before the SARS-CoV-2 pandemic.
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Affiliation(s)
- B A Sandoval-Bonilla
- Department of Neurosurgery, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, Mexico
| | - María F De la Cerda-Vargas
- Department of Neurosurgery, Hospital de Especialidades No. 71, Instituto Mexicano del Seguro Social, Torreón, Coahuila, Mexico
| | - Martin N Stienen
- Department of Neurosurgery, Kantonsspital St.Gallen, St.Gallen, Switzerland
| | - Bárbara Nettel-Rueda
- Department of Neurosurgery, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, Mexico
| | - Alma G Ramírez-Reyes
- Department of Pediatric Neurosurgery, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México
| | - José A Soriano-Sánchez
- President of the Mexican Society of Neurological Surgery, Mexico City, México; Latin American Federation of Neurosurgical Societies, Montevideo, Uruguay; Spine Clinic, The American British Cowdray Medical Center IAP, Mexico City, Mexico; World Federation of Neurosurgical Societies, Nyon, Vaud, Switzerland
| | | | - Sonia Mejia-Pérez
- Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico
| | - V R Chávez-Herrera
- Department of Neurosurgery, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, Mexico
| | - Pedro Navarro-Domínguez
- Department of Neurosurgery, Hospital de Especialidades No. 71, Instituto Mexicano del Seguro Social, Torreón, Coahuila, Mexico
| | - J J Sánchez-Dueñas
- Laboratory of Comparative Cognition, Faculty of Psychology, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Araceli Ramirez-Cardenas
- Graduate School of Neural and Behavioural Sciences, International Max Planck Research School, Tuebingen University, Tuebingen, Germany
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De la Cerda-Vargas MF, Stienen MN, Campero Á, Pérez-Castell AF, Soriano-Sánchez JA, Nettel-Rueda B, Borba LAB, Castillo-Rangel C, Navarro-Domínguez P, Muñoz-Hernández MA, Segura-López FK, Guinto-Nishimura GY, Sandoval-Bonilla BA. Burnout, Discrimination, Abuse and Mistreatment in Latin America Neurosurgical Training During the COVID-19 Pandemic. World Neurosurg 2021; 158:e393-e415. [PMID: 34763105 PMCID: PMC8574080 DOI: 10.1016/j.wneu.2021.10.188] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Discrimination, abuse and mistreatment are prevailing problems reported in neurosurgical-training programs globally. Moreover, the current COVID-19-pandemic may also display a negative impact on burnout levels in neurosurgery-residents. This study aims to evaluate burnout, discrimination and mistreatment in neurosurgical-residents training in Latin-America during the SARS-CoV-2 era. METHODS A 33-item electronic survey was sent to neurosurgery-residents from Latin-America from May-10 to May-25, 2021. Statistical analysis was made using IBM-SPSS-25. RESULTS 111 neurosurgery residents responded the survey. Mean age was 29.39±2.37 years; 22.5% were female and 36% were training in Mexico. Residents who reported suffering from discrimination for testing positive to COVID-19 had the highest levels of depersonalization (66.7%, p=0.043) and emotional-exhaustion (75%, p= 0.023). Female respondents presented higher rates of gender discrimination (80%vs.1.2%, p=0.001), abuse (84%vs.58.1%, p<0.005) and sexual-harassment (24%vs.0%, p<0.001) than male respondents. Residents training in Mexico presented lower rates of emotional or verbal abuse (59.2%vs.32.5%, p=0.007) and bullying (p<0.005) than other countries in Latin-America. Older-age was a protective factor for high depersonalization scores (OR 0.133, 95%CI 0.035-0.500). Suffering from discrimination represented a risk factor for presenting high emotional-exhaustion scores (OR 3.019, 95%CI 1.057-8.629). High levels of depersonalization were associated with a 7-fold increased risk of presenting suicidal ideation (OR 7.869, 95%CI 1.266-48.88). CONCLUSION The COVID-19 pandemic has been a significant burden on several aspects of healthcare workers' lives. Our results provide a broad overview of its impact on burnout, discrimination and mistreatment as experienced by neurosurgery residents training in Latin-America, laying the groundwork for future studies and potential interventions.
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Affiliation(s)
- María F De la Cerda-Vargas
- Department of Neurosurgery. Hospital de Especialidades N° 71, Instituto Mexicano del Seguro Social (IMSS), Torreón Coahuila, Mexico
| | - Martin N Stienen
- Department of Neurosurgery, Kantonsspital St. Gallen, Switzerland
| | - Álvaro Campero
- Department of Neurosurgery, Padilla Hospital, Tucumán, Argentina
| | - Armando F Pérez-Castell
- Department of Neurosurgery. Hospital de Especialidades N° 71, Instituto Mexicano del Seguro Social (IMSS), Torreón Coahuila, Mexico
| | - José A Soriano-Sánchez
- President of Mexican Society of Neurological Surgery, Mexico City, México. Latin American Federation of Neurosurgical Societies, Montevideo, Montevideo, Uruguay; Spine Clinic, The American-British Cowdray Medical Center IAP, Campus Santa Fe, Mexico City, Mexico; World Federation of Neurosurgical Societies, Nyon, Vaud, Switzerland
| | - Barbara Nettel-Rueda
- Department of Neurosurgery. Hospital de Especialidades. Centro Médico Nacional (CMN) Siglo XXI. Instituto Mexicano del Seguro Social (IMSS), México City, México
| | - Luis A B Borba
- Department of Neurosurgery, Federal University of Paraná, Curitiba, PR, Brazil
| | | | - Pedro Navarro-Domínguez
- Department of Neurosurgery. Hospital de Especialidades N° 71, Instituto Mexicano del Seguro Social (IMSS), Torreón Coahuila, Mexico
| | - Melisa A Muñoz-Hernández
- Director of health research and education. Hospital de Especialidades No. 71, Instituto Mexicano del Seguro Social, Torreon Coahuila, Mexico
| | - F K Segura-López
- Head of division in health research. Hospital de Especialidades No. 71, Instituto Mexicano del Seguro Social, Torreon Coahuila, Mexico
| | | | - B A Sandoval-Bonilla
- Department of Neurosurgery. Hospital de Especialidades. Centro Médico Nacional (CMN) Siglo XXI. Instituto Mexicano del Seguro Social (IMSS), México City, México.
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