Identification of knowledge gaps in neurosurgery through analysis of responses to the self-assessment in neurological surgery (SANS)

Objective: To examine the gaps in knowledge of neurosurgeons responding to the Self-Assessment in Neurological Surgery (SANS). Methods: From 2008-2010, 267 neurosurgery residents and 993 attending neurosurgeons completed the 245 available question in SANS. Mean scores were calculated and assessed according to 18 major neurosurgical knowledge disciplines. Statistical analysis was carried out to evaluate for knowledge gaps among all users and differences in performance between residents and practicing neurosurgeons. Results: The mean overall score was 66% ± 12. Of the 18 major knowledge categories in SANS, respondents answered questions incorrectly ≥30% of the time in half of the categories. Mean scores in anatomy (76%) were the highest, and mean scores in vascular (60%) were the lowest (P < 0.001). The mean score per category was significantly higher for practicing neurosurgeons (71.5% ± 8.9) than residents (60.5% ± 12.6; P < 0.001). Residents answered questions incorrectly ≥30% of the time in all 18 categories versus 7 categories for attending neurosurgeons. Among residents, the highest mean scores were achieved in anatomy and the lowest were achieved in vascular (P < 0.001); this differential response was also reflected among attending neurosurgeons. Conclusions: SANS demonstrated areas of knowledge gaps in a broad group of neurosurgeons. There were also significant differences between residents and attending neurosurgeons. Identification of areas of deficiency could prove useful in future educational endeavors. • Peer-Reviewed Article.