title: Identification of knowledge gaps in neurosurgery through analysis of responses to the Self-Assessment in Neurological Surgery (SANS).
abstract: 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.
authors.affiliation: Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA. Electronic address: jps2f@virginia.edu.
authors.forename: Jason
authors.initials: J
authors.lastname: Sheehan
authors.affiliation: Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
authors.affiliation: Department of Neurological Surgery, University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Nader
authors.initials: N
authors.lastname: Pouratian
authors.affiliation: Department of Neurological Surgery, George Washington University, Washington, DC, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Litvack
authors.affiliation: Surgical Neurology Branch of the National Institutes of Neurological Disorders and Stroke at the National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Ashok
authors.initials: A
authors.lastname: Asthagiri
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004502:Education, Medical, Continuing; D004521:Educational Measurement; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008505:Medical Staff, Hospital / Q000193:education* / Q000523:psychology; D009493:Neurosurgery / Q000193:education* / Q000523:psychology; D019635:Neurosurgical Procedures / Q000193:education; D012647:Self-Assessment