Neuroanatomy education access by country income level : a mixed-methods analysis
Ramsay, Daniele S C Nicholls, Benjamin J Dixon, Natasha Rossiter, Marimo Al-Nusair, Lana Adegboyega, Gideon Tsang, Kevin Mendoza, Nigel
Ramsay, Daniele S C
Nicholls, Benjamin J
Dixon, Natasha
Rossiter, Marimo
Al-Nusair, Lana
Adegboyega, Gideon
Tsang, Kevin
Mendoza, Nigel
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Affiliation
Imperial College London; Walsall Healthcare NHS Trust; Dorset County Hospital; UCL School of Medicine; The Walton Centre, Liverpool; University of Plymouth; University Hospital Plymouth; Charing Cross Hospital
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Publication date
2025-11-27
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Abstract
Neuroanatomy is complex and often perceived as challenging to students and residents. It is important to have an appreciation of neuroanatomy as it directs sound clinical reasoning and may provide inspiration to pursue higher training in a neuroscience related medical specialty. A sample 519 responses to a pre-course questionnaire to a neuroanatomy course was analysed. The questionnaire collected basic demographic variables and opinions regarding the provision of neuroanatomy on a Likert scale. A mixed methods approach was undertaken comparing quantitative and free text responses between respondents from high-income (HIC) and low-middle income countries (LMIC). Participants from HIC (N=383) formed the largest group compared to LMIC (N=136) and most respondents reported being in medical school (N=271, 52%). Multivariable proportional ordinal regression, highlighted greater dissatisfaction with neuroanatomy provision by LMIC trainees (OR=2.34, 95% CI=1.58-3.48, p<0.001). Thematic analysis uncovered four barriers to surgical neuroanatomy education including the need for greater multimodal teaching, a lack of specialist led teaching, systematic barriers and the complexity of neuroanatomy. LMIC trainees were more likely to report a lack of specialist teaching as a barrier (χ2=7.68, p=0.006). HIC and LMIC neuroanatomy provision differs, with a lack of specialist teaching highlighted as a barrier in our survey. Greater focus is required to ensure equitable access to neuroanatomy teaching with international online courses providing a useful bridge between HIC and LMIC neuroanatomy provision.
Citation
Ramsay DSC, Nicholls BJ, Dixon N, Rossiter M, Al-Nusair L, Adegboyega G, Tsang K, Mendoza N. Neuroanatomy Education Access by Country Income Level: A Mixed-Methods Analysis. World Neurosurg. 2025 Nov 27:124683. doi: 10.1016/j.wneu.2025.124683. Epub ahead of print. PMID: 41318088.
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Article