The Impact of Online Neurosurgical Education and Izmir Online Neurosurgery on Global Neurosurgical Training: An International Survey and Comparative Digital Platform Analysis.

OBJECTIVE: The COVID-19 pandemic accelerated virtual learning in neurosurgery, but the durability and educational value of these initiatives remain incompletely defined. We evaluated online neurosurgical education and Izmir Online Neurosurgery (ION) by integrating digital platform metrics with an international bilingual survey. METHODS: This mixed-methods observational study compared publicly available production and engagement metrics from selected neurosurgical and spine education platforms across pre-pandemic, pandemic, and post-pandemic periods. A bilingual English-Turkish survey was distributed from May 4 to June 19, 2026, through approximately 10 professional WhatsApp groups and the corresponding author's professional Instagram account. Domains addressed general perceptions, educational impact, subspecialty impact, limitations, and ION. Internal consistency and nonparametric subgroup comparisons were assessed. RESULTS: ION produced 317 videos and increased annualized production from 32 videos/year during the pandemic to 79 videos/year afterward. Among 162 respondents from 35 countries, domain reliability was good to excellent (Cronbach alpha, 0.816-0.925). More than 80% reported perceived improvements in clinical decision-making (81%), surgical planning (85%), and daily practice (86%). Among 138 respondents completing ION-specific items, the mean ION score was 4.1 (SD 0.7). ION participants reported more favorable general perceptions than nonparticipants (nominal p = 0.046); this exploratory association is vulnerable to multiplicity and self-selection. Per-video views declined after the pandemic despite increased content production. CONCLUSIONS: Structured online initiatives may provide a durable and accessible complement to conventional neurosurgical education. The findings support a hybrid model while emphasizing that self-reported benefit and platform engagement do not establish objective learning gain or technical competence.