Strategy to Increase Research in Latin America: Project on Education in Research by AOSpine Latin America.

I am delighted to see the growth of research internationally in the AOSpine organization. Nowhere has this growth been studied recently than in Latin America. I would like to commend Dr. Asdrubal Falavigna for helping to push the awareness of academics, research, and publications in the Latin America Region. I have asked him to write a guest editorial to demonstrate his findings and to further promote the awareness of spine education and research in Latin America.

Jeffrey C. Wang

Editor-in-Chief

Global Spine Journal

Guest Editorial

It is my pleasure to be invited to write a guest editorial for the Global Spine Journal to promote the growth and awareness of spine education in research in Latin America. Research is the engine that drives knowledge forward. Without it, knowledge stagnates and eventually becomes obsolete. Over the past several years, AOSpine has been leading the effort to promote spine research in Latin America through publications, educational conferences, and mentoring efforts. We believe that these efforts can be replicated in most regions of the world and I write this editorial to encourage such efforts.

The number and quality of scientific publications by Latin American (LA) spine surgeons found in the Medline database was low between 2000 and 2011.1 A total of 320 articles were published in 12 years and most LA papers had Levels of Evidence of 4 (N = 171, 53.4%) and 5 (N = 56, 17.5%) when analyzed by the Oxford classification.1 Nevertheless, the Research Bank Survey of AOSpine Latin America (AOSLA) members showed that 96% of responders were very interested and motivated to perform scientific research. The main barrier was the lack of knowledge and experience in doing research.

As the research officer of AOSLA, the first author spearheaded a team effort with the Country Council and the AOSpine Research Commission to enable and increase spine research output in Latin America. This was primarily done by establishing a competency-based curriculum to improve understanding of what is necessary to produce research and the best methods to achieve this goal. The Research Curriculum had four main components: (1) research educational plan, (2) performing research, (3) technical and professional support, and (4) assessment. Initially, the existing competence of the students, learning outcomes, syllabus, and lectures regarding educational activities in research were established. This information was then compiled into a book “Education in Research by AOSpine Latin America: from the idea to publication” and also as an eLearning module “Research in a Scientific Database” in Portuguese, Spanish, and English. Contributors from all AOSpine regions and 11 countries participated in the effort. Ten specific courses on education in research were established in the last 3 years, and the last “AOne Research Meeting” was taught across the AO clinical divisions (AOSpine, AOTrauma, AOVET, and AOCMF). The lectures were given as a research session during various congresses (on clinical topics not related to research). These sessions were always tailored to fit the content of the meeting (e.g., during a meeting where a new surgical technique is presented, there might be a lecture on “How to measure outcomes following surgery.”) We also promoted education in research with a mentorship program, matching up mentees with appropriate mentors for 6 projects. Instead of providing direct funding for these projects, we helped them to develop and improve their projects to make them eligible for external grants.

The Research Curriculum resulted in a growing number of published articles, presentations, intellectual property, a greater involvement of University students in research activities, and national or international multicenter studies. Although research may initially appear to be an optional activity, future directions in healthcare policies, as well as our own edification, require an analysis of the effectiveness or the ineffectiveness of our treatment.

It is never too soon or too late to learn how to do research. The emancipatory nature of education requires research as its fundamental base, because physicians can only improve their skills and knowledge through enquiry.