James Ausman1,2, Carolyn Ausman2, Mike Cheley3, Jim West4, Jorge Lazareff5, Jim Cook6
  1. Department of Neurosurgery, UCLA, Los Angeles; Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, California; Emeritus Editor in Chief & Creator, Surgical Neurological International; Editor-in-Chief, SNIDigital™, United States.
  2. James I and Carolyn Ausman Educational Foundation, Rancho Mirage, United States.
  3. Graphtek, Rancho Mirage, California, United States.
  4. Department of Neurology, Dartmouth Medical School, Hanover, New Hampshire, United States.
  5. Emeritus Professor, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, United States.
  6. Editorial Offices, Surgical Neurology International, Cathedral City, California, United States.


Copyright: © 2021 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ausman J1,2, Ausman C2, Cheley M3, West J4, Lazareff J5, Cook J6. How do we learn?. Surg Neurol Int 21-Jun-2021;12:298

How to cite this URL: Ausman J1,2, Ausman C2, Cheley M3, West J4, Lazareff J5, Cook J6. How do we learn?. Surg Neurol Int 21-Jun-2021;12:298. Available from:

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Surgical Neurology International® (SNI) surveyed its readers and asked, “How do you Learn?” The most favored sources the readers reported were as follows: (1) learning by reading abstracts likely associated with the single papers they read, (2) searching the Internet, or (3) “Talking with Colleagues.” Following these, the next most popular sources of information were local, national, and international meetings. The least preferred sources of learning were Continuing Medical Education courses and manufacturers’ information. Asked how they would handle the growth of information in the future, over 50% wanted editors or experts to help them extract credible information from the mass of new information. Over 80% wanted this information free.[ 1 ]

SNI has the third highest number of readers of all the neurosurgical journals. Most journals are rated by their citation indices, which have no relationship to the number of people who read the journal. These indices are primarily used in academic circles as a measure of academic productivity. In the past century, when all that existed were paper journals and libraries, citations were the only quantifiable metric of the value of the information conveyed by a journal or a specific paper. In the 21st century, with the introduction of the internet and social media, the ability to measure the details of a paper’s readership has changed. In contrast to citation indices or social media impressions, “Talking with Colleagues” is a method of information exchange that is difficult to quantify. Yet, it is the method of communication used by people of all ages since the beginning of civilization.[ 1 ]

As a technological advance in communication, Zoom has been a huge advantage to civilization in connecting people with each other. However, the rapid mass adoption of Zoom because of COVID-19 has led to some problems with its integration into our lives. Zoom learning has failed in the education of our youth, because people need social interaction to learn.[ 3 , 5 , 6 ] “Zoom Fatigue” is widespread.[ 4 ] It is impersonal. Educators from elementary schools to medical schools have simply taken the traditional teaching methods of formal lectures and transferred them to the Internet, leading to one-way discussions which have become even more impersonal. These problems are not a failure of the technology but only of its use.[ 1 ]

SNI Digital™ was developed by drawing on years of practice. I (JIA) used the open discussion format of “Talking with Colleagues” in my conferences. It is a fundamental way in which we all learn. Ask someone you trust for his or her opinion; no slides or lectures are needed, just practical information you and others can understand.

The SNI Digital World Education Summit will be launched publicly on June 5 and 6, 2021. The fundamental principle of “Talking with Colleagues” is incorporated into each of the discussions included in the Summit.[ 2 ] The Summit is a 2-day event that consists of two simultaneous discussion sessions that each cover selected neurosurgical conditions in a case-based format. The audience can hear the opinions of experienced people all over the world on the cases presented. It is what physicians do every day. It is practical information you can use. In the course of solving challenging cases, multiple types of information are revealed. The listener can decide what is best for them in their circumstances. At the conclusion of the simultaneous sessions, a 30 min “Neuroscience Lecture of the Future” is given to the combined audience with ample time for questions and answers.

SNI Digital is introducing a new method of learning surgical principles. For our first series, our audience will “Scrub” with Juha Hernesniemi, MD, PhD, who will go guide us through videos highlighting challenging surgical cases. He will answer questions from the audience of what he is doing and why, in a step-by-step fashion. That session will last for 1 h. We believe that this will become the standard way for teaching surgical principles in the future.

A 15 min break separates the discussion sessions from the lecture that follows those sessions. At the end of the meeting, there is unlimited time for the audience to meet with the discussants, moderators, colleagues, and friends, and to connect with people from all over the world. It is also a time to visit with the sponsors who will be available throughout the meeting for those who want to see the new products that were developed. It is a time to make new friends and chat. At any time during the meeting, the audience can virtually meet others or visit sponsor booths. In today’s world, physicians have less time and money. They want value for their time spent. Over the years, I have found that they want practical information they can use.

The SNI Digital World Education Summit provides the opportunity to be with over 50 well respected discussants from around the world. The audience also has a chance to ask questions and get answers in each session, during the breaks and in the social meeting time or at the end of a day’s sessions. The audience will rate the value of the sessions, moderators, and discussants so that we can constantly improve what we do. The SNI Digital World Education Summit is a meeting for the audience.

In our Beta trials of various formats, the discussants have uniformly stated that they learned also as they shared ideas with others and wanted to spend more time discussing cases.

The Summit starts at 600 AM California time, which is at an hour that almost everyone around the world can be at the Summit “live.” It is held on Saturday and Sunday and will be scheduled in future at regular intervals to be determined by the audience. People want “live” information. For those who cannot be at the meeting, all of the sessions will be recorded, translated into multiple languages, and put into podcast form on SNI to be accessed 24/7-365. It is all free to everyone, everywhere.

SNI Digital Education has been tested in different learning formats. It has been used in Grand Rounds, Specialty Case Conferences integrated with short lectures, and new lecture formats, using the same “Talking with Colleagues” principle. SNI Digital will do what its audience wants. We are learning also. Help us make it better for you, because it is for you. It is your conference, your information. It is the 21st century of learning with interpersonal, interactive information transfer.


1. Ausman J, Epstein N, West JL. Comparative metrics of neurosurgical scientific journals: What do they mean to readers?. Surg Neurol Int. 2020. 11: 169

2. Ausman JI. SNI Digital Neurosurgery Global Summit. Available from: [Last accessed on 2021 Jan 06].

3. Hirsh-Pasek K. Play breeds better thinkers. Science. 2021. 371: 131

4. McConnon A. Zoom fatigue: The differing impact on introverts and extroverts. Wall Street J. 2021. p.

5. McDonald K. Zoom School Gets an F. But Some Online Learning Providers Excel. Available from: [Last accessed on 2020 Dec 21].

6. Weitzner E. After a Year of Zoom Meetings. we’ll need to Rebuild Trust through Eye Contact. Available from: [Last accessed on 2021 May 17].

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