Document Detail


Neurosurgery simulation in residency training: feasibility, cost, and educational benefit.
MedLine Citation:
PMID:  24051881     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The effort required to introduce simulation in neurosurgery academic programs and the benefits perceived by residents have not been systematically assessed.
OBJECTIVE: To create a neurosurgery simulation curriculum encompassing basic and advanced skills, cadaveric dissection, cranial and spine surgery simulation, and endovascular and computerized haptic training.
METHODS: A curriculum with 68 core exercises per academic year was distributed in individualized sets of 30 simulations to 6 neurosurgery residents. The total number of procedures completed during the academic year was set to 180. The curriculum includes 79 simulations with physical models, 57 cadaver dissections, and 44 haptic/computerized sessions. Likert-type evaluations regarding self-perceived performance were completed after each exercise. Subject identification was blinded to junior (postgraduate years 1-3) or senior resident (postgraduate years 4-6). Wilcoxon rank testing was used to detect differences within and between groups.
RESULTS: One hundred eighty procedures and surveys were analyzed. Junior residents reported proficiency improvements in 82% of simulations performed (P < .001). Senior residents reported improvement in 42.5% of simulations (P < .001). Cadaver simulations accrued the highest reported benefit (71.5%; P < .001), followed by physical simulators (63.8%; P < .001) and haptic/computerized (59.1; P < .001). Initial cost is $341 978.00, with $27 876.36 for annual operational expenses.
CONCLUSION: The systematic implementation of a simulation curriculum in a neurosurgery training program is feasible, is favorably regarded, and has a positive impact on trainees of all levels, particularly in junior years. All simulation forms, cadaver, physical, and haptic/computerized, have a role in different stages of learning and should be considered in the development of an educational simulation program.
ABBREVIATION: PPDIS, Physician Performance Diagnostic Inventory Scale.
Authors:
Jaime Gasco; Thomas J Holbrook; Achal Patel; Adrian Smith; David Paulson; Alan Muns; Sohum Desai; Marc Moisi; Yong-Fan Kuo; Bart Macdonald; Juan Ortega-Barnett; Joel T Patterson
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  73 Suppl 1     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-09-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S39-45     Citation Subset:  IM    
Affiliation:
*Division of Neurosurgery; and ‡Division of Epidemiology & Biostatistics, Preventive Medicine Department, University of Texas Medical Branch, Galveston, Texas.
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