Document Detail


Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components.
MedLine Citation:
PMID:  24051873     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: In the era of surgical resident work hour restrictions, the traditional apprenticeship model may provide fewer hours for neurosurgical residents to hone technical skills. Spinal dura mater closure or repair is 1 skill that is infrequently encountered, and persistent cerebrospinal fluid leaks are a potential morbidity.
OBJECTIVE: To establish an educational curriculum to train residents in spinal dura mater closure with a novel durotomy repair model.
METHODS: The Congress of Neurological Surgeons has developed a simulation-based model for durotomy closure with the ongoing efforts of their simulation educational committee. The core curriculum consists of didactic training materials and a technical simulation model of dural repair for the lumbar spine.
RESULTS: Didactic pretest scores ranged from 4/11 (36%) to 10/11 (91%). Posttest scores ranged from 8/11 (73%) to 11/11 (100%). Overall, didactic improvements were demonstrated by all participants, with a mean improvement between pre- and posttest scores of 1.17 (18.5%; P = .02). The technical component consisted of 11 durotomy closures by 6 participants, where 4 participants performed multiple durotomies. Mean time to closure of the durotomy ranged from 490 to 546 seconds in the first and second closures, respectively (P = .66), whereby the median leak rate improved from 14 to 7 (P = .34). There were also demonstrative technical improvements by all.
CONCLUSION: Simulated spinal dura mater repair appears to be a potentially valuable tool in the education of neurosurgery residents. The combination of a didactic and technical assessment appears to be synergistic in terms of educational development.
ABBREVIATIONS: CNS, Congress of Neurological SurgeonsPGY, postgraduate year.
Authors:
George M Ghobrial; Paul A Anderson; Rohan Chitale; Peter G Campbell; Darlene A Lobel; James Harrop
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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:  S111-5     Citation Subset:  IM    
Affiliation:
*Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; ‡Department of Orthopedics, University of Wisconsin, Madison, Wisconsin; §Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
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