A Novel Craniotomy Simulator Provides a Validated Method to Enhance Education in the Management of Traumatic Brain Injury

Abstract

BACKGROUND: In a variety of surgical specialties, simulation-based technologies play an important role in resident training. The Congress of Neurological Surgeons (CNS) established an initiative to enhance neurosurgical training by developing a simulationbased curriculum to complement standard didactic and clinical learning. OBJECTIVE: To enhance resident education in the management of traumatic brain injury by the use of simulation-based training. METHODS: A course-based neurosurgical simulation curriculum was developed and offered at the 2012 CNS annual meeting. Within this curriculum, a trauma module was developed to teach skills necessary in the management of traumatic brain injury, including the performance of craniotomy for trauma. Didactic and simulator-based instruction were incorporated into the course. Written and practical pre-and posttests, as well as questionnaires, were used to assess the improvement in skill level and to validate the simulator as a teaching tool. RESULTS: Fourteen trainees participated in the didactic section of the trauma module. Average performance improved significantly in written scores from pretest (75%) to posttest (87.5%, P , .05). Eight participants completed the trauma craniotomy simulator. Incision planning, burr hole placement (P , .02), and craniotomy size (P , .05) improved significantly. Junior residents (postgraduate years 1-3) demonstrated the most improvement during the course. CONCLUSION: The CNS simulation trauma module provides a complementary method for residents to acquire necessary skills in the management of traumatic brain injury. Preliminary data indicate improvement in didactic and hands-on knowledge after training. Additional data are needed to confirm the validity of the simulator.

Mixed Reality Ventriculostomy Simulation

“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] As technology continues to improve, neurosurgery offers a unique environment to combine patient-specific central nervous system imaging with simulators to form patient-specific virtual models. 14,21 One procedure that is common to all neurosurgical practices is the placement of an external ventricular drain (EVD).…”

Concept and evaluation of the German War Surgery Course – Einsatzchirurgie-Kurs der Bundeswehr

“…While useful in providing feedback to guide curricular development, reports such as these do not measure any real gain in knowledge or skills. Evaluation of the knowledge gained as a result of a course represents the next level of measuring course effectiveness 20. Ideally, surgical skills training curricula should assess the gain in the performance of the actual skill 12 18.…”

The role of simulation in neurosurgery

“…Burr hole and trauma craniotomy simulators have been developed by the National Capital Area Simulation Center (Uniformed Services University, Bethesda, Maryland) to teach residents as well as military surgeons who are being deployed to manage neurotrauma cases [43,44]. Also, there have been several reports on ventriculostomy simulators that demonstrate validated learning experiences for the treatment of neurosurgical emergencies, including VR models with haptic feedback and mixed-reality simulator [45][46][47][48].…”