Cerebrospinal Fluid Leak Repair Simulation Model: Face, Content, and Construct Validation

Alqahtani, Abdulaziz; Albathi, Abeer; Castelnuovo, Paolo; Alfawwaz, Fahad

doi:10.1177/1945892420952262

Cited by 11 publications

(8 citation statements)

References 15 publications

(33 reference statements)

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“…Christian et al 26 used a similar model but with intrathecal perfusion of fluorescein‐dyed saline to optimize visual feedback of successful repair. Lastly, AlQatahni et al 10 , 11 described a similar model using fluorescein‐dyed saline and conducted two studies to establish the feasibility as well as face, content, and construct validity of their model.…”

Section: Resultsmentioning

confidence: 99%

Simulation training in endoscopic skull base surgery: A scoping review

James

Irace

Gudis

et al. 2022

World j. otorhinolaryngol.-head neck surg.

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Objective Proficiency in endoscopic endonasal skull base surgery requires both substantial baseline training and progressive lifelong learning. Endoscopic simulation models continue to evolve in an effort to optimize trainee education and preoperative preparation and improve surgical outcomes. The current scoping review systematically reviews all available literature and synthesizes the current paradigms of simulation models for endoscopic skull base surgery training and skill enhancement. Methods In accordance with Preferred Reporting Items for Systemic Review and Meta‐Analyses guidelines, we systematically searched PubMed, Embase, CINAHL, and Cochrane databases. Studies were categorized according to the type of simulation models investigated. Results We identified 238 unique references, with 55 studies ultimately meeting inclusion criteria. Of these, 19 studies described cadaveric dissection models, 17 discussed three‐dimensional (3D) printed models, 14 examined virtual surgical planning and augmented reality‐based models, and five 5 articles described task trainers. Conclusions There are a wide variety of simulation models for endoscopic skull base surgery, including high‐fidelity cadaveric, virtual reality, and 3D‐printed models. These models are an asset for trainee development and preoperative surgical preparation.

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Section: Resultsmentioning

confidence: 99%

Simulation training in endoscopic skull base surgery: A scoping review

James

Irace

Gudis

et al. 2022

World j. otorhinolaryngol.-head neck surg.

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“…Donoho et al perfused cadavers with artificial blood and demonstrated face and construct validity, as well as utility as an educational tool ( 23 , 34 ). Other cadaveric studies have looked at simulating CSF leak repair and demonstrated face, content and construct validity ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

High fidelity simulation of the endoscopic transsphenoidal approach: Validation of the UpSurgeOn TNS Box

et al. 2022

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ObjectiveEndoscopic endonasal transsphenoidal surgery is an established technique for the resection of sellar and suprasellar lesions. The approach is technically challenging and has a steep learning curve. Simulation is a growing training tool, allowing the acquisition of technical skills pre-clinically and potentially resulting in a shorter clinical learning curve. We sought validation of the UpSurgeOn Transsphenoidal (TNS) Box for the endoscopic endonasal transsphenoidal approach to the pituitary fossa.MethodsNovice, intermediate and expert neurosurgeons were recruited from multiple centres. Participants were asked to perform a sphenoidotomy using the TNS model. Face and content validity were evaluated using a post-task questionnaire. Construct validity was assessed through post-hoc blinded scoring of operative videos using a Modified Objective Structured Assessment of Technical Skills (mOSAT) and a Task-Specific Technical Skill scoring system.ResultsFifteen participants were recruited of which n = 10 (66.6%) were novices and n = 5 (33.3%) were intermediate and expert neurosurgeons. Three intermediate and experts (60%) agreed that the model was realistic. All intermediate and experts (n = 5) strongly agreed or agreed that the TNS model was useful for teaching the endonasal transsphenoidal approach to the pituitary fossa. The consensus-derived mOSAT score was 16/30 (IQR 14–16.75) for novices and 29/30 (IQR 27–29) for intermediate and experts (p < 0.001, Mann–Whitney U). The median Task-Specific Technical Skill score was 10/20 (IQR 8.25–13) for novices and 18/20 (IQR 17.75–19) for intermediate and experts (p < 0.001, Mann-Whitney U). Interrater reliability was 0.949 (CI 0.983–0.853) for OSATS and 0.945 (CI 0.981–0.842) for Task-Specific Technical Skills. Suggested improvements for the model included the addition of neuro-vascular anatomy and arachnoid mater to simulate bleeding vessels and CSF leak, respectively, as well as improvement in materials to reproduce the consistency closer to that of human tissue and bone.ConclusionThe TNS Box simulation model has demonstrated face, content, and construct validity as a simulator for the endoscopic endonasal transsphenoidal approach. With the steep learning curve associated with endoscopic approaches, this simulation model has the potential as a valuable training tool in neurosurgery with further improvements including advancing simulation materials, dynamic models (e.g., with blood flow) and synergy with complementary technologies (e.g., artificial intelligence and augmented reality).

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“…Simulation in neuro-otology was captured in 20 models (Supplemental Table 1). 10-30 Eight were intended for myringotomy +/− pressure equalization tube (PET) insertion, 7 for mastoidectomy, 2 for temporal bone dissection, one each for otoplasty, ossiculoplasty, and endoscopic transcanal tympanoplasty. Of the bench-top models, the myringotomy and PET insertion model described by Malekzadeh et al is notable for its low cost and low fidelity approach that incorporated readily available clinical supplies to enhance time to completion and global rating scores when compared to didactic training alone.…”

Section: State Of Simulation In Otolaryngology—head and Neck Surgerymentioning

confidence: 99%

Thinking Beyond the Temporal Bone Lab: A Systematic Process for Expanding Surgical Simulation in Otolaryngology Training

James

Irace

Drusin

et al. 2022

Ann Otol Rhinol Laryngol

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The COVID-19 pandemic led to a temporary lapse in the development of otolaryngology trainee operative skills due to the cancellation of elective procedures and redeployment of trainees and attendings to COVID-19 units. Although transient, this disruption provided an opportunity for otolaryngology programs to develop contingency plans and formalize nascent simulation training curricula. Integration of formal simulation training alongside current didactic and surgical education may offset lost exposure during surgically lean times while providing the framework and resources for enhanced baseline training. Here, we provide an up-to-date overview of surgical simulation models in otolaryngology and identify easily implementable, low-cost, low fidelity models for junior trainees. By taking advantage of rapid advancements in technology and a paradigm shift to a more hands-on approach in medical education, formal simulation training may prove to be a beneficial tool at all stages of residency training, allowing for expanded peer-mentored skill development and providing a safe haven during unforeseen disruptions in surgical case volume.

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Cerebrospinal Fluid Leak Repair Simulation Model: Face, Content, and Construct Validation

Cited by 11 publications

References 15 publications

Simulation training in endoscopic skull base surgery: A scoping review

Simulation training in endoscopic skull base surgery: A scoping review

High fidelity simulation of the endoscopic transsphenoidal approach: Validation of the UpSurgeOn TNS Box

Thinking Beyond the Temporal Bone Lab: A Systematic Process for Expanding Surgical Simulation in Otolaryngology Training

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