The Effect of 3-Dimensional Simulation on Neurosurgical Skill Acquisition and Surgical Performance: A Review of the Literature

Clark, Anna D.; Barone, Damiano G.; Candy, Nicholas G.; Guilfoyle, Mathew R.; Budohoski, Karol P.; Hofmann, Riikka; Santarius, Thomas; Kirollos, Ramez; Trivedi, Rikin

doi:10.1016/j.jsurg.2017.02.007

Cited by 28 publications

(11 citation statements)

References 21 publications

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“…Physical models can achieve anatomical accuracy, especially with the engineering tools available today. Three-D printing allows us to create reproducible models that can be subjected to real-world manipulation 8. Some physical models are incredibly ornate, such as the traumatic brain injury model used during a course at CNS and the Vascular Simulations Replicator (Stony Brook, NY, USA).…”

Section: Simulation In Neurosurgerymentioning

confidence: 99%

Simulation training in neurosurgery: advances in education and practice

Konakondla

Fong

Schirmer

2017

AMEP

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The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the “real-life” feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training. The technologies can be directed at achieving early resident milestones placed by the Accreditation Council for Graduate Medical Education. We discuss various aspects of neurosurgery disciplines with specific technologic advances of simulation software. An overview of the scholarly landscape of the recent publications in the realm of medical simulation and virtual reality pertaining to neurologic surgery is provided. We analyze concurrent concept overlap between PubMed headings and provide a graphical overview of the associations between these terms.

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Section: Simulation In Neurosurgerymentioning

confidence: 99%

Simulation training in neurosurgery: advances in education and practice

Konakondla

Fong

Schirmer

2017

AMEP

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“…Multiple studies have consistently demonstrated that the use of simulators improves qualitative and quantitative performance measures as well as overall resident and surgeon confidence in clinical settings. [ 35 – 38 ]…”

Section: Discussionmentioning

confidence: 99%

Neurosurgical simulator for training aneurysm microsurgery—a user suitability study involving neurosurgeons and residents

et al. 2020

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Background Due to its complexity and to existing treatment alternatives, exposure to intracranial aneurysm microsurgery at the time of neurosurgical residency is limited. The current state of the art includes training methods like assisting in surgeries, operating under supervision, and video training. These approaches are labor-intensive and difficult to fit into a timetable limited by the new work regulations. Existing virtual reality (VR)–based training modules lack patient-specific exercises and haptic properties and are thus inferior to hands-on training sessions and exposure to real surgical procedures. Materials and methods We developed a physical simulator able to reproduce the experience of clipping an intracranial aneurysm based on a patient-specific 3D-printed model of the skull, brain, and arteries. The simulator is made of materials that not only imitate tissue properties including arterial wall patency, thickness, and elasticity but also able to recreate a pulsatile blood flow. A sample group of 25 neurosurgeons and residents (n = 16: early residency with less than 4 years of neurosurgical exposure; n = 9: late residency and board-certified neurosurgeons, 4–15 years of neurosurgical exposure) took part to the study. Participants evaluated the simulator and were asked to answer questions about surgical simulation anatomy, realism, haptics, tactility, and general usage, scored on a 5-point Likert scale. In order to evaluate the feasibility of a future validation study on the role of the simulator in neurosurgical postgraduate training, an expert neurosurgeon assessed participants’ clipping performance and a comparison between groups was done. Results The proposed simulator is reliable and potentially useful for training neurosurgical residents and board-certified neurosurgeons. A large majority of participants (84%) found it a better alternative than conventional neurosurgical training methods. Conclusion The integration of a new surgical simulator including blood circulation and pulsatility should be considered as part of the future armamentarium of postgraduate education aimed to ensure high training standards for current and future generations of neurosurgeons involved in intracranial aneurysm surgery.

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“…31 Moreover, VRE may provide a 3D representation of traditional 2D radiological imaging, so improving the comprehension of the patient-specific anatomy. [32][33][34][35] A meta-analysis of 36 studies, including 28 RCTs and 2226 participants, showed that 3D visualization technology was associated with higher factual knowledge, better results in spatial knowledge acquisition, increased user satisfaction and growth of the learners' perception of tool effectiveness, respectively, with the following standardized mean differences: 0.30 (95% CI 0.02-0.62), 0.50 (95% CI 0.20-0.80), 0.28 (95% CI 0.12-0.44), and 0.28 (95% CI 0.14-0.43).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, VRE may provide a 3D representation of traditional 2D radiological imaging, so improving the comprehension of the patient-specific anatomy. 32-35…”

Section: Discussionmentioning

confidence: 99%

A Virtual Reality Environment to Visualize Three-Dimensional Patient-Specific Models by a Mobile Head-Mounted Display

et al. 2019

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Introduction. With the availability of low-cost head-mounted displays (HMDs), virtual reality environments (VREs) are increasingly being used in medicine for teaching and clinical purposes. Our aim was to develop an interactive, userfriendly VRE for tridimensional visualization of patient-specific organs, establishing a workflow to transfer 3-dimensional (3D) models from imaging datasets to our immersive VRE. Materials and Methods. This original VRE model was built using open-source software and a mobile HMD, Samsung Gear VR. For its validation, we enrolled 33 volunteers: morphologists (n = 11), trainee surgeons (n = 15), and expert surgeons (n = 7). They tried our VRE and then filled in an original 5-point Likert-type scale 6-item questionnaire, considering the following parameters: ease of use, anatomy comprehension compared with 2D radiological imaging, explanation of anatomical variations, explanation of surgical procedures, preoperative planning, and experience of gastrointestinal/neurological disorders. Results in the 3 groups were statistically compared using analysis of variance. Results. Using cross-sectional medical imaging, the developed VRE allowed to visualize a 3D patient-specific abdominal scene in 1 hour. Overall, the 6 items were evaluated positively by all groups; only anatomy comprehension was statistically significant different among the 3 groups. Conclusions. Our approach, based on open-source software and mobile hardware, proved to be a valid and well-appreciated system to visualize 3D patient-specific models, paving the way for a potential new tool for teaching and preoperative planning.

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The Effect of 3-Dimensional Simulation on Neurosurgical Skill Acquisition and Surgical Performance: A Review of the Literature

Cited by 28 publications

References 21 publications

Simulation training in neurosurgery: advances in education and practice

Simulation training in neurosurgery: advances in education and practice

Neurosurgical simulator for training aneurysm microsurgery—a user suitability study involving neurosurgeons and residents

A Virtual Reality Environment to Visualize Three-Dimensional Patient-Specific Models by a Mobile Head-Mounted Display

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