Neurosurgery simulation in residency training

Feasibility, cost, and educational benefit

Jaime Gasco, Thomas J. Holbrook, Achal Patel, Adrian Smith, David Paulson, Alan Muns, Sohum Desai, Marc Moisi, Yong Fang Kuo, Bart MacDonald, Juan Ortega-Barnett, Joel Patterson

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

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

Original languageEnglish (US)
JournalNeurosurgery
Volume73
Issue numberSUPPL. 4
DOIs
StatePublished - Oct 2013

Fingerprint

Neurosurgery
Internship and Residency
Curriculum
Cost-Benefit Analysis
Cadaver
Dissection
Spine
Learning
Exercise
Physicians
Education
Costs and Cost Analysis
Equipment and Supplies

Keywords

  • Cost, Education
  • Laboratory
  • Neurosurgery
  • Simulation
  • Training

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Neurosurgery simulation in residency training : Feasibility, cost, and educational benefit. / Gasco, Jaime; Holbrook, Thomas J.; Patel, Achal; Smith, Adrian; Paulson, David; Muns, Alan; Desai, Sohum; Moisi, Marc; Kuo, Yong Fang; MacDonald, Bart; Ortega-Barnett, Juan; Patterson, Joel.

In: Neurosurgery, Vol. 73, No. SUPPL. 4, 10.2013.

Research output: Contribution to journalArticle

Gasco, J, Holbrook, TJ, Patel, A, Smith, A, Paulson, D, Muns, A, Desai, S, Moisi, M, Kuo, YF, MacDonald, B, Ortega-Barnett, J & Patterson, J 2013, 'Neurosurgery simulation in residency training: Feasibility, cost, and educational benefit', Neurosurgery, vol. 73, no. SUPPL. 4. https://doi.org/10.1227/NEU.0000000000000102
Gasco, Jaime ; Holbrook, Thomas J. ; Patel, Achal ; Smith, Adrian ; Paulson, David ; Muns, Alan ; Desai, Sohum ; Moisi, Marc ; Kuo, Yong Fang ; MacDonald, Bart ; Ortega-Barnett, Juan ; Patterson, Joel. / Neurosurgery simulation in residency training : Feasibility, cost, and educational benefit. In: Neurosurgery. 2013 ; Vol. 73, No. SUPPL. 4.
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abstract = "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",
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AU - Moisi, Marc

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