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

60 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 - Gasco, Jaime

AU - Holbrook, Thomas J.

AU - Patel, Achal

AU - Smith, Adrian

AU - Paulson, David

AU - Muns, Alan

AU - Desai, Sohum

AU - Moisi, Marc

AU - Kuo, Yong Fang

AU - MacDonald, Bart

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AU - Patterson, Joel

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N2 - 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

AB - 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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KW - Training

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