• Jaime Gasco, Thomas J Holbrook, Achal Patel, Adrian Smith, David Paulson, Alan Muns, Sohum Desai, Marc Moisi, Yong-Fan Kuo, Bart Macdonald, Juan Ortega-Barnett, and Joel T Patterson.
• *Division of Neurosurgery; and ‡Division of Epidemiology & Biostatistics, Preventive Medicine Department, University of Texas Medical Branch, Galveston, Texas.
• Neurosurgery. 2013 Oct 1; 73 Suppl 1: 39-45.

BackgroundThe effort required to introduce simulation in neurosurgery academic programs and the benefits perceived by residents have not been systematically assessed.ObjectiveTo create a neurosurgery simulation curriculum encompassing basic and advanced skills, cadaveric dissection, cranial and spine surgery simulation, and endovascular and computerized haptic training.MethodsA 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.ResultsOne 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.ConclusionThe 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.

22 keywords...

hide…