• Matthew A Kirkman, William Muirhead, Dipankar Nandi, and Nick Sevdalis.
• Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, United Kingdom; Department of Surgery and Cancer, Imperial College London, St Mary's Campus, London, United Kingdom. Electronic address: matthew.kirkman@gmail.com.
• World Neurosurg. 2014 Sep 1;82(3-4):284-91.

ObjectiveNeurosurgical simulation training is becoming increasingly popular. Attitudes toward simulation among residents can contribute to the effectiveness of simulation training, but such attitudes remain poorly explored in neurosurgery with no psychometrically proven measure in the literature. The aim of the present study was to evaluate prospectively a newly developed tool for this purpose: the Neurosurgical Evaluation of Attitudes towards simulation Training (NEAT).MethodsThe NEAT tool was prospectively developed in 2 stages and psychometrically evaluated (validity and reliability) in 2 administrations with the same participants. The tool comprises a questionnaire with 9 Likert scale items and 2 free-text sections assessing attitudes toward simulation in neurosurgery.ResultsThe evaluation was completed with 31 neurosurgery residents in London, United Kingdom, who were generally favorable toward neurosurgical simulation. The internal consistency of the questionnaire was high, as demonstrated by the overall Cronbach α values (α=0.899 and α=0.955). All but 2 questionnaire items had "substantial" or "almost perfect" test-retest reliability following repeated survey administrations (median Pearson r correlation=0.688; range, 0.248-0.841). NEAT items were well correlated with each other on both occasions, showing good validity of content within the NEAT tool. There was no significant relationship between either gender or length of neurosurgical experience and item ratings.ConclusionsNEAT is the first psychometrically evaluated tool for evaluating attitudes toward simulation in neurosurgery. Further implementation of NEAT is required in wider neurosurgical populations to establish whether specific population groups differ. Use of NEAT in studies of neurosurgical simulation could offer an additional outcome measure to performance metrics, permitting evaluation of the impact of neurosurgical simulation on attitudes toward simulation both between participants and within the same participants over time.Copyright © 2014 Elsevier Inc. All rights reserved.

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