• Ebrahim Adnan Patel, Abdullatif Aydin, Michael Cearns, Prokar Dasgupta, and Kamran Ahmed.
• Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
• World Neurosurg. 2020 Jan 1; 133: e850-e873.

ObjectiveThe recent emphasis on simulation-based training in neurosurgery has led to the development of many simulation models and training courses. We aim to identify the currently available simulators and training courses for neurosurgery, assess their validity, and determine their effectiveness.MethodsBoth MEDLINE and Embase were searched for English language articles which validate simulation models for neurosurgery. Each study was screened according to the Messick validity framework and rated in each domain. The McGaghie model of translational outcomes was then used to determine a level of effectiveness (LoE) for each simulator or training course.ResultsOn screening of 6006 articles, 114 were identified to either validate or determine an LoE for 108 simulation-based training models or courses. Achieving the highest rating for each validity domain were 6 models and training courses for content validity, 12 for response processes, 4 for internal structure, 14 for relations to other variables, and none for consequences. For translational outcomes, 6 simulators or training achieved an LoE >2 and thus showed skills transfer beyond the simulation setting.ConclusionsWith the advent of increasing neurosurgery simulators and training tools, there is a need for more validity studies. Further attempts to investigate translational outcomes to the operating theater when using these simulators is particularly warranted. More training tools incorporating full-immersion simulation and nontechnical skills training are recommended.Copyright © 2019 Elsevier Inc. All rights reserved.

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