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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 364-370
DOI: 10.4103/ajns.AJNS_269_18
Review Article

Simulation training methods in neurological surgery

Louise Oliveira
School of Medicine, Federal University of Amazonas, Manaus
,
Eberval Figueiredo
1   Division of Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo
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Simulation training plays a paramount role in medicine, especially when it comes to mastering surgical skills. By simulating, students gain not only confidence, but expertise, learning to apply theory in a safe environment. As the technological arsenal improved, virtual reality and physical simulators have developed and are now an important part of the Neurosurgery training curriculum. Based on deliberate practice in a controlled space, simulation allows psychomotor skills augment without putting neither patients nor students at risk. When compared to the master-apprentice ongoing model of teaching, simutation becomes even more appealing as it is time-efficient, shortening the learning curve and ultimately leading to error reduction, which is reflected by diminished health care costs in the long run. In this chapter we will discuss the current state of neurosurgery simulation, highlight the potential benefits of this approach, assessing specific training methods and making considerations towards the future of neurosurgical simulation.

Key-words:

Medical education - neurological surgery - neurosurgery - neurosurgical education - simulation

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Akhtar KS, Chen A, Standfield NJ, Gupte CM. The role of simulation in developing surgical skills. Curr Rev Musculoskelet Med 2014;7:155-60.
  • 2 Chikwe J, de Souza AC, Pepper JR. No time to train the surgeons. BMJ 2004;328:418-9.
  • 3 Sonnadara RR, Van Vliet A, Safir O, Alman B, Ferguson P, Kraemer W, et al. Orthopedic boot camp: Examining the effectiveness of an intensive surgical skills course. Surgery 2011;149:745-9.
  • 4 Mirza S, Athreya S. Review of simulation training in interventional radiology. Acad Radiol 2018;25:529-39.
  • 5 Gasco J, Holbrook TJ, Patel A, Smith A, Paulson D, Muns A, et al. Neurosurgery simulation in residency training: Feasibility, cost, and educational benefit. Neurosurgery 2013;73 Suppl 1:39-45.
  • 6 Coelho G, Zanon N, Warf B. The role of simulation in neurosurgery. Childs Nerv Syst 2014;30:1997-2000.
  • 7 Zanello M, Zerah M, Sainte-Rose C, Di Rocco F. Virtual simulation in neurosurgery: A comparison between pediatric and general neurosurgeons. Acta Neurochir (Wien) 2014;156:2215-6.
  • 8 Issenberg SB. The scope of simulation-based healthcare education. Simul Healthc 2006;1:203-8.
  • 9 Chan S, Conti F, Salisbury K, Blevins NH. Virtual reality simulation in neurosurgery: Technologies and evolution. Neurosurgery 2013;72 Suppl 1:154-64.
  • 10 Seymour NE, Gallagher AG, Roman SA, O'Brien MK, Bansal VK, Andersen DK, et al. Virtual reality training improves operating room performance: Results of a randomized, double-blinded study. Ann Surg 2002;236:458-63.
  • 11 Ahlberg G, Enochsson L, Gallagher AG, Hedman L, Hogman C, McClusky DA 3rd, et al. Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. Am J Surg 2007;193:797-804.
  • 12 Bova FJ, Rajon DA, Friedman WA, Murad GJ, Hoh DJ, Jacob RP, et al. Mixed-reality simulation for neurosurgical procedures. Neurosurgery 2013;73 Suppl 1:138-45.
  • 13 Suri A, Patra DP, Meena RK. Simulation in neurosurgery: Past, present, and future. Neurol India 2016;64:387-95.
  • 14 Persaud TV. A History of Anatomy: The Post-Vesalian Era. Illinois, Springfield: Charles C Thomas Publisher; 1997.
  • 15 Kunkler K. The role of medical simulation: An overview. Int J Med Robot 2006;2:203-10.
  • 16 Limbrick DD Jr., Dacey RG Jr. Simulation in neurosurgery: Possibilities and practicalities: Foreword. Neurosurgery 2013;73 Suppl 1:1-3.
  • 17 Robison RA, Liu CY, Apuzzo ML. Man, mind, and machine: The past and future of virtual reality simulation in neurologic surgery. World Neurosurg 2011;76:419-30.
  • 18 Singh H, Kalani M, Acosta-Torres S, El Ahmadieh TY, Loya J, Ganju A, et al. History of simulation in medicine: From Resusci Annie to the Ann Myers medical center. Neurosurgery 2013;73 Suppl 1:9-14.
  • 19 Fahey DG. The self-inflating resuscitator – Evolution of an idea. Anaesth Intensive Care 2010;38 Suppl 1:10-5.
  • 20 Cooper JB, Taqueti VR. A brief history of the development of mannequin simulators for clinical education and training. Qual Saf Health Care 2004;13 Suppl 1:i11-8.
  • 21 Willaert WI, Aggarwal R, Van Herzeele I, Cheshire NJ, Vermassen FE. Recent advancements in medical simulation: Patient-specific virtual reality simulation. World J Surg 2012;36:1703-12.
  • 22 Cobb MI, Taekman JM, Zomorodi AR, Gonzalez LF, Turner DA. Simulation in neurosurgery – A brief review and commentary. World Neurosurg 2016;89:583-6.
  • 23 Auer LM, Auer DP. Virtual endoscopy for planning and simulation of minimally invasive neurosurgery. Neurosurgery 1998;43:529-37.
  • 24 Li Y, Brodlie K, Phillips N. Web-based VR training simulator for percutaneous rhizotomy. Stud Health Technol Inform 2000;70:175-81.
  • 25 Dias LA, Gebhard H, Mtui E, Anand VK, Schwartz TH. The use of an ultraportable universal serial bus endoscope for education and training in neuroendoscopy. World Neurosurg 2013;79:337-40.
  • 26 Delorme S, Laroche D, DiRaddo R, Del Maestro RF. NeuroTouch: A physics-based virtual simulator for cranial microneurosurgery training. Neurosurgery 2012;71:32-42.
  • 27 Spiotta AM, Rasmussen PA, Masaryk TJ, Benzel EC, Schlenk R. Simulated diagnostic cerebral angiography in neurosurgical training: A pilot program. J Neurointerv Surg 2013;5:376-81.
  • 28 Fargen KM, Siddiqui AH, Veznedaroglu E, Turner RD, Ringer AJ, Mocco J, et al. Simulator based angiography education in neurosurgery: Results of a pilot educational program. J Neurointerv Surg 2012;4:438-41.
  • 29 Hsu JH, Younan D, Pandalai S, Gillespie BT, Jain RA, Schippert DW, et al. Use of computer simulation for determining endovascular skill levels in a carotid stenting model. J Vasc Surg 2004;40:1118-25.
  • 30 Eftekhar B, Ghodsi M, Ketabchi E, Rasaee S. Surgical simulation software for insertion of pedicle screws. Neurosurgery 2002;50:222-3.
  • 31 Alaraj A, Lemole MG, Finkle JH, Yudkowsky R, Wallace A, Luciano C, et al. Virtual reality training in neurosurgery: Review of current status and future applications. Surg Neurol Int 2011;2:52.
  • 32 Beier F, Sismanidis E, Stadie A, Schmieder K, Männer R. An aneurysm clipping training module for the neurosurgical training simulator NeuroSim. Stud Health Technol Inform 2012;173:42-7.
  • 33 Leong JJ, Leff DR, Das A, Aggarwal R, Reilly P, Atkinson HD, et al. Validation of orthopaedic bench models for trauma surgery. J Bone Joint Surg Br 2008;90:958-65.
  • 34 Konakondla S, Fong R, Schirmer CM. Simulation training in neurosurgery: Advances in education and practice. Adv Med Educ Pract 2017;8:465-73.
  • 35 Grechenig W, Fellinger M, Fankhauser F, Weiglein AH. The Graz learning and training model for arthroscopic surgery. Surg Radiol Anat 1999;21:347-50.
  • 36 Gasco J, Patel A, Ortega-Barnett J, Branch D, Desai S, Kuo YF, et al. Virtual reality spine surgery simulation: An empirical study of its usefulness. Neurol Res 2014;36:968-73.
  • 37 Malone HR, Syed ON, Downes MS, D'Ambrosio AL, Quest DO, Kaiser MG. Simulation in neurosurgery: A review of computer-based simulation environments and their surgical applications. Neurosurgery 2010;67:1105-16.
  • 38 Doyle WK. Low end interactive image-directed neurosurgery. Update on rudimentary augmented reality used in epilepsy surgery. Stud Health Technol Inform 1996;29:1-1.
  • 39 Gnanakumar S, Kostusiak M, Budohoski KP, Barone D, Pizzuti V, Kirollos R, et al. Effectiveness of cadaveric simulation in neurosurgical training: A review of the literature. World Neurosurg 2018;118:88-96.
  • 40 Duguid A, Arundell M, Bainbridge L. How to set up and run a cadaveric surgical simulation programme. Bulletin 2016;98:358-61.
  • 41 Why there is a Shortage of Cadavers. Available from: https://www.economist.com/blogs/economist-explains/2014/01/economist-explains-10. [Last accessed on 2017 Aug 28].
  • 42 Gomoll AH, O'Toole RV, Czarnecki J, Warner JJ. Surgical experience correlates with performance on a virtual reality simulator for shoulder arthroscopy. Am J Sports Med 2007;35:883-8.
  • 43 Jaung R, Cook P, Blyth P. A comparison of embalming fluids for use in surgical workshops. Clin Anat 2011;24:155-61.
  • 44 Gragnaniello C, Nader R, van Doormaal T, Kamel M, Voormolen EH, Lasio G, et al. Skull base tumor model. J Neurosurg 2010;113:1106-11.
  • 45 Payner TD, Melamed I, Ansari S, Leipzig TJ, Scott JA, Denardo AJ, et al. Trends over time in the management of 2253 patients with cerebral aneurysms: A single practice experience. Surg Neurol Int 2011;2:110.
  • 46 Lawton MT, Du R. Effect of the neurosurgeon's surgical experience on outcomes from intraoperative aneurysmal rupture. Neurosurgery 2005;57:9-15.
  • 47 Aboud E, Aboud G, Al-Mefty O, Aboud T, Rammos S, Abolfotoh M, et al. “Live cadavers” for training in the management of intraoperative aneurysmal rupture. J Neurosurg 2015;123:1339-46.
  • 48 de Oliveira MM, Ferrarez CE, Ramos TM, Malheiros JA, Nicolato A, Machado CJ, et al. Learning brain aneurysm microsurgical skills in a human placenta model: Predictive validity. J Neurosurg 2018;128:846-52.
  • 49 Winer JL, Kramer DR, Robison RA, Ohiorhenuan I, Minneti M, Giannotta S, et al. Cerebrospinal fluid reconstitution via a perfusion-based cadaveric model: Feasibility study demonstrating surgical simulation of neuroendoscopic procedures. J Neurosurg 2015;123:1316-21.
  • 50 Ciporen JN, Lucke-Wold B, Mendez G, Cameron WE, McCartney S. Endoscopic management of cavernous carotid surgical complications: Evaluation of a simulated perfusion model. World Neurosurg 2017;98:388-96.
  • 51 Cohen AR, Lohani S, Manjila S, Natsupakpong S, Brown N, Cavusoglu MC, et al. Virtual reality simulation: Basic concepts and use in endoscopic neurosurgery training. Childs Nerv Syst 2013;29:1235-44.
  • 52 Rosser JC Jr., Lynch PJ, Cuddihy L, Gentile DA, Klonsky J, Merrell R. The impact of video games on training surgeons in the 21st century. Arch Surg 2007;142:181-6.
  • 53 de Faria JW, Teixeira MJ, de Moura Sousa Júnior L, Otoch JP, Figueiredo EG. Virtual and stereoscopic anatomy: When virtual reality meets medical education. J Neurosurg 2016;125:1105-11.
  • 54 Miller GE. The assessment of clinical skills/competence/performance. Acad Med 1990;65:S63-7.
  • 55 Seagull FJ, Rooney DM. Filling a void: Developing a standard subjective assessment tool for surgical simulation through focused review of current practices. Surgery 2014;156:718-22.
  • 56 Boulet JR, Murray D. Review article: Assessment in anesthesiology education. Can J Anaesth 2012;59:182-92.
  • 57 Berry M, Lystig T, Beard J, Klingestierna H, Reznick R, Lönn L, et al. Porcine transfer study: Virtual reality simulator training compared with porcine training in endovascular novices. Cardiovasc Intervent Radiol 2007;30:455-61.
  • 58 Bagai A, O'Brien S, Al Lawati H, Goyal P, Ball W, Grantcharov T, et al. Mentored simulation training improves procedural skills in cardiac catheterization: A randomized, controlled pilot study. Circ Cardiovasc Interv 2012;5:672-9.
  • 59 Hseino H, Nugent E, Lee MJ, Hill AD, Neary P, Tierney S, et al. Skills transfer after proficiency-based simulation training in superficial femoral artery angioplasty. Simul Healthc 2012;7:274-81.
  • 60 Picard M, Curry N, Collins H, Soma L, Hill J. Comparison of high-fidelity simulation versus didactic instruction as a reinforcement intervention in a comprehensive curriculum for radiology trainees in learning contrast reaction management: Does it matter how we refresh? Acad Radiol 2015;22:1268-76.
  • 61 Luboz V, Zhang Y, Johnson S, Song Y, Kilkenny C, Hunt C, et al. ImaGiNe seldinger:First simulator for seldinger technique and angiography training. Comput Methods Programs Biomed 2013;111:419-34.
  • 62 Reedy G. Using cognitive load theory to inform simulation design and practice. Clin Simul Nurs 2015;11:355-60.
  • 63 Wright MC, Taekman JM, Endsley MR. Objective measures of situation awareness in a simulated medical environment. Qual Saf Health Care 2004;13 Suppl 1:i65-71.