113 Testing the Efficacy of Simulation in Neurosurgical Education: First Results of the SENSE Trial

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 223-224
Author(s):  
A Nimer Amr ◽  
Michael Kosterhon ◽  
Eleftherios Archavlis ◽  
Florian Ringel ◽  
Alexander L Green
Keyword(s):  
Skill Acquisition ◽  
Simulation Training ◽  
Neurosurgical Procedures ◽  
Neurosurgical Procedure ◽  
Experienced Surgeon ◽  
Skull Model ◽  
Accuracy Test ◽  
First Results ◽  
Neurosurgical Education ◽  
Blinded Assessor

Abstract INTRODUCTION Surgical education has hitherto relied heavily on the age-old acute;see one, do oneacute; paradigm. Factors such as traineesacute; decreased OR exposure due to worktime directives have put this paradigm to the test. The improvement of surgical skills in simulation laboratories has been touted as a possible solution and adopted in disciplines such as general surgery. We investigated the efficacy of a simulation curriculum on skill acquisition of a neurosurgical procedure (EVD-placement) by means of a single-blinded RCT. METHODS The Simulation Efficacy in Neurosurgical Education (SENSE) trial is a single-blinded RCT with two arms. Recruits to Arm A underwent simulation training (software and cadaver-based), after which they attempted to place an EVD on a plastic skull model. Recruits to the control Arm B witnessed the placement of an EVD by an experienced surgeon, after which attempted the EVD placement. The time needed to undertake the procedure and the accuracy of catheter placement were assessed by a blinded assessor. RESULTS >21 interns/residents were recruited to the trial (Arm A n = 10, Arm B n = 11). There was a significant reduction of the time needed to execute the procedure in the simulation arm vs. the control arm (147.54s vs. 242.72s, P = 0.000961). The simulation arm recruits performed better in the accuracy test, with n = 8 placing the drain correctly (80%), compared with the control arm (n = 3, 27.27%, P = 0.03). The simulation arm recruits reported a statistically significant increase in their confidence in performing the procedure both under supervision (P = 0.016) and independently (P = 0.027) compared to the control arm in subjective questionnaires. CONCLUSION Our results show that skill acquisition in simulation laboratories could be a beneficial tool in neurosurgical education in the age of decreased OR exposure. Further simulation trials are proposed to further investigate the efficacy of simulation in more complex neurosurgical procedures.

Neuroblastoma with intracerebral metastases and the need for neurosurgery: a single-center experience

2020 ◽  
Vol 25 (1) ◽  
pp. 51-56
Author(s):  
Steffen Fleck ◽  
Sascha Marx ◽  
Clara Bobak ◽  
Victoria Richter ◽  
Stephan Nowak ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Neurosurgical Procedures ◽  
Normal Brain ◽  
Indications For Surgery ◽  
Single Center ◽  
Neurosurgical Procedure ◽  
Oncological Treatment ◽  
Single Center Experience ◽  
Stage 4 ◽  
Neurosurgical Treatment

OBJECTIVEIntracerebral metastases in neuroblastoma patients are rare, and information about the indication for and the outcome of neurosurgical procedures in this setting is scarce in the literature. The authors’ aim in the present study was to report a single-center experience with the neurosurgical treatment of intracerebral metastases in neuroblastoma.METHODSThis study is a retrospective single-center analysis of all neurosurgical strategies used in the treatment of intracerebral metastases in neuroblastoma patients.RESULTSBetween 2009 and 2017, 237 pediatric patients (94 girls, 143 boys) with a mean age of 39 months at diagnosis were treated for neuroblastoma. Five (2.1%) of the 237 patients had a neurosurgical procedure for intracerebral metastases. The metastases occurred a mean of 46 months after initial diagnosis. All of these patients had neuroblastoma stage 4. Indications for surgery were recurrent metastases after initial successful oncological treatment or progression of the metastasis under oncological treatment as well as deterioration of neurological function. Intraoperatively, the tumor usually had a distinguishable dissection plane but was infiltrative to adjacent nerves in some spots. Mean overall survival after the neurosurgical procedure was 22 months. Furthermore, in another 3 patients, a neurosurgical procedure was done for an intracranial but extracerebral metastasis.CONCLUSIONSNeurosurgical procedures for intracerebral metastases in neuroblastoma patients are rare and were performed in 2.1% of patients in the present study. Intracerebral metastases occurred during disease progression, and the prognosis after surgery was very limited. The main indications for surgery were rapid neurological deterioration or recurrence of the metastasis after initial successful oncological treatment. Intraoperatively, the metastases usually had a distinguishable dissection plane from the normal brain tissue.

scholarly journals New cost-effective pleural procedure training: manikin-based model to increase the confidence and competency in trainee medical officers

2019 ◽  
Vol 95 (1123) ◽  
pp. 245-250 ◽  
Author(s):  
Subash Heraganahally ◽  
Sumit Mehra ◽  
Daisy Veitch ◽  
Dimitar Sajkov ◽  
Henrik Falhammar ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Online Survey ◽  
Prospective Observational Study ◽  
Simulation Training ◽  
Cost Effective ◽  
Training Model ◽  
Further Training ◽  
Pleural Diseases ◽  
Cost Effective Method

Purpose of the studyPleural diseases are common in clinical practice. Doctors in training often encounter these patients and are expected to perform diagnostic and therapeutic pleural procedures with confidence and safely. However, pleural procedures can be associated with significant complications, especially when performed by less experienced. Structured training such as use of training manikin and procedural skills workshop may help trainee doctors to achieve competence. However, high costs involved in acquiring simulation technology or attending a workshop may be a hurdle. We hereby describe a training model using a simple manikin developed in our institution and provide an effective way to document skill acquisition and assessment among trainee medical officers.Study designThis was a prospective observational study. The need for training, competence and confidence of trainees in performing pleural procedures was assessed through an online survey. Trainees underwent structured simulation training through a simple manikin developed at our institute. Follow-up survey after the training was then performed to access confidence and competence in performing pleural procedures.ResultsForty-seven trainees responded to an online survey and 91% of those expressed that they would like further training in pleural procedure skills. 81% and 85% of responders, respectively, indicated preferred method of training is either practising on manikin or performing the procedure under supervision. Follow-up survey showed improvement in the confidence and competence.ConclusionOur pleural procedure training manikin model is a reliable, novel and cost-effective method for acquiring competences in pleural procedures.

scholarly journals Simulation in Neurosurgery: A Survey of Experiences and Perceptions in the UK

2013 ◽  
Vol 95 (9) ◽  
pp. 304-307 ◽  
Author(s):  
IC Coulter ◽  
PM Brennan
Keyword(s):  
Patient Safety ◽  
Surgical Training ◽  
Skill Acquisition ◽  
Simulation Training ◽  
Surgical Skill ◽  
Hands On ◽  
Form Part ◽  
Apprenticeship Model ◽  
The Uk ◽  
Working Hour

The traditional, time-intensive apprenticeship model of surgical skill acquisition has become impracticable in the current era of working hour restrictions that limit the total hours available for surgical training.1–3 Trainees feel 'hands on' operative exposure has been reduced, having an impact on training as well as patient safety.4 while working hour restrictions persist, simply increasing the length of surgical training will not adequately overcome reduced exposure to operative training. Improving quality and efficiency of training must therefore utilise learning outside the operating theatre; simulation training could form part of this.

scholarly journals P.061 Stroke Care and Neurological Emergency Response Simulation (SCaNERS): Creation and Implementation into a Resident Curriculum

2021 ◽  
Vol 48 (s3) ◽  
pp. S36-S36
Author(s):  
K Archibold ◽  
B Graham
Keyword(s):  
Acute Stroke ◽  
Skill Acquisition ◽  
Simulation Training ◽  
Stroke Care ◽  
High Fidelity ◽  
Risk Environment ◽  
Acute Stroke Care ◽  
Therapeutic Goals ◽  
Professional Activities ◽  
Competency Based

Background: Resident physicians often observe stroke alerts before managing them alone. However, this practice exposes patients to potential harm from trainees’ lack of experience. To address this, we created a acute stroke simulation course. Simulation training offers a low-risk environment for skill acquisition, complimenting the Royal College’s recent transition away from a time-based to competency-based learning curriculum. The purpose of this project was to develop and implement a stroke simulation training program into resident neurology rotations at the University of Saskatchewan. Methods: Six high-fidelity acute stroke simulation cases were developed with the aid of a Simulation Operation Specialist. We identified objectives corresponding to Royal College Entrustable Professional Activities for Adult Neurology encompassing several diagnostic and therapeutic goals of acute stroke care. To increase fidelity, a standardized patient was recruited and trained on how to respond to neurologic exams given a specific stroke syndrome. A standardized debrief was given after each session in a safe, non-judgemental environment. Results: Simulation sessions have been running monthly since March 25, 2021. Conclusions: The creation and implementation of high-fidelity simulation training into a resident curriculum is feasible. Ongoing data is being collected to explore residents’ experiences and knowledge improvement in stroke, and to asses local reductions in treatment delays.

scholarly journals Incidence of emergency neurosurgical TBI procedures: a population-based study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Cathrine Tverdal ◽  
Mads Aarhus ◽  
Pål Rønning ◽  
Ola Skaansar ◽  
Karoline Skogen ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Incidence Rates ◽  
University Hospital ◽  
Neurosurgical Procedures ◽  
Trauma Centers ◽  
Pressure Monitor ◽  
Severe Injuries ◽  
Neurosurgical Procedure ◽  
Standard Population

Abstract Background The rates of emergency neurosurgery in traumatic brain injury (TBI) patients vary between populations and trauma centers. In planning acute TBI treatment, knowledge about rates and incidence of emergency neurosurgery at the population level is of importance for organization and planning of specialized health care services. This study aimed to present incidence rates and patient characteristics for the most common TBI-related emergency neurosurgical procedures. Methods Oslo University Hospital is the only trauma center with neurosurgical services in Southeast Norway, which has a population of 3 million. We extracted prospectively collected registry data from the Oslo TBI Registry – Neurosurgery over a five-year period (2015–2019). Incidence was calculated in person-pears (crude) and age-adjusted for standard population. We conducted multivariate multivariable logistic regression models to assess variables associated with emergency neurosurgical procedures. Results A total of 2151 patients with pathological head CT scans were included. One or more emergency neurosurgical procedure was performed in 27% of patients. The crude incidence was 3.9/100,000 person-years. The age-adjusted incidences in the standard population for Europe and the world were 4.0/100,000 and 3.3/100,000, respectively. The most frequent emergency neurosurgical procedure was the insertion of an intracranial pressure monitor, followed by evacuation of the mass lesion. Male sex, road traffic accidents, severe injury (low Glasgow coma score) and CT characteristics such as midline shift and compressed/absent basal cisterns were significantly associated with an increased probability of emergency neurosurgery, while older age was associated with a decreased probability. Conclusions The incidence of emergency neurosurgery in the general population is low and reflects neurosurgery procedures performed in patients with severe injuries. Hence, emergency neurosurgery for TBIs should be centralized to major trauma centers.

Prospective, Randomized Assessment of Transfer of Training (ToT) and Transfer Effectiveness Ratio (TER) of Virtual Reality Simulation Training for Laparoscopic Skill Acquisition

2013 ◽  
Vol 257 (6) ◽  
pp. 1025-1031 ◽  
Author(s):  
Anthony G. Gallagher ◽  
Neal E. Seymour ◽  
Julie-Anne Jordan-Black ◽  
Brendan P. Bunting ◽  
Kieran McGlade ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Skill Acquisition ◽  
Transfer Of Training ◽  
Simulation Training ◽  
Laparoscopic Skill ◽  
Virtual Reality Simulation
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