Introduction: Neurosurgery training has seen many recent changes including work hour restrictions, increased supervision and more formalized educational goals. Political, economic and social forces have also created an environment where hands on training may be limited. In response, many innovators have used simulators to improve on limited patient interaction. Most simulators are virtual reality with haptic feedback with little to no physical elements. In a combined effort, the University of Florida Departments of Neurosurgery and Anesthesia created a novel “mixed” physical and virtual simulator to mimic the ventriculostomy procedure.
Methods: An initial validation study was carried out at the 2011 AANS meeting. Participants were stratified by experience and scored on time and accuracy. Post experience surveys were then conducted. Based on these results, a second study was developed to evaluate the educational value of a ventriculostomy didactic based on the simulator. Stratified participants were evaluated with a pre and post simulator experience written test, and in addition to simulator experience an educational course was given. Participants were also scored on an initial ventriculostomy and a second post-didactic ventriculostomy. Mean scores were compared using paired t-tests and ANOVA.
Results: 68 participants were evaluated in initial trial. Experience was stratified according to number of ventriculostomies performed (intern 0-10; junior 10-60; senior > 60). Statistically significant results were seen with improved scores in the junior and senior populations compared to the intern. Survey results demonstrated that most believed it would help with future ventriculostomies but did not teach about potential complications. In the second study (n=16) the intern group had a significant improvement in simulator score after the educational course, and experienced residents saw no significant changes their performances.
Conclusions: The mixed reality simulator provides a real life experience, and can be used to educate novice neurological surgeons and improving patient safety.
Patient Care: Our ventriculostomy simulator offers unique training experience to residents improving their skills and knowledge, especially at the novice level, on a life saving procedure.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Understand the changes in neurosurgical educations 2) Understand the role of simulators with real haptic feedback in neurosurgical education
References: 1. Lemole GM Jr, Banerjee PP, Luciano C, Neckrysh S, Charbel FT: Virtual reality in neurosurgical education: part-task ventriculostomy simulation with dynamic visual and haptic feedback. Neurosurgery 2007 Jul; 61(1):142-8; discussion 148-9.