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  • Introduction of a Validated Trauma Craniotomy Simulator to Complement Resident Education in Neurosurgical Trauma Procedures at the 2012 CNS Simulation Symposium

    Final Number:

    Darlene Angela Lobel MD; Clemens M. Schirmer MD PhD; James Bradley Elder MD; Mark W Bowyer MD, FACS; Ali R. Rezai MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Simulation-based technologies are gaining increasing relevance to complement standard didactic and clinical resident training strategies. The Congress of Neurological Surgeons (CNS) Simulation Committee developed a course-based simulation curriculum which incorporated a trauma module to train residents in skills critical to neurosurgical trauma procedures.

    Methods: A trauma simulation module was offered to neurosurgical trainees during the CNS Simulation Symposium at the 2012 CNS meeting. The module incorporated both didactic training and hands-on sessions with simulators, including a physical model craniotomy simulator (Operative Experience, Inc, North East, MD, Figure 1A). Written and practical tests, along with pre- and post-course questionnaires were used to assess improvement in skill level and validate the simulator as a teaching tool. Performance measures included knowledge of anatomy, incision planning, bur hole placement, craniotomy size, and complication management, among other criteria (Table 1).

    Results: Fifteen trainees participated in the trauma module didactic section. Average performance improved significantly in written scores from pre-test (75%) to post-test (87.5%, p<0.05). Eight participants completed the trauma craniotomy simulator. In the pre-training evaluation, senior residents (PGY4-7) demonstrated greater facility in skin flap planning and bur hole placement (CA test p<0.03) and significantly better dexterity (CA test p<0.05) than the junior group (PGY1-3), confirming construct validity of the simulator. After training with faculty, junior residents improved significantly in incision planning and bur hole placement (p<0.04, Figure 2), and showed the greatest improvement overall (Figure 3). Craniotomy size was judged ideal in 63% of attempts after training, significantly improved from 38% (p=0.24, CA test p<0.05) (Figure 1B). Post-course questionnaires supported the simulator as an anatomically accurate and clinically relevant representation of a trauma craniotomy, supporting face and content validity of the simulator.

    Conclusions: The trauma craniotomy simulator introduced at the 2012 CNS Simulation Symposium provides a validated model to enhance resident training in neurosurgical trauma procedures using simulation.

    Patient Care: Introduction of a validated craniotomy simulator model into neurosurgical resident education may enhance current training techniques and may increase patient safety by allowing trainees to first hone surgical skills using a simulator.

    Learning Objectives: By the conclusion of this sessions, participants should be able to: 1 Discuss the benefits of simulation based technologies as an adjunct to standard resident education techniques 2 Describe common validation measures used to assess efficacy of simulators 3 Discuss the role of the trauma craniotomy simulator in enhancing the training experience of neurosurgical residents


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