Introduction: Validated simulation curricula have not yet been established in Neurosurgery. To this aim, we used our validated microanastomosis grading scale (Northwestern Objective Microanastomosis Assessment Tool – NOMAT) and pre/post lecture questions to evaluate the effects of a microanastomosis simulation curriculum on resident technical skills and microanastomosis related knowledge at the 2012 Congress of Neurological Surgeons annual meeting.
Methods: A microanastomosis module consisting of surgical microscopes, 3 mm silicon vessels and 8-O nylon sutures was replicated in the simulation-based neurosurgical training course that was held at the 2012 Congress of Neurological Surgeons (CNS) annual meeting. The experiment was divided into three phases: (1) a cognitive and practical pre-testing phase, (2) a didactic lecture (3) a cognitive and practical post-testing phase. We compared data collected from the cognitive and practical pre-testing with data collected form the cognitive and practical post-testing.
Results: One neurosurgeon and seven neurosurgery residents from six countries participated in the study. None of the particpants had significant previous experience in microvascular surgery. None of the participants was able to complete the anastomosis within the allocated 20 minutes. However, the number of completed microanstomoses at the end of each procedure was significantly higher for all subjects in the post-testing phase (p = 0.03). The average score for subjects on the practical pre-test and post-test, as measured by the NOMAT scale, was 32.50 (range: 21 – 46) and 39.75 (range: 26 – 49), respectively. This increase was found to be statistically significant (p = 0.0005). Similarly, the average score for subjects on the cognitive post-test (average = 12.75, range: 10 – 15) was significantly better than that on the cognitive pre-test (average = 8.38, range: 6 – 12) (p = 0.0008).
Conclusions: An educational curriculum consisting of didactic and hands on components can enhance knowledge and technical skill in microsurgery.
Patient Care: Simulation helps improve residents' surgical performance. Thus the present research can help improve patient care by avoiding mistakes due to lack of practice.
Learning Objectives: An educational curriculum consisting of didactic and hands on components can enhance knowledge and technical skill in microsurgery.