Introduction: Present carotid endarterectomy (CEA) simulators are often expensive to construct, contain biological hazards, and globally inaccessible. We sought to design a virtual, mobile-based CEA simulator that users could access on a personal handheld device.
Methods: We devised a protocol for performing a CEA and created a 3D, animated version of the procedure. Electronic files were subsequently coded into iOS and Android platforms and a mobile application (app) was developed for the Apple App and Google Play Stores. Our CEA module interacted with users through tactile feedback and was built with learn and test modes. The learn mode taught users how to perform the procedure and contained 113 steps while the test mode assessed users procedural knowledge and included 94 multiple-choice questions. Figures 1 and 2 depict mobile phone screenshots of the learn and test modes, respectively. User data were prospectively collected from July 2014 to November 2015.
Results: We created a free, mobile-based CEA simulator for iOS and Android operating systems. Over a 16-month period, 24,954 users from 6 continents (55% North America, 25% Europe, 11% South America, 6% Asia, 2% Africa and 1% Australia) downloaded the module. Users consisted of of 53% medical professionals (16% attending physicians, 8% resident physicians, 23% medical students, 6% other) and 47% non-medical professionals. Users completed 2,823 hours (1,571 hours with learn mode & 1,252 hours with test mode) of simulation time.
Conclusions: Creation of a mobile-based CEA simulator is achievable. We attained increased usability by making the module straightforward to download, accessible on mobile devices and cost-free. These characteristics make this type of simulator design pertinent to global neurosurgical training.
Patient Care: This carotid endarterectomy simulator will improve patient care by allowing surgeons, residents and other medical professionals to rehearse critical steps of the procedure on a mobile device.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of a CEA simulator, 2) Discuss, in small groups, the global applicability of mobile-based simulators, and 3) Identify future modalities of neurosurgical simulation.