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Simulation Training Curricula for Neurosurgical Residents: Cervical Foraminotomy and Durotomy Repair Modules.
World Neurosurg 2015; 84(3):751-5.e1-7WN

Abstract

INTRODUCTION

Since 2010, the Congress of Neurological Surgeons (CNS) has offered a neurosurgical skills simulation course for residents and medical students. The authors describe their experience with incorporation of two neurosurgical skills simulation modules into the dedicated resident training curriculum of a single ACGME-accredited training program, using lumbar dural repair (5) and posterior cervical laminoforaminotomy modules from the CNS simulation initiative (6).

METHODS

Each of the available 22 neurosurgery residents at a single residency program was given two 20-question pretests for a cervical laminoforaminotomy and durotomy repair module as a basic test of regional anatomy, general disease knowledge, surgical decision making, and recently published literature. This was followed by a faculty-directed skills simulation course and concluded with a final 20 question post-test.

RESULTS

Posterior cervical laminoforaminotomy was performed once by each resident, and grading was conducted using the predetermined OSATs. The overall score was 56.1 (70%, range 26-76, maximum 80 points) with a trend towards higher scores with advanced levels of training. All residents completed the durotomy repair OSATs for a total of three trials. Of a maximum composite score of 60, a mean 37.2 (62%, range 15-58) was scored by the residents (Table 3). The mean OSAT scores for each durotomy trial was 2.66, 3.15, and 3.48 on each success test. A trend towards higher scores in advanced years of training was observed, but did not reach statistical significance (Figure 3).

CONCLUSIONS

Duty hour limitations and regulatory pressure for enhanced quality and outcomes may limit access of neurosurgical residents to fundamental skills training. Fundamental skills training as part of a validated simulation curriculum can mitigate this challenge to residency education. National development of effective technical simulation modules for use in individual residency training programs is a promising strategy to achieve these goals.

Authors+Show Affiliations

Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. Electronic address: Georgeghobrial@gmail.com.Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.Department of Neurological Surgery, Tulane University, New Orleans, Louisiana, USA.Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.Campagna Professor of Pediatric Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA.Professor of Neurological Surgery, Thomas Jefferson University Hospital, Department of Neurological Surgery, Philadlephia, Pennsylvania, USA.Professor of Neurological Surgery, Thomas Jefferson University Hospital, Department of Neurological Surgery, Philadlephia, Pennsylvania, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25957725

Citation

Ghobrial, George M., et al. "Simulation Training Curricula for Neurosurgical Residents: Cervical Foraminotomy and Durotomy Repair Modules." World Neurosurgery, vol. 84, no. 3, 2015, pp. 751-5.e1-7.
Ghobrial GM, Balsara K, Maulucci CM, et al. Simulation Training Curricula for Neurosurgical Residents: Cervical Foraminotomy and Durotomy Repair Modules. World Neurosurg. 2015;84(3):751-5.e1-7.
Ghobrial, G. M., Balsara, K., Maulucci, C. M., Resnick, D. K., Selden, N. R., Sharan, A. D., & Harrop, J. S. (2015). Simulation Training Curricula for Neurosurgical Residents: Cervical Foraminotomy and Durotomy Repair Modules. World Neurosurgery, 84(3), pp. 751-5.e1-7. doi:10.1016/j.wneu.2015.04.056.
Ghobrial GM, et al. Simulation Training Curricula for Neurosurgical Residents: Cervical Foraminotomy and Durotomy Repair Modules. World Neurosurg. 2015;84(3):751-5.e1-7. PubMed PMID: 25957725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simulation Training Curricula for Neurosurgical Residents: Cervical Foraminotomy and Durotomy Repair Modules. AU - Ghobrial,George M, AU - Balsara,Karl, AU - Maulucci,Christopher M, AU - Resnick,Daniel K, AU - Selden,Nathan R, AU - Sharan,Ashwini D, AU - Harrop,James S, Y1 - 2015/05/07/ PY - 2015/02/26/received PY - 2015/04/27/revised PY - 2015/04/27/accepted PY - 2015/5/11/entrez PY - 2015/5/11/pubmed PY - 2015/12/15/medline KW - Cervical foraminotomy KW - Durotomy repair KW - Resident education KW - Simulation SP - 751-5.e1-7 JF - World neurosurgery JO - World Neurosurg VL - 84 IS - 3 N2 - INTRODUCTION: Since 2010, the Congress of Neurological Surgeons (CNS) has offered a neurosurgical skills simulation course for residents and medical students. The authors describe their experience with incorporation of two neurosurgical skills simulation modules into the dedicated resident training curriculum of a single ACGME-accredited training program, using lumbar dural repair (5) and posterior cervical laminoforaminotomy modules from the CNS simulation initiative (6). METHODS: Each of the available 22 neurosurgery residents at a single residency program was given two 20-question pretests for a cervical laminoforaminotomy and durotomy repair module as a basic test of regional anatomy, general disease knowledge, surgical decision making, and recently published literature. This was followed by a faculty-directed skills simulation course and concluded with a final 20 question post-test. RESULTS: Posterior cervical laminoforaminotomy was performed once by each resident, and grading was conducted using the predetermined OSATs. The overall score was 56.1 (70%, range 26-76, maximum 80 points) with a trend towards higher scores with advanced levels of training. All residents completed the durotomy repair OSATs for a total of three trials. Of a maximum composite score of 60, a mean 37.2 (62%, range 15-58) was scored by the residents (Table 3). The mean OSAT scores for each durotomy trial was 2.66, 3.15, and 3.48 on each success test. A trend towards higher scores in advanced years of training was observed, but did not reach statistical significance (Figure 3). CONCLUSIONS: Duty hour limitations and regulatory pressure for enhanced quality and outcomes may limit access of neurosurgical residents to fundamental skills training. Fundamental skills training as part of a validated simulation curriculum can mitigate this challenge to residency education. National development of effective technical simulation modules for use in individual residency training programs is a promising strategy to achieve these goals. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/25957725/Simulation_Training_Curricula_for_Neurosurgical_Residents:_Cervical_Foraminotomy_and_Durotomy_Repair_Modules_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(15)00489-1 DB - PRIME DP - Unbound Medicine ER -