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Ashraf M, Ismahel H, Shah D, Middleton EES, Gardee A, Chaudhary A, Salloum LA, Evans V, Nelson-Hughes M, Cheng Y, Goonewardena E, Ball E, Minnis M, Anyaegbunam GK, Salim O, Bashir ABBA, Hay S, Ismahel N, Ismahel S, Mackenzie I, Wang W, Shew W, Wynne S, Doherty J, Hassan S, Brown J, Bhattathiri P, Davidson A, Alakandy L. Shaping Perceptions and Inspiring Future Neurosurgeons: The Value of a Hands-On Simulated Aneurysm Clipping Workshops at a Student-Organized Neurosurgical Conference. Asian J Neurosurg 2024; 19:26-36. [PMID: 38751389 PMCID: PMC11093635 DOI: 10.1055/s-0043-1778634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Objective Early exposure to niche specialities, like neurosurgery, is essential to inform decisions about future training in these specialities. This study assesses the impact of a hands-on simulated aneurysm clipping workshop on medical students' and junior doctors' perceptions of neurosurgery at a student-organized neurosurgical conference. Methods Ninety-six delegates were sampled from a hands-on workshop involving hydrogel three-dimensional printed aneurysms clipping using surgical microscopes. Consultant neurosurgeons facilitated the workshop. Changes in delegates' perceptions of neurosurgery were collected using Likert scale and free-text responses postconference. Results Postworkshop, 82% of participants reported a positive impact on their perception of neurosurgery. Thematic analysis revealed that delegates valued the hands-on experience, exposure to microsurgery, and interactions with consultant neurosurgeons. Thirty-six of the 96 delegates (37.5%) expressed that the workshop dispelled preconceived fears surrounding neurosurgery and improved understanding of a neurosurgeon's day-to-day tasks. Several delegates initially apprehensive about neurosurgery were now considering it as a career. Conclusion Hands-on simulated workshops can effectively influence medical students' and junior doctors' perceptions of neurosurgery, providing valuable exposure to the specialty. By providing a valuable and immersive introduction to the specialty, these workshops can help to dispel misconceptions, fears, and apprehensions associated with neurosurgery, allowing them to consider the specialty to a greater degree than before. This study of a one-time workshop cannot effectively establish its long-term impact on said perceptions, however.
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Affiliation(s)
- Mohammad Ashraf
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Hassan Ismahel
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Devansh Shah
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | | | - Ameerah Gardee
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Attika Chaudhary
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Laulwa Al Salloum
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Vivienne Evans
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Meaghan Nelson-Hughes
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Yihui Cheng
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Eranga Goonewardena
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Emma Ball
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Meghan Minnis
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | | | - Omar Salim
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | | | - Sophie Hay
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Nadeen Ismahel
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
| | - Sophia Ismahel
- Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | | | | | - Wenmiao Shew
- Organlike Limited, Scotland, United Kingdom
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Simon Wynne
- Carl Zeiss UK Ltd, Cambridge, United Kingdom
| | - John Doherty
- Aesculap Division, B. Braun Medical Ltd, Sheffield, United Kingdom
| | - Samih Hassan
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Jennifer Brown
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Parameswaran Bhattathiri
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Amy Davidson
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Likhith Alakandy
- Glasgow Neuro Society, Wolfson School of Medicine, University of Glasgow, Scotland, United Kingdom
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
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Cuba M, Vanluchene H, Murek M, Goldberg J, Müller MD, Montalbetti M, Janosovits K, Rhomberg T, Zhang D, Raabe A, Joseph FJ, Bervini D. Training Performance Assessment for Intracranial Aneurysm Clipping Surgery Using a Patient-Specific Mixed-Reality Simulator: A Learning Curve Study. Oper Neurosurg (Hagerstown) 2024; 26:01787389-990000000-01028. [PMID: 38251883 PMCID: PMC11086963 DOI: 10.1227/ons.0000000000001041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/10/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The value of simulation-based training in medicine and surgery has been widely demonstrated. This study investigates the introduction and use of a new mixed-reality neurosurgical simulator in aneurysm clipping surgery, focusing on the learning curve and performance improvement. METHODS Five true-scale craniotomy head models replicating patient-specific neuroanatomy, along with a mixed-reality simulator, a neurosurgical microscope, and a set of microsurgical instruments and clips, were used in the operation theater to simulate aneurysm microsurgery. Six neurosurgical residents participated in five video-recorded simulation sessions over 4 months. Complementary learning modalities were implemented between sessions. Thereafter, three blinded analysts reported on residents' use of the microscope, quality of manipulation, aneurysm occlusion, clipping techniques, and aneurysm rupture. Data were also captured regarding training time and clipping attempts. RESULTS Over the course of training, clipping time and number of clipping attempts decreased significantly (P = .018, P = .032) and the microscopic skills improved (P = .027). Quality of manipulation and aneurysm occlusion scoring improved initially although the trend was interrupted because the spacing between sessions increased. Significant differences in clipping time and attempts were observed between the most and least challenging patient models (P = .005, P = .0125). The least challenging models presented higher rates of occlusion based on indocyanine green angiography evaluation from the simulator. CONCLUSION The intracranial aneurysm clipping learning curve can be improved by implementing a new mixed-reality simulator in dedicated training programs. The simulator and the models enable comprehensive training under the guidance of a mentor.
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Affiliation(s)
- Miguel Cuba
- Image Guided Therapy, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Hanne Vanluchene
- Image Guided Therapy, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Michael Murek
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Johannes Goldberg
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mandy D. Müller
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matteo Montalbetti
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Katharina Janosovits
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Rhomberg
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - David Zhang
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Raabe
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fredrick J. Joseph
- Image Guided Therapy, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - David Bervini
- Department of Neurosurgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
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Belykh E, Abramov I, Bardonova L, Patel R, McBryan S, Enriquez Bouza L, Majmundar N, Zhao X, Byvaltsev VA, Johnson SA, Singla A, Gupta G, Sun H, Liu JK, Nanda A, Preul MC, Lawton MT. Seven bypasses simulation set: description and validity assessment of novel models for microneurosurgical training. J Neurosurg 2023; 138:732-739. [PMID: 35932275 DOI: 10.3171/2022.5.jns22465] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Microsurgical training remains indispensable to master cerebrovascular bypass procedures, but simulation models for training that accurately replicate microanastomosis in narrow, deep-operating corridors are lacking. Seven simulation bypass scenarios were developed that included head models in various surgical positions with premade approaches, simulating the restrictions of the surgical corridors and hand positions for microvascular bypass training. This study describes these models and assesses their validity. METHODS Simulation models were created using 3D printing of the skull with a designed craniotomy. Brain and external soft tissues were cast using a silicone molding technique from the clay-sculptured prototypes. The 7 simulation scenarios included: 1) temporal craniotomy for a superficial temporal artery (STA)-middle cerebral artery (MCA) bypass using the M4 branch of the MCA; 2) pterional craniotomy and transsylvian approach for STA-M2 bypass; 3) bifrontal craniotomy and interhemispheric approach for side-to-side bypass using the A3 branches of the anterior cerebral artery; 4) far lateral craniotomy and transcerebellomedullary approach for a posterior inferior cerebellar artery (PICA)-PICA bypass or 5) PICA reanastomosis; 6) orbitozygomatic craniotomy and transsylvian-subtemporal approach for a posterior cerebral artery bypass; and 7) extended retrosigmoid craniotomy and transcerebellopontine approach for an occipital artery-anterior inferior cerebellar artery bypass. Experienced neurosurgeons evaluated each model by practicing the aforementioned bypasses on the models. Face and content validities were assessed using the bypass participant survey. RESULTS A workflow for model production was developed, and these models were used during microsurgical courses at 2 neurosurgical institutions. Each model is accompanied by a corresponding prototypical case and surgical video, creating a simulation scenario. Seven experienced cerebrovascular neurosurgeons practiced microvascular anastomoses on each of the models and completed surveys. They reported that actual anastomosis within a specific approach was well replicated by the models, and difficulty was comparable to that for real surgery, which confirms the face validity of the models. All experts stated that practice using these models may improve bypass technique, instrument handling, and surgical technique when applied to patients, confirming the content validity of the models. CONCLUSIONS The 7 bypasses simulation set includes novel models that effectively simulate surgical scenarios of a bypass within distinct deep anatomical corridors, as well as hand and operator positions. These models use artificial materials, are reusable, and can be implemented for personal training and during microsurgical courses.
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Affiliation(s)
- Evgenii Belykh
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.,2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Irakliy Abramov
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Liudmila Bardonova
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Ruchi Patel
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Sarah McBryan
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Lara Enriquez Bouza
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Neil Majmundar
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.,2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Xiaochun Zhao
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | | | - Stephen A Johnson
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Amit Singla
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Gaurav Gupta
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Hai Sun
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - James K Liu
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Anil Nanda
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Mark C Preul
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Michael T Lawton
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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