Developing a pediatric neurosurgical training model

Abstract

<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>One of the greatest challenges of pediatric neurosurgery training is balancing the training needs of the trainee against patient safety and parental expectation. The traditional “see one, do one, teach one” approach to training is no longer acceptable in pediatric neurosurgery. The authors have developed the baby Modeled Anatomical Replica for Training Young Neurosurgeons (babyMARTYN). The development of this new training model is described, its feasibility as a training tool is tested, and a new approach of integrating simulation into day-to-day training is suggested.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>In part 1 (development), a prototype skull was developed using novel model-making methods. In part 2 (validation), 18 trainee neurosurgeons (at various stages in training) performed the following 4 different procedures: 1) evacuation of a posterior fossa hematoma; 2) pterional craniotomy; 3) tapping of the fontanelle to obtain a CSF specimen; and 4) external ventricular drain insertion. Completion of the procedural stages (scored using a curriculum-based checklist) was used to test the feasibility of babyMARTYN as a training tool. Likert scale–based questionnaires were used to assess the model for face and content validity. Training benefit was assessed using pre- and posttraining ratings on the Physician Performance Diagnostic Inventory Scale (PPDIS). To determine the significance of improvement in median PPDIS score, the Wilcoxon matched-pairs signed-rank test was performed.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>In part 1 (development), the model was successfully developed with good fidelity. In part 2 (validation), the validation data demonstrated feasibility, face, and content validity. The PPDIS score significantly increased for all groups after babyMARTYN training, thereby indicating a potential future role for babyMARTYN in the training of pediatric neurosurgeons.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>This recent collaborative neurosurgical development by the Royal College of Surgeons of England is designed to supplement current neurosurgical training. High-fidelity, portable, operation-specific models enable preoperative planning and have the potential to be used in an operating room environment prior to novel operations. A “see one, simulate one, do one” approach for pediatric neurosurgical training using babyMARTYN is suggested.</jats:p></jats:sec>

The effectiveness of the Peyton’s 4-step teaching approach on skill acquisition of procedures in health professions education: A systematic review and meta-analysis with integrated meta-regression

“…In this phase of the selection process 405 records were excluded. The full-texts of the remaining 37 records were assessed for eligibility and 23 records were excluded with the following reasons: 12 records reported an intervention, which was not eligible for inclusion ( Bode et al, 2012 ; Bube, Konge & Hansen, 2017 ; Craven et al, 2018 ; Custers et al, 1999 ; Handley & Handley, 1998 ; Hill et al, 2010 ; Holmes et al, 1998 ; Krautter et al, 2015 ; Liu & Hunt, 2017 ; Velmahos et al, 2004 ; Wirth et al, 2018 ; Yoganathan et al, 2018 ); 8 records used a study design, which was not eligible for inclusion ( Easton, Stratford-Martin & Atherton, 2012 ; Mishra & Dornan, 2003 ; Nikendei et al, 2014 ; Schroder et al, 2017 ; Skrzypek et al, 2018 ; Smith et al, 2019 ; Sopka et al, 2012 ; Tommaso, 2016 ); 2 records were excluded because of missing data ( Archer, Van Hoving & De Villiers, 2015 ; Seymour-Walsh et al, 2015 ) and 1 record did not use the specified primary outcome assessment for procedural skills ( Greif et al, 2010 ). Finally, 14 studies were included into this systematic review.…”

The evolution of an SBNS-accredited NANSIG simulated skills workshop for aspiring neurosurgical trainees: an analysis of qualitative and quantitative data

“…Conversely, another VR simulator study confirmed that simulator performance reflects surgeons' ability to place an EVD correctly [30]. Examples of physical simulator models other than ROWENA include MARTYN [23], babyMARTYN [8], Sinus Model Oto-Rhino Neuro Trainer (SIMONT) [11] and the OMeR model (for simulation of deep microvascular anastomosis procedures) [17]. Qualitative and quantitative benefits from neurosurgical simulation have been widely described [9,11,15], although there exists a lack of standardised methodology and long-term follow-up within studies investigating the effects of simulation upon trainee skill acquisition and patient outcomes.…”

Simulation with 3D Neuronavigation for Learning Cortical Bone Trajectory Screw Placement

“…Items tested in PPDIS were the following: using of awl, using of ball-tip probe, performance of procedure, knowledge of anatomy, and economy of movements/efficiency of procedure. 9,15 Technique Implementation…”

“…2,4 Nevertheless, in recent years, the interest in developing new simulators has increased, because the advancing technology allows creating models with reliable tissue interfaces adequately representing surgical landmarks. 3,9 Today, both trained surgeons and trainees broadly accept the use of modern simulators. This fact has been recognized by entities such as the Joint Committee on Surgical Training.…”