Development of a modelled anatomical replica for training young neurosurgeons

Craven, Claudia; Baxter, David; Cooke, Martyn; Carline, Lydia; Alberti, Samuel J.M.M.; Beard, Jonathan; Murphy, Mary

doi:10.3109/02688697.2014.913775

Cited by 16 publications

(17 citation statements)

References 12 publications

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“…This project builds on the previous development of MARTYN (the adult neurosurgery training head). 3 We assessed 4 main neurosurgical procedures commonly performed on infants to test the model's feasibility and validity as a training tool.…”

Section: Feasibility and Validation Of Babymartynmentioning

confidence: 99%

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Developing a pediatric neurosurgical training model

Craven

Cooke

Rangeley

et al. 2018

Journal of Neurosurgery: Pediatrics

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OBJECTIVEOne 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.METHODSIn 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.RESULTSIn 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.CONCLUSIONSThis 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.

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Section: Feasibility and Validation Of Babymartynmentioning

confidence: 99%

“…Cerebrovascular structures have been developed (albeit for adultMARTYN) and may also be integrated into future prototypes. 3…”

Section: Future Studies and Developmentsmentioning

confidence: 99%

Developing a pediatric neurosurgical training model

Craven

Cooke

Rangeley

et al. 2018

Journal of Neurosurgery: Pediatrics

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“…Other surgical disciplines have successfully implemented simulation tools and considered them as an effective training method [6,7]. However, existing neurosurgical training models, like static simulators and virtual reality (VR) training, do not provide a realistic experience and are hard to use for limited and complex surgical anatomy [8][9][10][11][12]. Intracranial aneurysm microsurgery is also difficult to practice on ex vivo models (human or animal specimens) because vascular pulsatility cannot yet be realistically replicated [1,[13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Neurosurgical simulator for training aneurysm microsurgery—a user suitability study involving neurosurgeons and residents

et al. 2020

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Background Due to its complexity and to existing treatment alternatives, exposure to intracranial aneurysm microsurgery at the time of neurosurgical residency is limited. The current state of the art includes training methods like assisting in surgeries, operating under supervision, and video training. These approaches are labor-intensive and difficult to fit into a timetable limited by the new work regulations. Existing virtual reality (VR)–based training modules lack patient-specific exercises and haptic properties and are thus inferior to hands-on training sessions and exposure to real surgical procedures. Materials and methods We developed a physical simulator able to reproduce the experience of clipping an intracranial aneurysm based on a patient-specific 3D-printed model of the skull, brain, and arteries. The simulator is made of materials that not only imitate tissue properties including arterial wall patency, thickness, and elasticity but also able to recreate a pulsatile blood flow. A sample group of 25 neurosurgeons and residents (n = 16: early residency with less than 4 years of neurosurgical exposure; n = 9: late residency and board-certified neurosurgeons, 4–15 years of neurosurgical exposure) took part to the study. Participants evaluated the simulator and were asked to answer questions about surgical simulation anatomy, realism, haptics, tactility, and general usage, scored on a 5-point Likert scale. In order to evaluate the feasibility of a future validation study on the role of the simulator in neurosurgical postgraduate training, an expert neurosurgeon assessed participants’ clipping performance and a comparison between groups was done. Results The proposed simulator is reliable and potentially useful for training neurosurgical residents and board-certified neurosurgeons. A large majority of participants (84%) found it a better alternative than conventional neurosurgical training methods. Conclusion The integration of a new surgical simulator including blood circulation and pulsatility should be considered as part of the future armamentarium of postgraduate education aimed to ensure high training standards for current and future generations of neurosurgeons involved in intracranial aneurysm surgery.

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“…However, no validity was investigated for the model. The MARTYN bench model was designed to train craniotomy and EVD insertion via burr holes 12 . Both realism and confidence were assessed, with an improvement demonstrated in both parameters.…”

Section: Introductionmentioning

confidence: 99%