Development, outcome and costs of a simulation-based neurosurgery bootcamp at the national level

Abstract

Introduction With a growing interest in simulation-based training to develop clinical proficiency, bootcamps have been utilized for imparting basic skills to medical trainees. While considerable research on the topic exists in high income countries, no such neurosurgical teaching standards have been employed in Low- and Middle-Income Countries. Methods We conducted a cross-sectional study to explore the effectiveness of first low-cost, multi-center regional neurosurgery bootcamp in South Asia. Twenty-two participants attended the bootcamp and practiced 12 hands-on skills over the course of 2 days. Burr-holes and craniotomies were done on 3D printed skulls. Lumbar drain insertion was practiced on a purpose-built lumbar puncture mannequin. For laminectomy, we used an in-house designed simulation. The modified Objective Structured Assessment of Technical Skills tool was utilized for skills Assessment. Feedback from faculty and residents was collected via a standard 5-point Likert scale. Results Only one participant (4.55%) had previously attended a neurosurgical skills workshop. Comparison of outcomes on 1st and 3rd attempts of cranial and spinal skills showed a significant improvement in all 14 domains assessed (p <0.05). Positive feedback was received ranging from 3.9 up to 4.8 on a 5-point Likert scale. Overall cost per participant culminated to $145, significantly lower than previously reported data. Conclusion Our findings report the effectiveness of sustainable, low-cost training models which can be easily reproduced elsewhere. These indigenously designed simulators can be modified for variable difficulty level and serve as an effective educational strategy in improving learners’ skills, knowledge and confidence.

Dural Closure Training With Prototyped Model

“…Among these, four gave the maximum score, while 71.4% considered it essential. In a concurrent investigation, Bakhshi et al (2022) reported that, among the 22 apprentices evaluated, only one (4.55%) had previously participated in a neurosurgical skills workshop [ 20 ]. This scenario reiterates the observation that, although training in 3D simulators is accessible and low-cost, it is a rarity in neurosurgery residency programs, despite representing a response to a need identified by residents around the world.…”