Simulation for skills training in neurosurgery: a systematic review, meta-analysis, and analysis of progressive scholarly acceptance

Davids, Joseph; Manivannan, Susruta; Darzi, Ara; Giannarou, Stamatia; Ashrafian, Hutan; Marcus, Hani J.

doi:10.1007/s10143-020-01378-0

Cited by 63 publications

(40 citation statements)

References 124 publications

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“…Many applications were developed for surgical simulation, such as Surgical Theater and ImmersiveTouch. 2,12 However, none of these used photographs of a real human body.…”

Section: Discussionmentioning

confidence: 99%

Virtual dissection of the real brain: integration of photographic 3D models into virtual reality and its effect on neurosurgical resident education

Roh

Jang

et al. 2021

Neurosurgical Focus

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OBJECTIVE Virtual reality (VR) is increasingly being used for education and surgical simulation in neurosurgery. So far, the 3D sources for VR simulation have been derived from medical images, which lack real color. The authors made photographic 3D models from dissected cadavers and integrated them into the VR platform. This study aimed to introduce a method of developing a photograph-integrated VR and to evaluate the educational effect of these models. METHODS A silicone-injected cadaver head was prepared. A CT scan of the specimen was taken, and the soft tissue and skull were segmented to 3D objects. The cadaver was dissected layer by layer, and each layer was 3D scanned by a photogrammetric method. The objects were imported to a free VR application and layered. Using the head-mounted display and controllers, the various neurosurgical approaches were demonstrated to neurosurgical residents. After performing hands-on virtual surgery with photographic 3D models, a feedback survey was collected from 31 participants. RESULTS Photographic 3D models were seamlessly integrated into the VR platform. Various skull base approaches were successfully performed with photograph-integrated VR. During virtual dissection, the landmark anatomical structures were identified based on their color and shape. Respondents rated a higher score for photographic 3D models than for conventional 3D models (4.3 ± 0.8 vs 3.2 ± 1.1, respectively; p = 0.001). They responded that performing virtual surgery with photographic 3D models would help to improve their surgical skills and to develop and study new surgical approaches. CONCLUSIONS The authors introduced photographic 3D models to the virtual surgery platform for the first time. Integrating photographs with the 3D model and layering technique enhanced the educational effect of the 3D models. In the future, as computer technology advances, more realistic simulations will be possible.

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“…Many applications were developed for surgical simulation, such as Surgical Theater and ImmersiveTouch. 2,12 However, none of these used photographs of a real human body.…”

Section: Discussionmentioning

confidence: 99%

Virtual dissection of the real brain: integration of photographic 3D models into virtual reality and its effect on neurosurgical resident education

Roh

Jang

et al. 2021

Neurosurgical Focus

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“…Some studies point to alternative simulations, such as 3D printed simulation devices and a smartphone centred microsurgical skill training programme, in order to maintain training of manual skills [20,30]. Simulation has been demonstrated to be highly beneficial to improve procedural knowledge and technical skills, with a growing trend of adopting neurosurgical simulators [35]. The upside is that the so-called immersive technologies, such as virtual simulation, can often be implemented with the use of existing equipment [3].…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review

et al. 2021

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The COVID-19 pandemic has disrupted neurosurgical training worldwide, with the shutdown of academic institutions and the reduction of elective surgical procedures. This impact has disproportionately affected LMICs (lower- and/or middle-income countries), already burdened by a lack of neurosurgical resources. Thus, a systematic review was conducted to examine these challenges and innovations developed to adapt effective teaching and learning for medical students and neurosurgical trainees. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and The Cochrane Handbook of Systematic Reviews of Interventions. MEDLINE, PubMed, Embase and Cochrane databases were accessed, searching and screening literature from December 2019 to 5th December 2020 with set inclusion and exclusion criteria. Screening identified 1254 articles of which 26 were included, providing data from 96 countries. Twenty-three studies reported transition to online learning, with 8 studies also mentioned redeployment into COVID wards with 2 studies mentioning missed surgical exposure as a consequence. Of 7 studies conducted in LMICs, 3 reported residents suffering financial insecurities from reduced surgical caseload and recession. Significant global disruption in neurosurgical teaching and training has arisen from the COVID-19 pandemic. Decreased surgical exposure has negatively impacted educational provision. However, advancements in virtual technology have allowed for more affordable, accessible training especially in LMICs. Using this, initiatives to reduce physical and mental stress experienced by trainees should be paramount.

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“…While the pandemic has led to some positive educational changes in the UK and globally including more online teaching, an increased use of open access resources 15 , reduced working hours with more time for activities such as research [16][17][18] there is nonetheless evidence of an expected detrimental effect on trainee morale and wellbeing 19 . Furthermore, the effect on operative experience cannot be underestimated and future protections for training using ancillary resources such as simulation should be encouraged and supported 20 .…”

Section: In the Context Of Relevant Literaturementioning

confidence: 99%

Re-visiting the impact of the first wave of COVID-19 on neurosurgical practice and training in a large UK neurosurgery unit: a retrospective review

et al. 2022

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Introduction The response throughout the National Health Service (NHS) to the first wave of coronavirus disease 2019 (COVID-19) was substantial. With repeat winter waves of COVID-19 or other viral pathogens in the future being likely, we sought to review the impact of the response to the first wave on the delivery and training of neurosurgery in a large tertiary neurosurgical centre. Methods We performed a retrospective review over the three-month period of 8th March to 7th June 2020 as indicative of the peak of the pandemic in the UK. For referrals, our online referral portal was reviewed (ORION). For admissions and operations, electronic patient records were reviewed (EPIC systems). Trust wide update emails and policies were also reviewed. Results In response to the pandemic, neurosurgical service provision was severely restricted in the early days of the pandemic in the form of reduced beds, medical and nursing staff and theatres. This was rapidly realised to be unsustainable, and resources were slowly reopened although not to pre-COVID-19 levels. Although referrals did not substantially reduce, the number of elective and emergency admissions, length of stay, theatre efficiency and operative numbers (by pathology and grade of operating surgeon) did significantly reduce except for emergencies performed by consultants. If similar trainee operating numbers would have persisted, this would lead to a significant delay to completion of training. Conclusions All aspects of neurosurgical provision were detrimentally affected due to the rapid response to the first wave of COVID-19 in our institution. Such repeated reductions in acute services such as neurosurgery would be unsustainable. It is pertinent to re-visit these effects in preparation for future infection waves to better protect acute neurosurgical services.

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Simulation for skills training in neurosurgery: a systematic review, meta-analysis, and analysis of progressive scholarly acceptance

Cited by 63 publications

References 124 publications

Virtual dissection of the real brain: integration of photographic 3D models into virtual reality and its effect on neurosurgical resident education

Virtual dissection of the real brain: integration of photographic 3D models into virtual reality and its effect on neurosurgical resident education

The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review

Re-visiting the impact of the first wave of COVID-19 on neurosurgical practice and training in a large UK neurosurgery unit: a retrospective review

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