The role of simulation in neurosurgery

Abstract

It is increasingly apparent that the standards for surgical training are shifting from time-based to criterion-based parameters that emphasize obtaining and maintaining competencies [24]. The formation of a surgeon demands significant dedication and effort, in addition to time [54]. Current, wellestablished methods of surgical training are being challenged as the environment becomes increasingly competitive and litigious with greater scrutiny of patient outcomes [14,17,40,44,50]. In order to increase patient safety and improve treatment outcomes, several strategies such as problem-based learning and objective structured clinical examinations have promoted the development of new curricula in surgical education [13,15,35,51,52].Some of these changes have been driven by events in the 1980s and 1990s such as medical misconduct and overworked, unsupervised resident staff that contributed to patient morbidity and mortality. This also coincided with a growing medical malpractice crisis. As a result, regulatory bodies began to initiate new standards of work hour restrictions and supervision for residents in training. The New York Health Code of 1989 compiled regulations restricting resident work hours (80 h per week) and one day free a week and placed limits on the number of calls [24,32]. Concerns arose about the long-established methods of training surgical residents, and solutions were sought to reduce preventable errors and perioperative complications [24,9].The airline industry, with the development of flight simulators and pilot coaching methods, proved to be an excellent precedent for innovation in surgical education. Many surgical educators believe such methods are keys to accelerating the acquisition of fundamental skills and the rate of performance improvement among surgical residents. A Yale University study demonstrated that criterion-based simulator training decreased operating time by 30 % and operative errors by 85 % [47,48].

The use of non-living animals as simulation models for cranial neurosurgical procedures: a literature review

“…The importance of simulation is well-ingrained in the field of surgical training [3,5]. Various models, both synthetic and biologic, are available as simulators [6].…”

“…Simulation is a well-established practice in emergency medicine and other non-medical fields, including aeronautics and the military [ 2 ]. It also plays a pivotal role in neurosurgical training by allowing trainees to develop the requisite expertise to enhance patient safety [ 3 – 5 ]. A wide range of biological and non-biological materials have been used in the neurosurgical simulation, including live animals, cadavers, synthetic, and computer-based models [ 6 ].…”

História da simulação cirúrgica e sua aplicação em Neurocirurgia

“…Muitos educadores acreditam que tais métodos são a chave para apressar a aquisição de habilidades fundamentais e, assim, obter a melhoria de desempenho entre os residentes em medicina clínica e cirúrgica. Um estudo da Universidade de Yale demonstrou que o treinamento com simulador diminuiu em 30% o tempo cirúrgico e reduziu os erros intraoperatórios em 85% [13,14].…”

O papel da simulação na prática cirúrgica e a criação de uma nova ferramenta para treinamento neurocirúrgico

“…A formação de um cirurgião exige significativa dedicação e esforço, além de tempo. Atualmente, métodos bem estabelecidos de treinamento cirúrgico estão sendo desafiados, já que o ambiente está crescentemente competitivo e litigioso, com maior controle da evolução dos pacientes [2][3][4][5]. A prática neurocirúrgica requer alto nível de competência técnica e produz notáveis consequências quando há erro, entretanto, há poucas oportunidades para jovens cirurgiões praticarem os casos mais complicados.…”