title: Neuro-critical care skills training using a human patient simulator.
abstract: BACKGROUND
  Neurosurgical trainees regularly encounter critical care situations. Traditionally, education was accomplished through lecture and experience. Increasingly, human patient simulators (HPS) are employed, allowing trainees to sharpen skills in a safe and realistic environment. We describe our experience using HPS in neurosurgical training.
  
  
  METHODS
  We developed a critical care training program for residents and medical students using HPS. We used a hi-fidelity, lifelike Human Patient Simulator™ (HPS™) produced by Medical Education Technologies, Inc.™ to simulate realistic scenarios for trainee education. Topics included spinal shock, closed head injury, and cerebral vasospasm. A three-way evaluation model was employed to test validity, including pre- and post-exercise testing, survey feedback, and videotaped replay. The simulation exercises were conducted by a neuro-critical care attending, a senior neurosurgical resident, and a HPS technician.
  
  
  RESULTS
  We currently have 29 participants. On a 20-point critical care multiple-choice exam for these participants, average improvement has been 4.5 points or 25%. In subgroup analysis, average improvement was 4.75 points (24%) amongst neurosurgery residents, 3.07 points (18%) amongst neurology residents, 7 points (38%) amongst general surgery residents, and 7 points (38%) amongst senior medical students. Post-exercise evaluations were overwhelmingly positive.
  
  
  CONCLUSIONS
  Neurosurgical critical care education is important for safe and effective care for patients. Clinical experience and didactic lectures help trainees obtain a solid knowledge base, but do not provide the benefit for learning in a fail-safe environment. Through the use of HPS, we have enhanced the critical care education of our trainees.
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, 1725 W. Harrison Ave, Suite 1115, Chicago, IL 60612, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Musacchio
authors.forename: Adam P
authors.initials: AP
authors.lastname: Smith
authors.forename: Christopher A
authors.initials: CA
authors.lastname: McNeal
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Munoz
authors.forename: David M
authors.initials: DM
authors.lastname: Rothenberg
authors.forename: Kelvin A
authors.initials: KA
authors.lastname: von Roenn
authors.forename: Richard W
authors.initials: RW
authors.lastname: Byrne
mesh_terms: D003422:Critical Care / Q000592:standards*; D004501:Education, Medical; D004867:Equipment Design; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D008348:Manikins; D009493:Neurosurgery / Q000379:methods*; D016544:Patient Simulation; D013337:Students, Medical; D013663:Teaching / Q000379:methods