A novel craniotomy simulator provides a validated method to enhance education in the management of traumatic brain injury.
BACKGROUND
In a variety of surgical specialties, simulation-based technologies play an important role in resident training. The Congress of Neurological Surgeons (CNS) established an initiative to enhance neurosurgical training by developing a simulation-based curriculum to complement standard didactic and clinical learning.


OBJECTIVE
To enhance resident education in the management of traumatic brain injury by the use of simulation-based training.


METHODS
A course-based neurosurgical simulation curriculum was developed and offered at the 2012 CNS annual meeting. Within this curriculum, a trauma module was developed to teach skills necessary in the management of traumatic brain injury, including the performance of craniotomy for trauma. Didactic and simulator-based instruction were incorporated into the course. Written and practical pre- and posttests, as well as questionnaires, were used to assess the improvement in skill level and to validate the simulator as a teaching tool.


RESULTS
Fourteen trainees participated in the didactic section of the trauma module. Average performance improved significantly in written scores from pretest (75%) to posttest (87.5%, P < .05). Eight participants completed the trauma craniotomy simulator. Incision planning, burr hole placement (P < .02), and craniotomy size (P < .05) improved significantly. Junior residents (postgraduate years 1-3) demonstrated the most improvement during the course.


CONCLUSIONS
The CNS simulation trauma module provides a complementary method for residents to acquire necessary skills in the management of traumatic brain injury. Preliminary data indicate improvement in didactic and hands-on knowledge after training. Additional data are needed to confirm the validity of the simulator.
*Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota ‡Department of Neurological Surgery, The Ohio State University Medical Center, Columbus, Ohio §Division of Neurosurgery, Baystate Medical Center, Springfield, Massachusetts ‖Department of Neurosurgery, Tufts University School of Medicine, Boston, Massachusetts ¶The Norman M. Rich Department of Surgery, Uniformed Services University, Bethesda, Maryland.
Darlene A
DA
Lobel
J Bradley
JB
Elder
Clemens M
CM
Schirmer
Mark W
MW
Bowyer
Ali R
AR
Rezai
D059925:Anatomic Landmarks; D001930:Brain Injuries / Q000473:pathology / Q000601:surgery*; D002983:Clinical Competence; D003198:Computer Simulation; D003399:Craniotomy / Q000193:education*; D003479:Curriculum; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D007431:Intraoperative Complications / Q000175:diagnosis / Q000628:therapy; D008887:Military Medicine; D008953:Models, Anatomic; D009493:Neurosurgery / Q000193:education*