Model-based simulation for early neurosurgical learners.
BACKGROUND
Restrictions on duty hours and shift length by the Accreditation Council for Graduate Medical Education and public pressure to reduce complications and to improve outcomes in the clinical educational environment have enhanced interest in the use of procedural and surgical simulation to train neurosurgical residents.


OBJECTIVE
To introduce simple, available, and, when possible, inexpensive model-based simulation for early learners into the initial stages of neurosurgical residency training.


METHODS
Simulation for early-stage trainees in neurological surgery has taken advantage of model-based systems. The Society of Neurological Surgeons postgraduate year 1 courses have served as one paradigm for designing and using model-based simulators for procedural and surgical skill training as part of a purpose-designed overall curriculum. Ongoing surveys of resident and faculty course participants have supported iterative improvements in simulator models and curriculum from year to year.


RESULTS
Simulation for basic neurosurgical and intensive care procedures has been undertaken through the use of available materials, surgical technology, and modifications of related existing model simulators. Simulation of common, standard surgical procedures for early learners may be broken into individual surgical skills and maneuvers to prepare trainees for safe practice of these component skills during live procedures under direct supervision appropriate to their training stage.


CONCLUSIONS
Model-based simulation is particularly effective for early surgical learners as part of a coordinated curriculum. Almost 600 residents have used model-based simulation during the first 3 years of the Society of Neurological Surgeons boot camp courses, with ongoing modification and improvement of individual simulation models.
*Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; ‡Neurological Surgery Division, Loyola University Medical Center, Maywood, Illinois; §Department of Neurological Surgery Emory University, Atlanta, Georgia; ¶Department of Neurosurgery, Rush University, Chicago, Illinois.
Nathan R
NR
Selden
Thomas C
TC
Origitano
Costas
C
Hadjipanayis
Richard
R
Byrne
D001921:Brain / Q000033:anatomy & histology / Q000601:surgery; D002983:Clinical Competence; D003399:Craniotomy / Q000193:education; D003479:Curriculum; D003625:Data Collection; D004388:Dura Mater / Q000033:anatomy & histology / Q000601:surgery; D004521:Educational Measurement; D006801:Humans; D020407:Internet; D007396:Internship and Residency; D008953:Models, Anatomic; D009493:Neurosurgery / Q000193:education*