title: Efficacy of a new video-based training model in spinal surgery.
abstract: BACKGROUND
  An important part of neurosurgical training is the improvement of surgical skills. Acquiring microsurgical skills follows a learning curve, influenced by specific exercises, feedback, and training. Aim of training should be rapid learning success. The study shows the way in which video-based training can influence the learning curve.
  
  
  METHODS
  Over a period of 18 months (2011-2012) 12 residents were evaluated in spinal surgery (12 cases per resident) by a skilled evaluator based on different criteria. The evaluation criteria (exposition of important anatomy, intraoperative bleeding, efficacy of using bipolar cauterization) were weighted and added to a single quality-score. The participating residents were divided into two groups. Only one group (n = 5) received video-based training.
  
  
  RESULTS
  Residents showed an individually different but explicit increase in microsurgical skills. The quality-score during the first surgery compared with the end point of the study demonstrated a faster improvement of surgical skills in the group with video-based training than in the group without special training. Considering all residents together, the video-training group displayed a steeper gradient of microsurgical success. Comparison of the single resident's microsurgical skills showed individual disparities. Various biases that influence the learning success are under examination.
  
  
  CONCLUSIONS
  Video-based training can improve microsurgical skills, leading to an improved learning curve. An earlier entry of the learning curve plateau in the video-training group promotes a higher acquisition of surgical skills. Because of the positive effect, we plan to apply the video-based training model to other neurosurgical subspecialties, especially neurovascular and skull base surgery.
authors.affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.
authors.forename: D H
authors.initials: DH
authors.lastname: Heiland
authors.affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.
authors.forename: A K
authors.initials: AK
authors.lastname: Petridis
authors.affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Maslehaty
authors.affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Thissen
authors.affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kinzel
authors.affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Scholz
authors.affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Schreiber
keywords: Learning curve; microsurgery; surgical skills; video-based training