title: Evaluation of a novel phantom-based neurosurgical training system.
abstract: BACKGROUND
  The complexity of neurosurgical interventions demands innovative training solutions and standardized evaluation methods that in recent times have been the object of increased research interest. The objective is to establish an education curriculum on a phantom-based training system incorporating theoretical and practical components for important aspects of brain tumor surgery.
  
  
  METHODS
  Training covers surgical planning of the optimal access path based on real patient data, setup of the navigation system including phantom registration and navigated craniotomy with real instruments. Nine residents from different education levels carried out three simulations on different data sets with varying tumor locations. Trainings were evaluated by a specialist using a uniform score system assessing tumor identification, registration accuracy, injured structures, planning and execution accuracy, tumor accessibility and required time.
  
  
  RESULTS
  Average scores improved from 16.9 to 20.4 between first and third training. Average time to craniotomy improved from 28.97 to 21.07 min, average time to suture improved from 37.83 to 27.47 min. Significant correlations were found between time to craniotomy and number of training (P < 0.05), between time to suture and number of training (P < 0.05) as well as between score and number of training (P < 0.01).
  
  
  CONCLUSIONS
  The training system is evaluated to be a suitable training tool for residents to become familiar with the complex procedures of autonomous neurosurgical planning and conducting of craniotomies in tumor surgeries. Becoming more confident is supposed to result in less error-prone and faster operation procedures and thus is a benefit for both physicians and patients.
authors.affiliation: Department of Neurosurgery, University Hospital Leipzig, Saxony, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Müns
authors.affiliation: Department of Neurosurgery, University Hospital Leipzig, Saxony, Germany ; Innovation Center, Computer Assisted Surgery, University Leipzig, Saxony, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Meixensberger
authors.affiliation: Department of Neurosurgery, University Hospital Leipzig, Saxony, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Lindner
keywords: Neurosurgical education; phantom; training system; tumor resection