Cobb Mary In-Ping Huang, Taekman Jeffrey M, Zomorodi Ali R, Gonzalez L Fernando, Turner Dennis A
Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Duke University Human Simulation and Patient Safety Center, Durham, North Carolina, USA.
World Neurosurg. 2016 May;89:583-6. doi: 10.1016/j.wneu.2015.11.068. Epub 2015 Dec 17.
Neurosurgery is one of the most technically demanding and liable of all medical professionals. More than 75% of neurosurgical errors are deemed as preventable and technical in nature. Yet in a specialty that requires such high level of technical expertise, with large consequences for error, there are even fewer opportunities for residents in training to practice on the most complicated cases. Although there is no replacement for actual experiences in the operating room, interpersonal mentorship, coaching, and training, there is room to supplement residency education through simulation. Here we review the evidence to support surgical simulation, describe the strengths and weaknesses of existing technologies in direct neurosurgery specific and indirect simulation applications, and advocate for the development of more neurosurgery-specific applications using emerging kinetic technologies.
神经外科是所有医学专业中技术要求最高且风险最大的专业之一。超过75%的神经外科手术失误被认为本质上是可预防的且与技术相关。然而,在这样一个需要高水平技术专长且失误后果严重的专业领域,住院医师在培训期间练习处理最复杂病例的机会更少。虽然手术室的实际经验、人际指导、辅导和培训无可替代,但通过模拟来补充住院医师教育仍有空间。在此,我们回顾支持手术模拟的证据,描述现有技术在直接神经外科特定模拟应用和间接模拟应用中的优缺点,并倡导利用新兴的动态技术开发更多神经外科特定应用。