Suri Ashish, Patra Devi Prasad, Meena Rajesh Kumar
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Neurol India. 2016 May-Jun;64(3):387-95. doi: 10.4103/0028-3886.181556.
Neurosurgery is one of the most technically demanding medical professions that warrants a high level of expertise. In the present context of competitive medical practice, high societal expectations regarding quality of patient care and medicolegal and financial constraints, there are fewer opportunities for a trainee to achieve competency in standard neurosurgical, microsurgical, and operative techniques. Practice on simulation models like cadavers has been a trend since antiquity; however, recent development of newer models with their strategic modifications has given simulation education a new dimension. It has allowed trainees to acquire and improve surgical skills and knowledge in specifically fabricated and controlled settings with no risk to real patients. Simulation also offers the opportunity for deliberate practice and repetition unlimited number of times so that psychomotor skills can be automated. There is ever-growing evidence showing the positive impact of simulation on resident training in various areas of health care. Advances in computer technology and imaging, development of sophisticated virtual reality simulators with haptic feedback and the recent addition of three-dimensional printing technology, have opened a wide arena for the development of high-fidelity patient-specific models to complement current neurosurgical training. Simulation training in neurosurgery in India is still elementary since its inception at the All India Institute of Medical Sciences, New Delhi. A structured modular training program has been developed which is yet to be implemented at a multi-institutional level. Stringent efforts are needed to establish a uniform resident training curriculum where simulators can be used to complement current neurosurgical training.
神经外科是技术要求最高的医学专业之一，需要高水平的专业知识。在当前竞争激烈的医疗实践环境下，社会对患者护理质量期望很高，同时存在法医学和财务方面的限制，培训学员掌握标准神经外科、显微外科和手术技术的机会较少。自古以来，在尸体等模拟模型上进行练习就是一种趋势；然而，新型模型及其策略性改进的最新发展为模拟教育带来了新的维度。它使学员能够在专门构建和可控的环境中获取并提高手术技能和知识，而不会对真实患者造成风险。模拟还提供了在无限制次数下进行刻意练习和重复的机会，从而使心理运动技能能够自动化。越来越多的证据表明模拟对医疗保健各个领域的住院医师培训具有积极影响。计算机技术和成像技术的进步、具有触觉反馈的先进虚拟现实模拟器的开发以及最近三维打印技术的加入，为开发高保真患者特异性模型以补充当前神经外科培训开辟了广阔领域。印度的神经外科模拟培训自新德里全印度医学科学研究所开展以来仍处于初级阶段。已经制定了一个结构化的模块化培训计划，但尚未在多机构层面实施。需要做出严格努力来建立一个统一的住院医师培训课程，以便能够使用模拟器来补充当前的神经外科培训。
