Department of Neurosurgery, Otto-von-Guericke University, Magdeburg , Germany.
Faculty of Computer Science, Otto-von-Guericke University, Magdeburg , Germany.
Oper Neurosurg (Hagerstown). 2024 Nov 1;27(5):618-631. doi: 10.1227/ons.0000000000001167. Epub 2024 Jun 7.
BACKGROUND AND OBJECTIVES: Traditional neurosurgical education has relied heavily on the Halstedian "see one, do one, teach one" approach which is increasingly perceived as inefficient in contemporary settings marked by a steady decline in surgical caseload. In recent years, simulation training has emerged as an effective and accessible training alternative. To date, however, there is no standardized criterion pertaining to the quality and implementation of simulators in neurosurgical education and training. This research aims to compare the efficacy of virtual reality (VR) and Phantom-based simulation training in the context of neurosurgical skill acquisition, with a focus on middle cerebral artery aneurysm clipping. METHODS: An immersive VR clipping tool and a haptic clipping simulator incorporating 3-dimensional printing, additive manufacturing, and rheological analyses were developed. Twenty-two participants, comprising 12 medical students, 6 neurosurgical residents, and 4 experienced neurosurgeons, tested and evaluated both simulators for face and content validity. Construct and predictive validity of the simulators were assessed using an objective structured assessment scale for aneurysm clipping, measuring participants' performances and progress. RESULTS: Both modalities were deemed highly advantageous for educational purposes. Objective evaluations, however, revealed measurable differences in usability, efficacy, and transferability of the learned skills with VR excelling in procedural planning and visualization while Phantom simulation being noticeably superior in conveying surgical skills. CONCLUSION: Simulation training can accelerate the neurosurgical learning curve. The results of this study highlight the importance of establishing standardized criteria for the implementation and assessment of simulation modalities, ensuring consistent quality and efficacy in neurosurgical education.
背景与目的:传统的神经外科学教育主要依赖于“看一个、做一个、教一个”的霍尔斯特德方法,而在手术病例量稳步下降的现代背景下,这种方法被认为效率低下。近年来,模拟训练已成为一种有效的、易于获取的替代培训方法。然而,迄今为止,神经外科学教育和培训中还没有关于模拟器质量和实施的标准化标准。本研究旨在比较虚拟现实(VR)和基于 Phantom 的模拟训练在神经外科技能获取方面的效果,重点是大脑中动脉动脉瘤夹闭。
方法:开发了一种沉浸式 VR 夹闭工具和一种基于触觉的夹闭模拟器,该模拟器结合了 3 维打印、增材制造和流变学分析。22 名参与者,包括 12 名医学生、6 名神经外科住院医师和 4 名经验丰富的神经外科医生,对这两种模拟器进行了表面效度和内容效度测试和评估。使用动脉瘤夹闭的客观结构化评估量表评估了模拟器的构建和预测效度,衡量了参与者的表现和进步。
结果:两种模式都被认为对教育目的非常有利。然而,客观评估显示,在可用性、效果和所学技能的可转移性方面存在可衡量的差异,VR 在手术规划和可视化方面表现出色,而 Phantom 模拟在传达手术技能方面明显更胜一筹。
结论:模拟训练可以加速神经外科学习曲线。本研究的结果强调了为模拟模式的实施和评估建立标准化标准的重要性,以确保神经外科学教育的一致性和有效性。
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