Neurosurgery

BACKGROUND: The effort required to introduce simulation in neurosurgery academic programs and the benefits perceived by residents have not been systematically assessed. OBJECTIVE: To create a neurosurgery simulation curriculum encompassing basic and advanced skills, cadaveric dissection, cranial and spine surgery simulation, and endovascular and computerized haptic training. METHODS: A curriculum with 68 core exercises per academic year was distributed in individualized sets of 30 simulations to 6 neurosurgery residents...

: The development of technical skills is a major goal of any neurosurgical training program. Residency programs in North America are focused on achieving an adequate level of training to produce technically competent surgeons. The training requirements and educational environments needed to produce expert surgeons are incompletely understood. This review explores the theoretical implications of training technical skills to expertise rather than competency in a complex field such as neurosurgery. First, the terms technical expertise and technical competency are defined...

BACKGROUND: Virtual reality (VR) applications promise the safe, efficacious, and valid replication of scenarios encountered in modern neurosurgery, and a number of navigation- or dissection-related and endovascular simulators have been successfully deployed in the last 2 decades. Concurrently, neurosurgical training is changing, and VR simulations are expected to play a part in future training. OBJECTIVE: To give an overview of currently available neurosurgical VR applications in the spectrum of desired applications and the outlook of the requirements to be met by future applications...

BACKGROUND: Manual skill is important for surgeons, but current methods to evaluate sensory-motor skills in applicants to a surgical residency are limited. OBJECTIVE: To develop a method of testing sensory-motor skill using objective and reproducible virtual reality simulation. METHODS: We designed a set of tests on a 3-dimensional surgical simulator with head and arm tracking, colocalization, and haptic feedback: (1) "trajectory planning in a simulated vertebra," ie, 3-dimensional memory and orientation; "hemostasis in the brain," ie, motor planning, sequence, timing, and precision; and "choose the softest object," ie, haptic perception...