Neurosurgery Skills Training - Past, Present and Future: Hands-On Skills Training Modules to Virtual Reality Simulation

Introduction: Teaching, assessment and practicing of basic neurosurgical skills via the apprenticeship-model in the operating room, is no longer considered appropriate. Issues of minimal access surgery, patient safety and cost effectiveness involve alternative methods of instruction.

Material and Method: Neurosurgery Education and Training School was established with the goal to enhance neurosurgery skills training and provide technological solutions for evaluation. The three-pillared ventures of the school are:

i. Hands-on Skills Training: Neurosurgery Skills Training Facility (NSTF) Neurosurgical skills training imparted is broadly covered under 5-modules: Neuro-anatomy tutorial, Neuroendoscopy, Microneurosurgery, High speed drilling, Spinal instrumentation. The training is provided on synthetic, semi-synthetic models, cadavers and animals with high-end equipment in an operation-room-like-environment. The skills training curriculum is defined by guidelines based on the evaluation of trainee by senior faculty and by computerized evaluation system.

ii. E-Learning: The virtual education material on open source free access E-learning platform and discussion forum, in the form of video library and webinars.

iii. Development of Computerized Virtual Reality (VR) Systems: Bridge the gap between skills training on subjects and live operations, while supplementing the use of live tissue for skills training.

Results: Hands-on skills training:

Total Daily Skills Training Sessions: 3056

Quarterly/Advanced Workshops: 18

Short term skills training program

Neurosurgery skills training modules and submodules have been formulated, standardised, validated and efficacy evaluation done on basis of short and long term feedbacks.

E-learning:

483 visits/ month with 59.6% returning visits and 40.40% new visits on the NETS Web site from over 58 nations.

55,012 Views with 141 subscribers for neurosurgery operation, animation and graphics based videos.

Average reach of data on Discussion Forum: 84.58% of the members, i.e., 465 34.6% used the electronic tablets followed by 13.5% fablets.

Computerized evaluation of dexterity, hand eye coordination, instrument tissue manipulation, speed and effectualness. The objective versus subjective assessment was analyzed; the computerized evaluation scored above the subjective assessment in terms of unbiased independent grading.

Conclusions: The incorporation of virtual and hands-on training with parallel assessment supplements education and skills training in Neurosurgery.