At a time of significant global unrest and uncertainty surrounding how the delivery of clinical training will unfold over the coming years, we offer a systematic review, meta-analysis, and bibliometric analysis of global studies showing the crucial role simulation will play in training. Our aim was to determine the types of simulators in use, their effectiveness in improving clinical skills, and whether we have reached a point of global acceptance. A PRISMA-guided global systematic review of the neurosurgical simulators available, a meta-analysis of their effectiveness, and an extended analysis of their progressive scholarly acceptance on studies meeting our inclusion criteria of simulation in neurosurgical education were performed. Improvement in procedural knowledge and technical skills was evaluated. Of the identified 7405 studies, 56 studies met the inclusion criteria, collectively reporting 50 simulator types ranging from cadaveric, low-fidelity, and part-task to virtual reality (VR) simulators. In all, 32 studies were included in the meta-analysis, including 7 randomised controlled trials. A random effects, ratio of means effects measure quantified statistically significant improvement in procedural knowledge by 50.2% (ES 0.502; CI 0.355; 0.649, p < 0.001), technical skill including accuracy by 32.5% (ES 0.325; CI − 0.482; − 0.167, p < 0.001), and speed by 25% (ES − 0.25, CI − 0.399; − 0.107, p < 0.001). The initial number of VR studies (n = 91) was approximately double the number of refining studies (n = 45) indicating it is yet to reach progressive scholarly acceptance. There is strong evidence for a beneficial impact of adopting simulation in the improvement of procedural knowledge and technical skill. We show a growing trend towards the adoption of neurosurgical simulators, although we have not fully gained progressive scholarly acceptance for VR-based simulation technologies in neurosurgical education.

在未来几年如何开展临床培训的全球性重大动荡和不确定性之际，我们对全球研究进行了系统回顾、荟萃分析和文献计量分析，显示模拟将在培训中发挥关键作用。我们的目标是确定正在使用的模拟器的类型、它们在提高临床技能方面的有效性，以及我们是否已达到全球接受的程度。我们对现有的神经外科模拟器进行了 PRISMA 指导的全球系统性审查，对其有效性进行了荟萃分析，并对符合我们神经外科教育模拟纳入标准的研究的学术接受度进行了扩展分析。对程序知识和技术技能的改进进行了评估。在已确定的 7405 项研究中，有 56 项研究符合纳入标准，总共报告了 50 种模拟器类型，从尸体模拟器、低保真模拟器、部分任务模拟器到虚拟现实 (VR) 模拟器。荟萃分析总共纳入了 32 项研究，其中包括 7 项随机对照试验。随机效应、均值效应测量比率量化了程序知识统计显着性改善 50.2% (ES 0.502; CI 0.355; 0.649, p < 0.001)，技术技能包括准确性提高 32.5% (ES 0.325; CI − 0.482; − 0.167) ，p < 0.001），速度提高 25%（ES − 0.25，CI − 0.399；− 0.107，p < 0.001）。VR 研究的初始数量 ( n = 91) 大约是精炼研究数量 ( n = 45) 的两倍，表明它尚未得到学术界的逐步认可。有强有力的证据表明，采用模拟对于提高程序知识和技术技能具有有益的影响。尽管神经外科教育中基于 VR 的模拟技术尚未完全获得学术界的认可，但我们显示出采用神经外科模拟器的趋势不断增长。