Skip to main content

Advertisement

SpringerLink
Log in

EANS Basic Brain Course (ABC): combining simulation to cadaver lab for a new concept of neurosurgical training

  • Original Article - Neurosurgery Training
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Neurosurgical training has traditionally been based on an apprenticeship model that requires considerable time and exposure to surgeries. Unfortunately, nowadays these requirements are hampered by several limitations (e.g., decreased caseload, worktime restrictions). Furthermore, teaching methods vary among residency programs due to cultural differences, monetary restrictions, and infrastructure conditions, with the possible consequence of jeopardizing residents’ training.

Methods

The EANS Basic Brain Course originated from a collaboration between the Besta NeuroSim Center in Milano and the Swiss Foundation for Innovation and Training in Surgery in Geneva. It was held for 5 neurosurgical residents (PGY1-3) who participated to this first pilot experience in January 2019. The main goal was to cover the very basic aspects of cranial surgery, including both technical and non-technical skills. The course was developed in modules, starting from the diagnostic paths and communication with patients (played by professional actors), then moving to practical simulation sessions, rapid theoretical lessons, and discussions based on real cases and critical ethical aspects. At the end, the candidates had cadaver lab sessions in which they practiced basic emergency procedures and craniotomies. The interaction between the participants and the faculties was created and maintained using role plays that smoothly improved the cooperation during debriefs and discussions, thus making the sessions exceedingly involving.

Results

At the end of the course, every trainee was able to complete the course curriculum and all the participants expressed their appreciation for this innovative format, with a particular emphasis on the time spent learning non-technical skills, confirming that they feel this to be a fundamental aspect of a comprehensive training in neurosurgery.

Conclusions

It is possible that this combined concept of training on technical and non-technical skills, using emerging technologies along with pedagogic techniques and cadaver dissection, may become the state-of-the-art for European Neurosurgical training programs in the next future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Akhigbe T, Zolnourian A, Bulters D (2017) Mentoring models in neurosurgical training: review of literature. J Clin Neurosci. https://doi.org/10.1016/j.jocn.2017.07.025

    Article  Google Scholar 

  2. Alaraj A, Charbel FT, Birk D et al (2013) Role of cranial and spinal virtual and augmented reality simulation using immersive touch modules in neurosurgical training. Neurosurgery. https://doi.org/10.1227/NEU.0b013e3182753093

    Article  Google Scholar 

  3. Banerjee PP, Luciano CJ, Lemole GM, Charbel FT, Oh MY (2008) Accuracy of ventriculostomy catheter placement using a head- and hand-tracked high-resolution virtual reality simulator with haptic feedback. J Neurosurg. https://doi.org/10.3171/jns-07/09/0515

    Article  Google Scholar 

  4. Cattell RB, Cattell AK, Cattell HEP (1993) 16PF fifth edition questionnaire. Institute for Personality and Ability Testing, Champaign

    Google Scholar 

  5. Cattell HEP, Mead AD (2008) The sixteen personality factor questionnaire (16PF). SAGE Handb Personal Theory Assess Vol 2 - Personal Meas Test. https://doi.org/10.4135/9781849200479.n7

  6. Chen Z, De Beuckelaer A, Wang X, Liu J (2017) Distinct neural substrates of visuospatial and verbal-analytic reasoning as assessed by Raven’s advanced progressive matrices. Sci Rep 7(1):16230

    Article  Google Scholar 

  7. Cohen-Gadol AA, Piepgras DG, Krishnamurthy S, Fessler RD (2005) Resident duty hours reform: results of a national survey of the program directors and residents in neurosurgery training programs. Neurosurgery. https://doi.org/10.1227/01.NEU.0000147999.64356.57

    Article  Google Scholar 

  8. Cook DA, Hatala R, Brydges R, Zendejas B, Szostek JH, Wang AT, Erwin PJ, Hamstra SJ (2011) Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA - J Am Med Assoc. https://doi.org/10.1001/jama.2011.1234

  9. Datta ST, Davies SJ (2015) Training for the future NHS: training junior doctors in the United Kingdom within the 48-hour European working time directive. BMC Med Educ. https://doi.org/10.1186/1472-6920-14-S1-S12

  10. Ganju A, Aoun SG, Daou MR, El Ahmadieh TY, Chang A, Wang L, Batjer HH, Bendok BR (2013) The role of simulation in neurosurgical education: a survey of 99 United States neurosurgery program directors. World Neurosurg. https://doi.org/10.1016/j.wneu.2012.11.066

    Article  Google Scholar 

  11. Gnanakumar S, Kostusiak M, Budohoski KP, Barone D, Pizzuti V, Kirollos R, Santarius T, Trivedi R (2018) Effectiveness of cadaveric simulation in neurosurgical training: a review of the literature. World Neurosurg. https://doi.org/10.1016/j.wneu.2018.07.015

    Article  Google Scholar 

  12. Gordon M, Darbyshire D, Baker P (2012) Non-technical skills training to enhance patient safety: a systematic review. Med Educ. https://doi.org/10.1111/j.1365-2923.2012.04343.x

    Article  Google Scholar 

  13. Hénaux P-L, Jannin P, Riffaud L (2019) Non-technical skills in neurosurgery : a systematic review of the literature. World Neurosurg. https://doi.org/10.1016/j.wneu.2019.06.204

    Article  Google Scholar 

  14. Henn P, Gallagher AG, Nugent E, Seymour NE, Haluck RS, Hseino H, Traynor O, Neary PC (2018) Visual spatial ability for surgical trainees: implications for learning endoscopic, laparoscopic surgery and other image-guided procedures. Surg Endosc 32(8):3634–3639

    Article  Google Scholar 

  15. Khan A, Doke T, Boeris D (2018) Nurturing the next generation of neurosurgeons: how important are nontechnical skills? World Neurosurg 120:e227–e233

    Article  Google Scholar 

  16. Kirkman MA, Ahmed M, Albert AF, Wilson MH, Nandi D, Sevdalis N (2014) The use of simulation in neurosurgical education and training. J Neurosurg. https://doi.org/10.3171/2014.5.JNS131766

    Article  Google Scholar 

  17. Konakondla S, Fong R, Schirmer CM (2017) Simulation training in neurosurgery: advances in education and practice. Adv Med Educ Pract. https://doi.org/10.2147/amep.s113565

    Article  Google Scholar 

  18. Luciano C, Banerjee P, Lemole GM, Charbel F (2006) Second generation haptic ventriculostomy simulator using the ImmersiveTouch system. Stud. Health Technol, Inform

    Google Scholar 

  19. Maillet B, Maisonneuve H (2011) Long-life learning for medical specialists doctors in Europe: CME. DPC and qualification Press Medicale. https://doi.org/10.1016/j.lpm.2011.01.014

    Article  Google Scholar 

  20. Nicolosi F, Rossini Z, Zaed I, Fornari M, Kolias AG, Servadei F (2018) Neurosurgical digital teaching in low-middle income countries: beyond the frontiers of traditional education. Neurosurg Focus. https://doi.org/10.3171/2018.7.focus18288

    Article  Google Scholar 

  21. Perin A, Galbiati TF, Gambatesa E et al (2018) Filling the gap between the OR and virtual simulation: a European study on a basic neurosurgical procedure. Acta Neurochir 160(11):2087–2097

    Article  Google Scholar 

  22. Perin A, Ugo Prada F, Moraldo M, et al (2017) USim: a new device and app for case-specific, Intraoperative ultrasound simulation and rehearsal in neurosurgery. A preliminary study, Oper Neurosurg. https://doi.org/10.1093/ons/opx144

    Article  Google Scholar 

  23. Sawaya R, Alsideiri G, Bugdadi A, Winkler-Schwartz A, Azarnoush H, Bajunaid K, Sabbagh AJ, Del Maestro R (2019) Development of a performance model for virtual reality tumor resections. J Neurosurg 131(1):192–200

    Article  Google Scholar 

  24. Sawaya R, Bugdadi A, Azarnoush H, Winkler-Schwartz A, Alotaibi FE, Bajunaid K, AlZhrani GA, Alsideiri G, Sabbagh AJ, Del Maestro RF (2017) Virtual reality tumor resection: the force pyramid approach. Oper Neurosurg. https://doi.org/10.1093/ons/opx189

    Article  Google Scholar 

  25. Schaller K (2013) Neurosurgical training under European law. Acta Neurochir 155(3):547

    Article  Google Scholar 

  26. Schirmer CM, Mocco J, Elder JB (2013) Evolving virtual reality simulation in neurosurgery. Neurosurgery. https://doi.org/10.1227/NEU.0000000000000060

    Article  Google Scholar 

  27. Servadei F, Rossini Z, Nicolosi F, Morselli C, Park KB (2018) The role of neurosurgery in countries with limited facilities: facts and challenges. World Neurosurg. https://doi.org/10.1016/j.wneu.2018.01.047

    Article  Google Scholar 

  28. Shetty KD, Bhattacharya J (2007) Changes in hospital mortality associated with residency work-hour regulations. Ann Intern Med. https://doi.org/10.7326/0003-4819-147-2-200707170-00161

    Article  Google Scholar 

  29. Winkler-Schwartz A, Bajunaid K, Mullah MAS et al (2016) Bimanual psychomotor performance in neurosurgical resident applicants assessed using NeuroTouch, a virtual reality simulator. J Surg Educ. https://doi.org/10.1016/j.jsurg.2016.04.013

    Article  Google Scholar 

Download references

Funding

Integra LifeSciences, Promedics GmbH, and Söring GmbH provided financial support in the form of sponsorship funding for the course.

Author information

Author notes

  1. Alessandro Moiraghi and Alessandro Perin contributed equally to this work.

Authors and Affiliations

  1. Division of Neurosurgery, Geneva University Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland

    Alessandro Moiraghi, Karl Schaller & Torstein R. Meling

  2. Department of Neurosurgery, Sainte-Anne Hospital, Paris, France

    Alessandro Moiraghi

  3. Swiss Foundation for Innovation and Training in Surgery (SFITS), Geneva, Switzerland

    Alessandro Moiraghi, Nicolas Sicky, Jelena Godjevac, Karl Schaller & Torstein R. Meling

  4. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico “C. Besta”, Milan, Italy

    Alessandro Perin, Roberta Ayadi, Enrico Gambatesa, Claudia Fanizzi & Francesco DiMeco

  5. Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale “C. Besta”, Milan, Italy

    Alessandro Perin, Giovanni Carone, Roberta Ayadi, Tommaso Galbiati, Alessandra Rocca, Claudia Fanizzi & Francesco DiMeco

  6. EANS Training Committee, , Cirencester, UK

    Francesco DiMeco & Torstein R. Meling

  7. University of Milan, Milan, Italy

    Tommaso Galbiati, Enrico Gambatesa & Alessandra Rocca

  8. University of Brescia, Brescia, Italy

    Giovanni Carone

  9. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

    Francesco DiMeco

  10. Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, USA

    Francesco DiMeco

  11. Department of Life Sciences, University of Trieste, Trieste, Italy

    Alessandro Perin

Authors
  1. Alessandro Moiraghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandro Perin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicolas Sicky
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jelena Godjevac
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giovanni Carone
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Roberta Ayadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tommaso Galbiati
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Enrico Gambatesa
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Alessandra Rocca
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Claudia Fanizzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Karl Schaller
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Francesco DiMeco
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Torstein R. Meling
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alessandro Moiraghi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest..

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclaimer

The sponsors had no role in the design or conduct of this research.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Neurosurgery Training

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moiraghi, A., Perin, A., Sicky, N. et al. EANS Basic Brain Course (ABC): combining simulation to cadaver lab for a new concept of neurosurgical training. Acta Neurochir 162, 453–460 (2020). https://doi.org/10.1007/s00701-020-04216-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-020-04216-w

Keywords

Search

Navigation