A Novel Craniotomy simulator provides a validated method to enhance education in the management of traumatic brain injury

BACKGROUND:: In a variety of surgical specialties, simulation-based technologies play an important role in resident training. The Congress of Neurological Surgeons (CNS) established an initiative to enhance neurosurgical training by developing a simulation-based curriculum to complement standard didactic and clinical learning. OBJECTIVE:: To enhance resident education in the management of traumatic brain injury by the use of simulation-based training. METHODS:: A course-based neurosurgical simulation curriculum was developed and offered at the 2012 CNS annual meeting. Within this curriculum, a trauma module was developed to teach skills necessary in the management of traumatic brain injury, including the performance of craniotomy for trauma. Didactic and simulator-based instruction were incorporated into the course. Written and practical pre-and posttests, as well as questionnaires, were used to assess the improvement in skill level and to validate the simulator as a teaching tool. RESULTS:: Fourteen trainees participated in the didactic section of the trauma module. Average performance improved significantly in written scores from pretest (75%) to posttest (87.5%, P < .05). Eight participants completed the trauma craniotomy simulator. Incision planning, burr hole placement (P < .02), and craniotomy size (P < .05) improved significantly. Junior residents (postgraduate years 1-3) demonstrated the most improvement during the course. CONCLUSION:: The CNS simulation trauma module provides a complementary method for residents to acquire necessary skills in the management of traumatic brain injury. Preliminary data indicate improvement in didactic and hands-on knowledge after training. Additional data are needed to confirm the validity of the simulator. ABBREVIATIONS:: ACGME, Accreditation Council for Graduate Medical EducationCA, Cochran-ArmitageCNS, Congress of Neurological SurgeonsNCAMSC, National Capital Area Medical Simulator CenterPGY, postgraduate yearTBI, traumatic brain injuryVR, virtual reality & copy; 2013 by the Congress of Neurological Surgeons.