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Simulation-based Education for Endoscopic Third Ventriculostomy: A Comparison Between Virtual and Physical Training

Gerben E Breimer1,2,3, Faizal A Haji4,5,6, Vivek Bodani1,2

  • 1Centre for Image Guided Innovation and Therapeutic Intervention (CIGITI), The Hospital for Sick Children, Toronto, Ontario, Canada.

Operative Neurosurgery (Hagerstown, Md.)
|September 22, 2017
PubMed
Summary

Virtual reality (VR) simulation offers superior anatomical visualization for endoscopic third ventriculostomy (ETV) training, while physical simulators excel in developing manual dexterity and procedural skills. Choosing the right model depends on specific neurosurgical training objectives.

Keywords:
Medical educationNeuroendoscopyNeurosurgerySimulationSurgical evaluationSurgical trainingVirtual reality

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Area of Science:

  • Neurosurgical Training
  • Medical Simulation
  • Surgical Education Technology

Background:

  • The comparative educational advantages of virtual reality (VR) versus physical simulation models for endoscopic third ventriculostomy (ETV) have not been directly assessed.
  • Neurosurgical training relies on effective simulation methods to impart complex procedural skills.

Purpose of the Study:

  • To compare the utility of physical and virtual reality (VR) simulation models for endoscopic third ventriculostomy (ETV) in neurosurgical training.
  • To identify specific training benefits offered by each simulation modality.

Main Methods:

  • Twenty-three neurosurgical residents and 3 fellows evaluated both physical and VR ETV simulation models.
  • Trainees utilized 5-point Likert scales to rate anatomy, instrument handling, procedural content, and overall fidelity.
  • Paired t-tests were employed to analyze mean scores for each domain.

Main Results:

  • The VR model demonstrated superior realistic representation of intraventricular anatomy, particularly at the foramen of Monro and third ventricle floor.
  • Physical simulators were rated higher for instrument handling and procedural content compared to the VR model.
  • Overall task fidelity was perceived as similar between the two simulation types.

Conclusions:

  • Simulation model selection for endoscopic third ventriculostomy (ETV) training should align with specific educational goals.
  • VR simulation is advantageous for learning anatomy and decision-making based on anatomical cues.
  • Physical simulation is more effective for developing manual dexterity and technical skills with endoscopic instruments.