Applying objective metrics to neurosurgical skill development with simulation and spaced repetition learning

Area of Science:

• Neurosurgery
• Medical Education
• Surgical Simulation

Background:

• Surgical skills laboratories enhance anatomy understanding and technical skill practice.
• High-fidelity, cadaver-free simulators increase access to surgical training.
• Neurosurgery traditionally lacks objective process measures for skill assessment.

Purpose of the Study:

• To evaluate the feasibility and impact of a pilot training module using spaced repetition for neurosurgical proficiency.
• To assess objective improvements in technical skills using novel simulators.

Main Methods:

• A 6-week training module utilized a pterional approach simulator.
• Neurosurgery residents underwent baseline and post-module video-recorded examinations.
• Objective skill assessment used validated Global Rating Scales (GRSs) and Task-based Specific Checklists (TSCs).

Main Results:

• The intervention group showed significant improvements in craniotomy (cGRS 25%, cTSC 84%) and microsurgical exploration (mGRS 18%, mTSC 52%).
• Junior residents in the intervention group demonstrated notable gains in objective skill metrics.
• While both groups improved, the intervention group surpassed controls in key performance indicators.

Conclusions:

• A 6-week simulation course with spaced repetition significantly improves objective neurosurgical technical skills.
• Objective performance metrics integrated with simulation enhance surgical training effectiveness.
• Further multi-institutional randomized controlled trials are recommended to validate these findings.