Develop and validate a reusable, cost-effective, high-fidelity training platform and build homogeneous assessment tools for aneurysm clipping simulation¶

Strategy · All strategies
Evidence · 5 claims (5 for) · 1 study (1 review), q3 · 0 of 1 report an effect size · 5 claims rest on one study

Description¶

The review's forward-looking recommendation is that future research should focus on "developing and validating a reusable, cost-effective, high-fidelity training platform" and that "there is a need to build homogenous assessment tools and validate the role of simulation training in education". It suggests combining the OSAACS and SAMBA scoring systems and combining technological methods, for example creating a mixed environment using augmented reality technology and incorporating dynamic flow on VR systems.

Design Implications¶

Context¶

Requirements¶

• A consensus on assessment methods should be reached to compare different studies

Constraints¶

• Implementing hands-on training is limited by simulator availability, supply chain, replacement of head micro-anatomy when ruptured, the training site's economic situation, and mentorship availability

Target Learners¶

• neurosurgery residents
• neurosurgeons in training

Target Learning Goals¶

• microsurgical aneurysm clipping skills
• patient safety in aneurysm surgery

Claims¶

• A systematic review identified 26 studies of aneurysm clipping simulation, most commonly virtual reality platforms (n = 11), followed by ex vivo methods and 3D static models (n = 6 each) and 3D dynamic models (n = 3) [+W]
• Construct validity evidence: experienced neurosurgeons performed significantly better than trainees on aneurysm clipping simulation models [+W]
• Each simulation approach has distinct limitations: ex vivo methods have limited availability, VR simulators lack haptics and tactility, 3D static models lack microanatomical components and blood flow, and 3D dynamic models miss microanatomical components [+W]
• Existing aneurysm clipping training methods are heterogeneous and do not realistically simulate the complete microsurgical workflow [+W]
• VR simulation studies with control groups showed decreased surgical time when training with a VR simulator [+W]

Related Strategies¶

• Strengthen vascular simulation research with modern validity frameworks, longer skill-retention follow-up, cost-effectiveness analysis, and more nontechnical-skills and cadaver models
• Develop a standardised simulation assessment template incorporating both subjective and objective validation assessments, adapted per neurosurgical skill
• Use validated homogeneous outcome measures, preferably in a patient setting, in future FB SBT studies
• Develop portable low-cost COTS-based simulators to enable ubiquitous training and presurgical warm-up in minimally invasive surgery
• Develop open, reusable, generalizable CBL platforms for specific learning contexts instead of building closed systems from scratch

Examples¶

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Key Sources¶

• Joseph Fredrick J., Vanluchene Hanne E. R., Bervini David. (2023). Simulation training approaches in intracranial aneurysm surgery—a systematic review. Neurosurgical Review. https://doi.org/10.1007/s10143-023-01995-5