Grace M Thiong'o1,2, Abhaya Kulkarni3,4, James M Drake3,4. 1. Posluns Center for Image Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. grace.muthonithiongo@sickkids.ca. 2. Department of Surgery, University of Toronto, Toronto, ON, Canada. grace.muthonithiongo@sickkids.ca. 3. Posluns Center for Image Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. 4. Department of Surgery, University of Toronto, Toronto, ON, Canada.
Abstract
INTRODUCTION: Pediatric hemispherectomy is a technically demanding procedure with significant risk. There are relatively few opportunities for surgeon trainees to gain confidence in this nuanced surgery solely through traditional apprenticeship prior to independent practice. Surgeon confidence has been linked to better intraoperative performance and surgical simulation has, according to literature, resulted in improved surgeon confidence. This manuscript measures the effect of epilepsy simulation on the procedural confidence of neurosurgical trainees as a marker of future improved intraoperative performance. METHODS: Eleven neurosurgery residents and fellows were allowed to practice on a novel hemispherectomy simulator. Pre- and post-simulation procedural confidence was measured using a 10-item questionnaire, with total scores ranging from 10 (least confident) to 50 (most confident). Matched pair t-testing was performed to determine participant mean difference between the pre- and post-procedural data sets. RESULTS: The assessment tool bore a high reliability coefficient (Cronbach's α = 0.93). The procedural confidence of all the study participants increased following simulation (p value < 0.001). The overall mean increase in confidence was 7.2 ± 4.0 (mean ± standard deviation), 7.5 ± 4.7 among fellows and 6.8 ± 3.6 among residents. Procedural confidence values were higher among the fellows (26.9 ± 8.1) compared to the residents (19.0 ± 7.4). This difference in means was statistically significant (p value 0.03). A positive association was calculated between the perceived confidence and the postgraduate year of training (p value 0.005, r = 0.57). CONCLUSION: The hemispherectomy simulator moderately improves perceived confidence among neurosurgical trainees and may augment pre-operative surgical practice opportunities.
INTRODUCTION: Pediatric hemispherectomy is a technically demanding procedure with significant risk. There are relatively few opportunities for surgeon trainees to gain confidence in this nuanced surgery solely through traditional apprenticeship prior to independent practice. Surgeon confidence has been linked to better intraoperative performance and surgical simulation has, according to literature, resulted in improved surgeon confidence. This manuscript measures the effect of epilepsy simulation on the procedural confidence of neurosurgical trainees as a marker of future improved intraoperative performance. METHODS: Eleven neurosurgery residents and fellows were allowed to practice on a novel hemispherectomy simulator. Pre- and post-simulation procedural confidence was measured using a 10-item questionnaire, with total scores ranging from 10 (least confident) to 50 (most confident). Matched pair t-testing was performed to determine participant mean difference between the pre- and post-procedural data sets. RESULTS: The assessment tool bore a high reliability coefficient (Cronbach's α = 0.93). The procedural confidence of all the study participants increased following simulation (p value < 0.001). The overall mean increase in confidence was 7.2 ± 4.0 (mean ± standard deviation), 7.5 ± 4.7 among fellows and 6.8 ± 3.6 among residents. Procedural confidence values were higher among the fellows (26.9 ± 8.1) compared to the residents (19.0 ± 7.4). This difference in means was statistically significant (p value 0.03). A positive association was calculated between the perceived confidence and the postgraduate year of training (p value 0.005, r = 0.57). CONCLUSION: The hemispherectomy simulator moderately improves perceived confidence among neurosurgical trainees and may augment pre-operative surgical practice opportunities.
Authors: Kent R Van Sickle; E Matt Ritter; Mercedeh Baghai; Adam E Goldenberg; Ih-Ping Huang; Anthony G Gallagher; C Daniel Smith Journal: J Am Coll Surg Date: 2008-07-14 Impact factor: 6.113
Authors: Shabnam Undre; Maria Koutantji; Nick Sevdalis; Sanjay Gautama; Nowlan Selvapatt; Samantha Williams; Parvinderpal Sains; Peter McCulloch; Ara Darzi; Charles Vincent Journal: World J Surg Date: 2007-07-04 Impact factor: 3.352