153 Hacking Neurosurgical Skills Training: Resident Education on the Cheap

INTRODUCTION:A constant conundrum for the surgical educator is the balancing act between resident training and patient safety. Surgical simulators have become attractive, allowing trainees to practice emerging skills without risking patient health. However, many surgical simulators are expensive, complex, and frequently do not offer realistic tissue or instrument manipulation. Residents typically understand the steps and anatomy of a procedure long before they develop the manual skills to perform the operation gracefully. It would therefore be valuable to develop simple surgical simulators that offer decreased complexity and faithfully reproduce the haptic experience of a given procedure. METHODS:The North Carolina Eye Bank Surgical Skills laboratory is a surgical educational facility operated by the University of North Carolina at Chapel Hill. We have developed several simulators for neurosurgical procedures, including third ventriculocisternostomy, Chiari decompression, minimally invasive spine surgery, etc. These simulators are open-source, cost less than $20 to construct, and cost less than $0.10 per simulation run. Neurosurgical residents use these surgical simulators to learn key components of neurosurgical procedures. Each simulation run is timed, and every fifth simulation is recorded to assess technical proficiency, adequacy of completion, and other subjective factors. RESULTS:We have demonstrated significant improvements in resident speed, technical proficiency, and adequacy of completion across all simulator platforms. Residents have expressed improved satisfaction with the educational experience as well as improved confidence in the operating room after repeated simulation runs in the lab. CONCLUSION:Surgical skill simulation is an emerging technology and is useful for safe, effective resident training. However, much work in this field has focused on complex, expensive training models. Here, we demonstrate that surgical simulation can be simple, cheap, and provide realistic haptic feedback, and that residents improve both subjectively and objectively with our simulation platforms.