Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components.
Publication/Presentation Date
10-1-2013
Abstract
BACKGROUND: In the era of surgical resident work hour restrictions, the traditional apprenticeship model may provide fewer hours for neurosurgical residents to hone technical skills. Spinal dura mater closure or repair is 1 skill that is infrequently encountered, and persistent cerebrospinal fluid leaks are a potential morbidity.
OBJECTIVE: To establish an educational curriculum to train residents in spinal dura mater closure with a novel durotomy repair model.
METHODS: The Congress of Neurological Surgeons has developed a simulation-based model for durotomy closure with the ongoing efforts of their simulation educational committee. The core curriculum consists of didactic training materials and a technical simulation model of dural repair for the lumbar spine.
RESULTS: Didactic pretest scores ranged from 4/11 (36%) to 10/11 (91%). Posttest scores ranged from 8/11 (73%) to 11/11 (100%). Overall, didactic improvements were demonstrated by all participants, with a mean improvement between pre- and posttest scores of 1.17 (18.5%; P = .02). The technical component consisted of 11 durotomy closures by 6 participants, where 4 participants performed multiple durotomies. Mean time to closure of the durotomy ranged from 490 to 546 seconds in the first and second closures, respectively (P = .66), whereby the median leak rate improved from 14 to 7 (P = .34). There were also demonstrative technical improvements by all.
CONCLUSION: Simulated spinal dura mater repair appears to be a potentially valuable tool in the education of neurosurgery residents. The combination of a didactic and technical assessment appears to be synergistic in terms of educational development.
Volume
73 Suppl 1
First Page
111
Last Page
115
ISSN
1524-4040
Published In/Presented At
Ghobrial, G. M., Anderson, P. A., Chitale, R., Campbell, P. G., Lobel, D. A., & Harrop, J. (2013). Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components. Neurosurgery, 73 Suppl 1, 111–115. https://doi.org/10.1227/NEU.0000000000000100
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
24051873
Department(s)
Administration and Leadership
Document Type
Article