PubMed, Web of Science, and Scopus were queried for eligible studies. After excluding duplicates, 1204 studies were screened. Eighteen studies were included in the final review.
Neurosurgical skills assessed included aneurysm clipping (n = 6), craniotomy and burr hole drilling (n = 2), tumour resection (n = 4), and vessel suturing (n = 3). All studies assessed face validity, 11 assessed content, and 6 assessed construct validity. Animal models (n = 5), synthetic models (n = 7), and VR models (n = 6) were assessed. In face validation, all studies rated visual realism favourably, but haptic realism was key limitation. The synthetic models ranked a high median tactile realism (4 out of 5) compared to other models. Assessment of content validity showed positive findings for anatomical and procedural education, but the models provided more benefit to the novice than the experienced group. The cadaver models were perceived to be the most anatomically realistic by study participants. Construct validity showed a statistically significant proficiency increase among the junior group compared to the senior group across all modalities.
Our review highlights evidence on the feasibility of implementing simulation models in neurosurgical training. Studies should include predictive validity to assess future skill on an individual on whom the same procedure will be administered. This study shows that future neurosurgical training systems call for surgical simulation and objectively validated models.
PubMed,WebofScience,和Scopus被查询为符合条件的研究。排除重复项之后,对1204项研究进行了筛选。18项研究包括在最终审查中。
评估的神经外科技能包括动脉瘤夹闭术(n=6),开颅术和钻孔钻孔(n=2),肿瘤切除(n=4),和血管缝合(n=3)。所有研究都评估了面部效度,11评估内容,和6个评估的结构效度。动物模型(n=5),合成模型(n=7),和VR模型(n=6)进行评估。在面部验证中,所有研究对视觉现实主义的评价都很好,但是触觉现实主义是关键的限制。与其他模型相比,合成模型的触觉真实感中位数较高(5个中的4个)。对内容有效性的评估显示了对解剖和程序教育的积极发现,但是这些模型为新手提供了比有经验的组更多的好处。研究参与者认为尸体模型在解剖学上是最现实的。结构效度显示,在所有模式下,与高级组相比,初级组的熟练程度在统计上显着提高。
我们的综述强调了在神经外科培训中实施模拟模型的可行性证据。研究应包括预测有效性,以评估将对其进行相同程序的个体的未来技能。这项研究表明,未来的神经外科培训系统需要手术模拟和客观验证的模型。