Simulation in Neurosurgery Supplement: Introduction to Neurosurgical Simulation

Medical education has changed significantly over the last several decades, in part as a result of advances in medical technology but most recently as a result of alterations in resident educational regulations. The greatest impact has been from the Accreditation Council for Graduate Medical Education 80-hour resident work-week limitation. Residency training programs are attempting to design medical training to be more efficient and proficient while simultaneously attempting to obtain objective data from which to define “competence.” Numerous medical educators have noted that medical simulators are able to meet these requirements and have readily accepted them in training programs.

Medical education simulators can be broadly categorized into 4 major types: physical, virtual reality, Web-based, and hybrids or combinations of the other 3 systems. The majority of medical simulators currently are of the physical and virtual reality subtypes, and these are the focus of this supplement.

The Congress of Neurological Surgeons (CNS) is a global organization dedicated to improving neurosurgical education to better patient care. Neurosurgical simulators are one technology that may be able to further achieve this goal. However, a simulator is only one element of an educational program, and to maximize educational potential, there needs to be a concurrent integrated didactic component. Thus, to maximize resident training, an educational curriculum with both a didactic and a technical portion is necessary and was created.

This supplement is dedicated to the use of neurosurgery simulators in an educational curriculum as a means to further educate and improve surgical training. It has been categorized into 5 main areas and separated by regional anatomy. The first section has 3 articles reviewing the history of simulation and neurosurgery. Specifically, these articles discuss medical simulators in general, the development of a procedural educational course, and the expansion of simulation into an educational curriculum. The second through fourth categories are based on the anatomic regions and disease-specific simulators types. Included are the treatment of vascular disorders, the treatment of intracranial disorders, and the treatment of spinal disorders. The concluding section reviews future advancements and adaptations of new technology.

Although this supplement has several articles that concentrate and focus on the individual simulators and models, it should be emphasized that the most important aspect of the CNS simulation objective is the underlying educational curriculum. With the inception of this curriculum, the CNS has initiated prospective data collection such as to obtain objective information on not only the didactic components but also the technical features. It is therefore our hope and aim to use this information to further advance and improve neurosurgical education.

Finally, I would like to thank the numerous individuals who have contributed to the CNS simulation course, specifically the CNS staff and neurosurgery volunteer faculty.

James S. Harrop, MD, Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania