Simulation to become a better neurosurgeon. An international prospective controlled trial: The Passion study
Claudia Fanizzi, Giovanni Carone, Alessandra Rocca, Roberta Ayadi, Veronika Petrenko, Cecilia Casali, Martina Rani, Marta Giachino, Lydia Viviana Falsitta, Enrico Gambatesa, Tommaso Francesco Galbiati, Eleonora Orena, Irene Tramacere, Nicole Irene Riker, Alessandro Mocca, Abdelaziz Najib, Adrian Ndroqi, A. Tomás-Biosca, A Dimitrov, Antanas Budėnas, Augustinas Fedaravicius, Aicha Ouchene, Dauleac Corentin, Djenaba Bah, Friedrich Erhart, Fahrudin Alić, Foughali Mehdi, Hajar Bechri, Jagoš Golubović, Julien Delaunois, Angela Dele Rampini, Karolis Simaitis, Milan Lepić, Mirel Grada, Miroslav Fimić, Mohamed Amgad Elsayed Matter, Benachour Mohamed Safouane, Nebojša Lasica, Olga Parras, Ran Xu, Demaerel Rik, Sandra Rutkowska, Margherita Castaldo, Tatyana Sarnecki, Angela Rita Elia, Tobias Rossmann, Volodymyr Smolanka, Fatima Fakhro, Y. Wang, Yakun Yang, Hu Yeshuai, Bianca Maria Baldassarre, Giuseppe Di Perna, Lei Qi, Ye Zhongxing, Alice Giotta Lucifero, Yuhao Zhao, Vittoria Cojazzi, Gianluca Mezzini, Bektaşoğlu Pınar Kuru, Marina Minichiello, Wenping Xiong, Yan Cui, Zhigang Tan, Yue Lü, Li Xu, Deng Gang, Xiaoyang Tao, Norbert Svoboda, Shiqiang Wang, Zhijie Zhoul, Tao Chang, Antonio D’Ammando, Fabio Grassia, Dong Wang, Jidong Sun, Yanwei Chen, Zongdang Wei, Andrew Stevens, Niko Njirić, Marco Cancedda, Ahmet Özdemir, Burak Tahmazoglu, Edoardo Porto, Namer Thana, Aqsa Adil, Francesco Maria Crisà, Karl Schaller, Torstein R. Meling, Francesco DiMeco, Alessandro Perin
Abstract
Introduction: Surgical training traditionally adheres to the apprenticeship paradigm, potentially exposing trainees to an increased risk of complications stemming from their limited experience. To mitigate this risk, augmented and virtual reality have been considered, though their effectiveness is difficult to assess. Research question: The PASSION study seeks to investigate the improvement of manual dexterity following intensive training with neurosurgical simulators and to discern how surgeons' psychometric characteristics may influence their learning process and surgical performance. Material and methods: Seventy-two residents were randomized into the simulation group (SG) and control group (CG). The course spanned five days, commencing with assessment of technical skills in basic procedures within a wet-lab setting on day 1. Over the subsequent core days, the SG engaged in simulated procedures, while the CG carried out routine activities in an OR. On day 5, all residents' technical competencies were evaluated. Psychometric measures of all participants were subjected to analysis. Results: The SG demonstrated superior performance (p < 0.0001) in the brain tumour removal compared to the CG. Positive learning curves were evident in the SG across the three days of simulator-based training for all tumour removal tasks (all p-values <0.05). No significant differences were noted in other tasks, and no meaningful correlations were observed between performance and any psychometric parameters. Discussion and conclusion: A brief and intensive training regimen utilizing 3D virtual reality simulators enhances residents' microsurgical proficiency in brain tumour removal models. Simulators emerge as a viable tool to expedite the learning curve of in-training neurosurgeons.