A multifaceted training approach for neurosurgery registrars incorporating cadaver-based simulation

Abstract

Background: Neurosurgical training has historically been grounded in an apprenticeship model. This approach to developing competence relies on authentic learning opportunities presenting themselves in the operating theatre. Recently, aspects such as medical litigation, increasing registrar numbers, reduction in mandatory work hours and the need to prioritise service delivery over training opportunities have led to the incorporation of cadaver-based simulation training to increase surgical exposure. Our study aimed to explore how a structured training package in anterior cervical discectomy and fusion influences a group of neurosurgery registrars' perception of their skills development. Methods: The training package consisted of an interactive lecture, a video and two cadaver-based simulation training sessions. The study population included seven registrars. Data was generated through a questionnaire completed at recruitment and semi-structured interviews conducted after exposure to the training package. Demographic information was captured and summarised, and the interviews were analysed using thematic analysis. Results: Structured training in a basic neurosurgical technique was found to be valuable and preferred to fragmented and opportunistic learning opportunities. It promoted confidence in procedural principles and theatre setup and provided invaluable opportunities for learning. Opportunities to practise basic techniques made the theatre environment less hostile and promoted learning in the workplace. Conclusion: Structured training packages incorporating cadaver-based simulation are a potentially important component of skills development in neurosurgical training. Contribution: Such learning resources are based on neurosurgical core competencies and can form part of a shift towards a more comprehensive competency-based training programme.