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Winkler-Schwartz A, Bajunaid K, Mullah MAS, Marwa I, Alotaibi FE, Fares J, Baggiani M, Azarnoush H, Zharni GA, Christie S, Sabbagh AJ, Werthner P, Del Maestro RF. Bimanual Psychomotor Performance in Neurosurgical Resident Applicants Assessed Using NeuroTouch, a Virtual Reality Simulator. J Surg Educ 2016; 73:942-953. [PMID: 27395397 DOI: 10.1016/j.jsurg.2016.04.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 03/01/2016] [Accepted: 04/14/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Current selection methods for neurosurgical residents fail to include objective measurements of bimanual psychomotor performance. Advancements in computer-based simulation provide opportunities to assess cognitive and psychomotor skills in surgically naive populations during complex simulated neurosurgical tasks in risk-free environments. This pilot study was designed to answer 3 questions: (1) What are the differences in bimanual psychomotor performance among neurosurgical residency applicants using NeuroTouch? (2) Are there exceptionally skilled medical students in the applicant cohort? and (3) Is there an influence of previous surgical exposure on surgical performance? DESIGN Participants were instructed to remove 3 simulated brain tumors with identical visual appearance, stiffness, and random bleeding points. Validated tier 1, tier 2, and advanced tier 2 metrics were used to assess bimanual psychomotor performance. Demographic data included weeks of neurosurgical elective and prior operative exposure. SETTING This pilot study was carried out at the McGill Neurosurgical Simulation Research and Training Center immediately following neurosurgical residency interviews at McGill University, Montreal, Canada. PARTICIPANTS All 17 medical students interviewed were asked to participate, of which 16 agreed. RESULTS Performances were clustered in definable top, middle, and bottom groups with significant differences for all metrics. Increased time spent playing music, increased applicant self-evaluated technical skills, high self-ratings of confidence, and increased skin closures statistically influenced performance on univariate analysis. A trend for both self-rated increased operating room confidence and increased weeks of neurosurgical exposure to increased blood loss was seen in multivariate analysis. CONCLUSIONS Simulation technology identifies neurosurgical residency applicants with differing levels of technical ability. These results provide information for studies being developed for longitudinal studies on the acquisition, development, and maintenance of psychomotor skills. Technical abilities customized training programs that maximize individual resident bimanual psychomotor training dependant on continuously updated and validated metrics from virtual reality simulation studies should be explored.
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Affiliation(s)
- Alexander Winkler-Schwartz
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
| | - Khalid Bajunaid
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Division of Neurosurgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Muhammad A S Mullah
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Ibrahim Marwa
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Fahad E Alotaibi
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Department of Neurosurgery, National Neuroscience Institute (NNI), King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Jawad Fares
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Marta Baggiani
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Hamed Azarnoush
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Gmaan Al Zharni
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Department of Neurosurgery, National Neuroscience Institute (NNI), King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Sommer Christie
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Abdulrahman J Sabbagh
- Section of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital & Research Center (Gen. Org) - Jeddah Branch, Jeddah, Saudi Arabia
| | - Penny Werthner
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Rolando F Del Maestro
- Department of Neurosurgery, Neurosurgical Simulation Research and Training Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
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