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A Systematic Review of Simulation-based Training in Neurosurgery, Part 1: Cranial Neurosurgery

Research output: Contribution to journalArticlepeer-review

Ebrahim Patel, Abdullatif Aydin, Michael Cearns, Prokar Dasgupta, Kamran Ahmed

Original languageEnglish
Pages (from-to)e850-e873
JournalWorld Neurosurgery
Early online date18 Sep 2019
Accepted/In press23 Aug 2019
E-pub ahead of print18 Sep 2019
Published1 Jan 2020

Bibliographical note

Copyright © 2019 Elsevier Inc. All rights reserved.


King's Authors


OBJECTIVE: The recent emphasis on simulation-based training in neurosurgery has led to the development of many simulation models and training courses. We aim to identify the currently available simulators and training courses for neurosurgery, assess their validity and determine their effectiveness.

DESIGN: Both Medline and EMBASE were searched for English language articles which validate simulation models for neurosurgery. Each study was screened according to Messick's validity framework, and rated in each domain. McGaghie's model of translational outcomes was then used to determine a level of effectiveness (LoE) for each simulator or training course.

RESULTS: Upon screening of 6006 articles, 114 were identified either validating or determining a LoE for 108 simulation-based training models or courses. Achieving the highest rating for each validity domain were: six models and training courses for content validity; 12 for response processes; 4 for internal structure; 14 for relations to other variables and none for consequences. For translational outcomes, 6 simulators or training achieved a LoE of greater than 2 and thus demonstrated skills transfer beyond the simulation setting.

CONCLUSIONS: With the advent of increasing neurosurgery simulators and training tools, there is a need for more validity studies. Further attempts to investigate translational outcomes to the operating theatre when using these simulators is particularly warranted. Finally, more training tools incorporating full immersion simulation and non-technical skills training are recommended.

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