The implementation of simulators in neurosurgery training. The application of the simulator program in Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Perú.
Diego Alonso Quiroz-Marcelo, Universidad Peruana Cayetano Heredia, Lima, Peru.
DOI:10.25259/SNI_755_2023Copyright: © 2023 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Aguilar-Zegarra LF, Quiroz-Marcelo DA, Ou-Li FS, Nombera-Aznarán MF. The implementation of simulators in neurosurgery training. The application of the simulator program in Peru. Surg Neurol Int 06-Oct-2023;14:356
How to cite this URL: Aguilar-Zegarra LF, Quiroz-Marcelo DA, Ou-Li FS, Nombera-Aznarán MF. The implementation of simulators in neurosurgery training. The application of the simulator program in Peru. Surg Neurol Int 06-Oct-2023;14:356. Available from: https://surgicalneurologyint.com/surgicalint-articles/12581/
The neurosurgery residency is one of the most demanding programs internationally. Peru must implement simulation spaces within its neurosurgery residency programs to face this competition. In addition, the implementation of the latest technologies in simulation programs will provide outstanding support to improve performance in neurosurgical training and address the challenge of current technologies.
In Latin America, the neurosurgery specialty faces a technological disadvantage compared to its international competitors during specialty training. For example, a study conducted by MurguiaFuentes et al. presents that 40% of residents from Latin American countries members of the Latin American Federation of Neurosurgical Societies (FLANC) do not achieve optimal academic performance during their training. This situation is connected to the level of support provided by their residency program, including participation in conferences, international rotations, and mental health meeting attendance, among others.[
In Peru, the National Medical Residency system is regulated by the National Council of Medical Residency (CONAREME). In this regard, there are “Minimum Training Standards for the Second Specialization Program in Neurosurgery” regulations that govern professional training in acquiring skills to tackle challenges in the field of neurosurgery.[
One branch of neurosurgery that greatly benefits from the use of the simulated practice is microneurosurgery. This involves the use of specific instruments to access complex and delicate areas, such as the brain or the base of the skull, through microsurgical techniques, supported by the magnification of an operating microscope. Due to these requirements, the development of advanced skills is needed, including hand-eye coordination, extensive microanatomical knowledge, fine surgical precision, and even control over physiological tremors. However, all of this represents a significant obstacle for young Peruvian neurosurgeons as they require equipped learning spaces and have fewer training opportunities during the early stages of their specialization. As demonstrated in the study by Lefevre et al., where the learning curve is influenced by both the duration of the training and technical errors,[
The implementation of simulation provides a safe and risk-free practice environment for residents. In addition, it allows them to train in rare or highly demanding clinical scenarios. The physician can identify their weaknesses early on and reduce the margin of error, which is crucial to ensuring the safety and integrity of patient health. Furthermore, simulation facilitates the acquisition of clinical skills before actual patient contact and corrects deficiencies in coordination with the professional team.[
To support simulation models, technological resources such as virtual reality and augmented reality are currently being used, which provide better spatial orientation for the surgical training of young residents. Kennedy et al. demonstrated that the group of students trained with virtual reality-assisted simulators had 40% fewer errors than the control group, which only trained with the traditional method.[
Artificial intelligence applied to virtual simulators offers the possibility to personalize the learning experience of users. A study conducted with 50 participants, including neurosurgeons, neurosurgery residents, and medical students, evaluated the development of surgical skills in subpial tumor resection using metrics selected by artificial intelligence. This allowed for detailed tracking of the evolution of their learning curve after repeated practice.[
At present, there are few examples of the implementation of simulation in the medical residency program for neurosurgery in Peru. One of these examples is Cayetano Heredia Peruvian University, which has completed the implementation of the first neurosurgery residency program that includes a simulation center as part of the residents’ training in neurosurgery in 2023.[
To promote future Peruvian neurosurgeons having international competencies focused on new technologies, it is crucial to encourage the creation of simulation spaces in surgical technical preparation.
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Journal or its management. The information contained in this article should not be considered to be medical advice; patients should consult their own physicians for advice as to their specific medical needs.
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