Cited by 106Surgical Simulation and TrainingSimulation-Based Education in HealthcareAnatomy and Medical Technology

Simulation for skills training in neurosurgery: a systematic review, meta-analysis, and analysis of progressive scholarly acceptance

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Davids, Joseph, Manivannan, Susruta, Darzi, Ara, Giannarou, Stamatia, Ashrafian, Hutan, Marcus, Hani J·2021·Neurosurgical Review

Abstract

At a time of significant global unrest and uncertainty surrounding how the delivery of clinical training will unfold over the coming years, we offer a systematic review, meta-analysis, and bibliometric analysis of global studies showing the crucial role simulation will play in training. Our aim was to determine the types of simulators in use, their effectiveness in improving clinical skills, and whether we have reached a point of global acceptance. A PRISMA-guided global systematic review of the neurosurgical simulators available, a meta-analysis of their effectiveness, and an extended analysis of their progressive scholarly acceptance on studies meeting our inclusion criteria of simulation in neurosurgical education were performed. Improvement in procedural knowledge and technical skills was evaluated. Of the identified 7405 studies, 56 studies met the inclusion criteria, collectively reporting 50 simulator types ranging from cadaveric, low-fidelity, and part-task to virtual reality (VR) simulators. In all, 32 studies were included in the meta-analysis, including 7 randomised controlled trials. A random effects, ratio of means effects measure quantified statistically significant improvement in procedural knowledge by 50.2% (ES 0.502; CI 0.355; 0.649, p < 0.001), technical skill including accuracy by 32.5% (ES 0.325; CI - 0.482; - 0.167, p < 0.001), and speed by 25% (ES - 0.25, CI - 0.399; - 0.107, p < 0.001). The initial number of VR studies (n = 91) was approximately double the number of refining studies (n = 45) indicating it is yet to reach progressive scholarly acceptance. There is strong evidence for a beneficial impact of adopting simulation in the improvement of procedural knowledge and technical skill. We show a growing trend towards the adoption of neurosurgical simulators, although we have not fully gained progressive scholarly acceptance for VR-based simulation technologies in neurosurgical education.

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  1. [31]Gasco JH Thomas Patel A Smith A Paulson D Muns A Desai S Moisi M Kuo Y-F Macdonald BO-B Juan Patterson J Neurosurgery simulation in residency training: Feasibility, cost, and educational benefit Neurosurgery 2013 73 S39 S45 10.1227/NEU.0000000000000102 24051881 · DOI

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Authors
Davids, J., Manivannan, S., Darzi, A., Giannarou, S., Ashrafian, H., & Marcus, H. J.
Affiliations
  • Imperial College Healthcare NHS Trust (GB)
  • University Hospital Southampton NHS Foundation Trust (GB)
Corresponding author
Davids, Joseph
Venue
Neurosurgical Review
Published
2020-09-18
Volume
44
Issue
4
Pages
1853-1867
ISSN
  • 0344-5607 (ISSN-L)
  • 1437-2320
OpenAlex
W3087239859
Cited by
106
References
130
Citations by year
2026: 16 · 2025: 23 · 2024: 26 · 2023: 12 · 2022: 24 · 2021: 5
FWCI
2.32
Type
journal article
Language
en
Open access
Locations
  • Neurosurgical Review (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Spiral (Imperial College London) (submittedVersion, cc-by)
  • UCL Discovery (University College London) (submittedVersion)
Funders
Imperial College London
Topics
  • Health Sciences › Medicine › Surgery › Surgical Simulation and Training
  • Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
  • Physical Sciences › Engineering › Biomedical Engineering › Anatomy and Medical Technology
Keywords
simulation-based training, neurosurgical training, virtual reality simulator, low-fidelity simulators, procedural knowledge, technical skills
MeSH terms
Virtual Reality, Clinical Competence, Computer Simulation, Humans, Neurosurgery, Neurosurgical Procedures

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