Simulation-based Neurosurgery Training: Enhancing Skills and Education for Residents and Medical Students in a Developing Latin American Country

Introduction: In developing countries, simulation-based neurosurgical training addresses the challenge of skill acquisition without patient risk. In 2023, a simulation center was launched in Peru, offering medical students and neurosurgery residents a platform to improve their technical skills in a safe, controlled environment.

Methods: The center offers various courses, including hybrid simulations for endoscopic abscess procedures (24 residents), virtual spinal endoscopy (60 participants), complex spine surgery (15 participants), and surgery-applied neuroanatomy (125 participants). Weekly 4-hour sessions train 8 residents. Fourteen residents, across five training years, rotate through specialties, practicing techniques like vascular microdissection and skull base approaches with microscopes, endoscopes, and neurosurgical instruments. Performance metrics: drilling time, procedural steps, and attempts

Results: The results show significant progress among neurosurgery residents using haptic drilling simulators, with improvements in drilling time, steps completed, and number of attempts.

Drilling Time Reduction: Residents reduced drilling time across sessions. For instance, the 5th-year resident A decreased from 30 to 28 minutes (6.7%), and the 2nd-year resident D from 60 to 50 minutes (16.7%), with an average reduction between 5% and 17%, indicating improved efficiency.
Increase in Steps: More steps were completed, showing increased precision. The 4th-year resident A went from 60 to 63 steps (5%), and the 2nd-year resident C from 55 to 72 steps (30.9%), with an overall increase of 5% to 30%, suggesting enhanced coverage and accuracy.
Reduction in Attempts: Attempts decreased in several cases, such as the 3rd-year resident A, who reduced attempts from 5 to 4 (20%), with reductions averaging 10% to 20%, indicating better technique and fewer repetitions

Conclusion : Residents improve drilling time by 10%, increase steps by 15%, and reduce attempts by 15%, demonstrating significant gains in efficiency, precision, and confidence. The simulation center has proven effective in enhancing neurosurgical training, providing a strong model for simulation-based education