A Playbook for Neurosurgical Resident Training in Skull Base Surgery

ABSTRACT

Introduction: To be adequately prepared for the technical surgical demands and interprofessional teamwork required of the operating room, cadaveric laboratory training is essential.1 A recent survey of neurosurgical residency programs in the United States bore this out 95.4% of respondents view laboratory dissection as an integral to training and an additional 89.2% would support a national “suggested” dissection curriculum and manual.2 To address this demand, the OHSU Neurosurgery residency program in partnership with OHSU Simulation, the OHSU Body Donation Program, and industry stakeholders have developed, over the past 6 years, an annual three-part cadaveric surgical simulation course series that has provided training in skull base procedures. Methods: Resident surgical education aims to (1) Develop decision-making, complication management and technical surgical abilities in a low-risk environment, (2) review anatomy, and (3) refine interprofessional teamwork typical to the operating room between otolaryngology (ENT) and neurosurgery disciplines. Successful resident education in simulation is dependent on collaboration between neurosurgical faculty, educational support staff, and industry experts. We describe a manuscript for successfully implementing a cadaveric surgical simulation course to meet the educational objectives above. This comprehensive overview details (1) equipment and instrumentation, (2) course maps and photos ([Figs. 1] and [2]), (3) curriculum development, (4) tissue procurement and preparation, (5) communications between major stakeholders, (6) scheduling and logistics, (7) evaluation of resident proficiency, and (8) COVID-19-specific modifications to course curriculum. Results: Course evaluations from 337 OHSU neurosurgery and otolaryngology residents over the past 6 years were collected and analyzed. Means and SDs of Likert's scale questions were calculated and indicated uniformly positive responses ([Table 1]). Free-text responses were analyzed via sentiment analysis. This resultant heat map ([Fig. 3]) indicated positive attitudes, with the lowest value being +0.41 (on a scale of -1.0 to 1.0). Conclusion: We hope this manuscript can serve as a guide for other institutes to develop their own residency educational curriculum in cadaveric skull base procedures. (Figure Presented).