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66 Cadaveric simulation training for approaches to the skull base: cross-specialty training collaborative
  1. SMT Jeffery1,
  2. O Davies1,
  3. A Henderson2,
  4. O Dale3,
  5. AP Williams1
  1. 1Department of Neurosurgery, North Bristol NHS Trust, UK
  2. 2Department of Otolaryngology, Royal United Hospitals Bath NHS Foundation Trust, UK
  3. 3Department of Otolaryngology, University Hospitals Bristol NHS Foundation Trust, UK

Abstract

Background Simulation is an increasingly important aspect of surgical training as it can provide opportunity for skill acquisition in a safe and controlled environment. This is particularly important in skull base surgery where the margins for error are small and their consequences grave. Skull base surgery often involves neurosurgery and ENT working closely together, combining their varied skills and experience. For the neurosurgical trainee, experience at anterior and lateral skull base approaches may not be obtained until the latter years of training, whereas for ENT trainees, the techniques and skills required for transnasal and transtemporal approaches are core competencies developed from earlier stages of training. The purpose of this collaborative was to assess the viability and utility of integrated skull base simulation training.

Methodology Each ENT trainee was paired with a neurosurgery trainee for cadaver-based simulated lateral and anterior approaches to skull base and sinuses. Peer-to-peer instruction with consultant supervision was utilised to exchange expertise between specialties. Qualitative feedback was obtained from participants.

Results Participants (n = 12) rated their confidence on a scale of 1 to 10, in performing 4 operative approaches prior to and after simulation training. On average, confidence improved by 2.3 points in each approach (paired t-tests p < 0.001). All participants “strongly agreed” that cadaver simulation is a positive training experience and all “strongly agreed” or “agreed” that training with peers in another related specialty was beneficial. There was disparity in opinion as to whether trainees should demonstrate competence in the simulated environment prior to operating on patients, with an equal number agreeing and disagreeing.

Conclusions Cadaveric simulation training for approaches to the skull base provides a positive training experience. Collaborative and integrated training amongst related surgical specialties offers additional benefits from the sharing of knowledge and experience, as well as maximising limited resources and reducing costs.

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