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49 Neurosurgical simulation – a multidisciplinary approach to human factors in theatre
  1. O Davies,
  2. S Jeffery,
  3. A Williams
  1. North Bristol NHS Trust, UK


Simulation is an effective and valuable asset to medical education. Skills unique to surgery such as procedural steps and communication in theatre are benefiting from improved surgical models and expertise in utilising them to produce high fidelity educational scenarios.

We delivered a simulation based Emergency Neurosurgery course for Foundation Year 2 doctors, junior Neurosurgical trainees and trainee theatre staff in fully functioning operating theatre, supported by the Trust. The aim was to provide delegates with the knowledge and practical skills, including decision making and effective communication that are required for safe working in a Neurosurgical theatre, within a controlled but realistic environment to maximise the learning potential.

Delegates were brought to a patient (SimMan®) in a resuscitation scenario to make their initial assessment with the patient demonstrating real time vitals, pupil sizes and verbal responses. After completing the initial assessment delegates were required to interpret CT scans and consent the patient’s relatives before taking the patient to theatre. Once there, delegates carried out the emergency Neurosurgical operation, using image guidance on surgical model heads (Rowena®) and surgical drills, assisted by trainee scrub nurses and theatre HCAs .

As the scenario unfolded, complications arose to highlight the importance of human factors and multi-disciplinary working. This tested delegates’ clinical acumen, decision making and communication skills in a pressured environment. Delegates were supervised by senior trainees who were able to give personalised feedback.

The course received global positive feedback from delegates, with particular focus on learning alongside other healthcare professionals to improve inter-professional working and theatre safety.

It is possible to deliver teaching to a multidisciplinary group using simulation to mimic the normal working environment as closely as possible. Future plans are to repeat the course with anaesthetic colleagues involved to help design increasingly challenging scenarios for senior trainees and scrub team members.

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