The latest covid-19 impact on the neurosurgery resident admission and training in Morocco

The Kingdom of Morocco is also affected by the COVID-19 in all filed. The coronavirus shutdown has been a great challenge for health policymakers, the citizens, and those traveling down for various reasons. Among them, there are undergraduate students, physicians seeking postgraduate education…etc. Some were lucky enough to start their courses online, pending the time to come to Morocco for continuing their studies. But unfortunately, this was not the case for the potential neurosurgical residents that were already accepted, and some were even holding scholarships but were unable to join their training centers. Meanwhile, a substantial effort has been made to feel the tremendous lack of neurosurgeons in Sub-Saharan Africa by quality massive education and training of neurosurgeons from those countries. Thus, these consequences of the COVID-19 shutdown are a dropping stone in a quiet lack, delaying the important project of the WFNS and others to fill up this gap. At the same time, it is worth thinking about the innovative model of neurosurgical education and training for the new generation of Sub-Saharan African neurosurgeons.

Virtual Reality Simulator for Training on Surgery Ergonomics Skills

This work focuses on ergonomics skills based on Virtual Reality (VR) training simulator for spine surgery. The proposed system used the Head Mounted Display (HMD) device for monitoring and data collection. The aim of the project was to provide a training approach for residents that would enable them to acquire the proper ergonomic skills needed while performing spine surgery. A VR training simulator has been designed and implemented to measure two ergonomic skills required that need to be maintained during any surgery. The two components were neck’s angle and table’s height. The experiments showed that the users are usually focused on their work and tend to pay less attention to their body’s position and movements. This can result in a wrong ergonomics setup, which leads to musculoskeletal pain. Thus, the users (residents) need to be trained to have good ergonomics positions. The proposed system measured this using a specific metric that collected head positions, angles, elbow height, and other parameters. The designed model was a VR simulator for neurosurgical education in particular; however, it might be good for some other similar surgeries. The study concluded that incorporating simulations into residents’ training and simulated surgeries can strengthen the surgeons’ skills and outcomes. As a result, both residents and expert surgeons can benefit from the use of the developed model.

Building a microneurosurgical laboratory in Latin America: challenges and possibilities

Background: Training in microsurgical neuroanatomy is a priority for neurosurgical education. During the 20th century, microsurgical laboratories arose and provided a way to develop surgical skills. Few reports addressed the assembly, construction, and details of a training laboratory. Methods: We have conducted a literature review and searched legislation on the need to plan the structure of the laboratory. Results: We projected and built a laboratory through a public-private partnership. High-tech workstations and instruments were planned to meet the needs of residents, fellows, and student. All steps and materials were in accordance with the Brazilian legislation and articles previously selected. Conclusion: We described our experience and demonstrated the implementation of a micro neurosurgical skills laboratory.

Assessment of Contemporary Virtual Reality Programs and 3D Atlases in Neuroanatomical and Neurosurgical Education

Statement of Significance: The utilization of innovative technologies in medical education has received increasing attention in both undergraduate and graduate medical curricula. Understanding spatial, physiological, and pathological aspects of neuroanatomy are important for medical students and residents, alike. As virtual reality applications and platforms become more accessible to educators, learners, and the general public, such technology now represents a feasible modality of neuroanatomical education. This qualitative observational study compares and evaluates five programs based on the accessibility, breadth of content, and utility for various learner populations. Objective: Virtual reality (VR) is a growing technology of interest in medical education, particularly as the millennial generation has become the primary learners. We sought to compare the five available and affordable neuroanatomical programs with objective comparisons of the neuroanatomy, format, and target audience. Methods: The following programs were included: Sharecare VR, Organon VR, The Neurosurgical Atlas 3D Operative Neuroanatomy, BioDigital 3D Human Anatomy, 3D Brain. These programs were selected based on their price ($0-30) and platform (HTC Vive, Oculus Rift, iOS, Google Chrome). The following neuroanatomical categories were assessed: CNS, Cranial Nerves, PNS Skull, and Spine. Neuroanatomical level of detail was scored from 0 (absence of structure) to 3 (operative anatomy). Points were provided if programs included explanations of neuroanatomical relevance, models of pathology & physiology, references, and quiz features. These scores were tallied and compared. Results: The Neurosurgical Atlas and BioDigital scored highest (22 points each), followed by Organon VR (11), 3D Brain (9), and Sharecare VR (6). The Neurosurgical Atlas had the most detail with a score of 3 in each neuroanatomical category. BioDigital included more, but simpler, models. 3D Brain included simple CNS models, but useful explanations and references. Disappointingly, the VR-exclusive programs had entertainment-only models (Score = 1). Conclusions: The Neurosurgical Atlas is the most relevant and detailed model of neuroanatomy and is most appropriate for resident- or attending-level anatomic review. The remaining programs lacked detailed neuroanatomy limiting their potential for a neurosurgical audience.

3D printing in neurosurgery education: a review

Objectives The objectives of this manuscript were to review the literature concerning 3D printing of brain and cranial vault pathology and use these data to define the gaps in global utilization of 3D printing technology for neurosurgical education. Methods Using specified criteria, literature searching was conducted to identify publications describing engineered neurosurgical simulators. Included in the study were manuscripts highlighting designs validated for neurosurgical skill transfer. Purely anatomical designs, lacking aspects of surgical simulation, were excluded. Eligible manuscripts were analyzed. Data on the types of simulators, representing the various modelled neurosurgical pathologies, were recorded. Authors’ countries of affiliation were also recorded. Results A total of thirty-six articles, representing ten countries in five continents were identified. Geographically, Africa as a continent was not represented in any of the publications. The simulation-modelling encompassed a variety of neurosurgical subspecialties including: vascular, skull base, ventriculoscopy / ventriculostomy, craniosynostosis, skull lesions / skull defects, intrinsic brain tumor and other. Finally, the vascular and skull base categories together accounted for over half (52.8 %) of the 3D printed simulated neurosurgical pathology. Conclusions Despite the growing body of literature supporting 3D printing in neurosurgical education, its full potential has not been maximized. Unexplored areas of 3D printing for neurosurgical simulation include models simulating the resection of intrinsic brain tumors or of epilepsy surgery lesions, as these require complex models to accurately simulate fine dissection techniques. 3D printed surgical phantoms offer an avenue for the advancement of global-surgery education initiatives.