Assessing the impact of neurosurgery and neuroanatomy simulation using 3D non-cadaveric models amongst selected African medical students

Abstract

Background: Laboratory dissections are essential to acquire practical skills to perform neurosurgical procedures. Despite being traditionally done on cadavers, they are often unavailable and suffer from cultural barriers in the African context. Non-cadaveric UpSurgeOn neurosurgery models have been developed to bridge this barrier, providing an almost similar experience with the human body. This study aimed to assess the impact of the UpSurgeOn hands-on-touch non-cadaver model training amongst selected Cameroon medical students.

Methods: An anonymous 35-item questionnaire was distributed online using Google drive systems to medical students who attended UpSurgeOn's hands-on-touch non-cadaver model training course. These questions aimed to capture data on previous experience with neuroanatomy and neurosurgery practicals and the perception, attitudes, and impact of the UpSurgeOn neurosurgery tool.

Results: Eighty-six students completed the survey. The mean age was 21.2 ± 1.868 years, 61.6% were males with 62.8% of respondents being medical students in preclinical years. Before the training, 29.4% had a fair knowledge of neuroanatomy. Textbooks and Youtube videos were the main sources of neuroanatomy and neurosurgery knowledge for more than half of the respondents. Up to 91.5% had no prior exposure to a neuroanatomy/neurosurgery cadaver laboratory dissection, and 22.6% and 17.6% had witnessed and performed at least one craniotomy before, respectively. There were 11.1%, 15.5%, and 31.3% of our respondents who had used a surgical microscope, a neurosurgical instrument, and the UpSurgeOn Neurosurgery tool before, respectively. The majority perceived the UpSurgeOn tool easy to use and felt they needed to learn just a few things before getting going with the box. Most thought of increasing the use of the UpSurgeOn Box and saw the need to be part of the training curriculum. Finally, the majority felt this tool helped to increase familiarity and acquire neurosurgical skills, and to develop the orientation skills needed during neurosurgical approaches.

Conclusion: Undergraduate exposure to traditional neurosurgery/neuroanatomy labs is limited in Cameroon. Neurosurgery/neuroanatomy practical skills are gained essentially using non-practical means. Most students found the UpSurgeOn tool user-friendly, saw the need to incorporate it as part of their training, and perceived it to be essential in getting acquainted with neurosurgical skills.

Keywords: Cameroon; brain; cadaver; neuroanatomy; neurosurgery; simulator; students; virtual reality.

Figure 1

First phase of the training. Medical students receiving lectures on basic neurosciences delivered by a consultant neurosurgeon.

Figure 2

(A–E) UpSurgeOn non-cadaveric neuroanatomy models. (A) Temporal approach simulator model. (B) Disposable skulls. (C) Retrosigmoid approach simulator box. (D) Life-size human encephalon model. (E) Simulation box for brain aneurysm clipping.

Figure 3

Second phase of the training. Medical students having a hands-on appraisal and exploring the brain structures of the simulation boxes with the help of a microscope under the guidance of a consultant neurosurgeon. All individuals in the photo gave their consent for publication in this article.

Figure 4

(A–C) Practical session using the surgical microscope, endoscope and simulator. (A) Residents and Neurosurgeons demonstrating the structures of the brain as seen under an endoscope. (B,C) Medical students performing a surgical exploration of brain organs with the help of a binocular microscope under the guidance of a neurosurgeon. All individuals in the photo gave their consent for publication in this article.

Figure 5

Neuroanatomy knowledge prior to the UpSurgeOn course (N = 85).

Figure 6

Proportions of different learning tools used to acquire knowledge in neuroanatomy prior to the UpSurgeOn course (N = 83).

Figure 7

Proportions of different learning tools used to acquire knowledge in neurosurgery prior to the UpSurgeOn course (N = 76).

Figure 8

Frequencies of craniotomy brainboxes to which participants who performed or witnessed a craniotomy were exposed prior to the UpSurgeOn course (N = 27).