Dundee Annual Neurosurgery Skills Event (DANSE)-Improving the Availability and Affordability of Neurosurgical Skills Workshops for Medical Students

Abstract

Background Neurosurgery can be a daunting career choice for medical students, with preparation for trainee application often being inaccessible and expensive. This article describes a student-led neurosurgical skills event supported by local neurosurgery faculty members. Such event was designed to offer a means to bridge this gap by providing an opportunity to practice neurosurgical techniques in simulation, and learn about what a career in neurosurgery involves. Methods Pre- and postskills laboratory surveys were used to ascertain the baseline confidence and knowledge of common neurosurgical techniques, as well as to what both the application to neurosurgery and the typical workload of a neurosurgeon involves. The conference offered six neurosurgical workshops as well as three lectures to provide practical and theoretical learning opportunities. The session included introduction to the candidates and faculty, identification of learning objectives, and career discussion. Postcourse feedback also was also used to assess learning outcomes. Results Eighteen students attended the event. Postskills event, students were significantly more likely to understand the principles behind all of the relevant neurosurgical skills included on the day. Additionally, students were more likely to understand what a career in neurosurgery involves, and how to approach applying for a training number. Respondents enjoyed the workshops, valued hands-on experience and interactions with consultants, found it affordable, and would recommend to their peers. Conclusions For medical students interested in a career in neurosurgery, opportunities to learn relevant techniques and skills are often expensive and difficult to come across. Here, we highlight affordable methods of simulation to result in significant student satisfaction. Additionally, providing ample opportunity to practice different neurosurgical techniques under almost 1:1 level tutoring enables significant increases in students' confidence and understanding of different neurosurgical concepts. We greatly encourage other medical student groups to develop their own hands-on simulation events to attract medical students to a surgical field often considered daunting and inaccessible, and address gaps in the medical school curriculum.

Keywords: accessibility; medical education; medical student; neurosurgical skills; simulation teaching.

Fig. 1

Event workflow and duration of contents. Three students attended each station at one time, with six stations being always in simultaneous operation. Each session was split into two, for example, A.1 and A.2.

Fig. 2

( A–D ) Cost-effective simulation for external ventricular drain and intracranial pressure monitoring. Handmade calvarium models were with cranial suture markings that were fixed to square plywood boards using Plaster of Paris. Internal to the calvarium was a small-sized bin/trashcan bag filled with children's play slime to model the dura and brain parenchyma, respectively. A small block of neoprene was added to model the area of scalp where the suture would be made.

Fig. 3

( A, B ) Neoprene for simulation of cranial skin flap techniques. We used custom-cut sheets of this material to cover and stick to the low-cost calvariums (using its adhesive bottom surface). The neoprene was of appropriate thickness to simulate layers of the scalp, as well as for penetration by a scalpel. Surgical drapes were used for additional visual simulation value.

Fig. 4

Using coconut shells to simulate burr holes and craniotomy. Each delegate had the opportunity to perform craniotomy on a coconut shell. This involved using a perforator to create multiple burr holes, and then connect these together with a craniotome to complete a craniotomy. The coconuts were secured to the work surface with a Mayfield.

Fig. 5

Each delegate had the opportunity to use a diamond drill on the eggshells of both boiled and raw eggs. The former involved ensuring to penetrate the shell (i.e., the skull), but not disrupting the underlying membrane (i.e., the dura), and thus indenting the underlying solid egg white. The latter involved ensuring full penetrate of the shell without seepage of the liquid egg white. Eggs were secured to a support (carton) beneath while using the drill. The aim for participating students was to create the biggest circular lesion as possible without penetrating the membrane.