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Grace M. Thiong’o, Thomas Looi, James T. Rutka, Abhaya V. Kulkarni, and James M. Drake

OBJECTIVE

Early adaptors of surgical simulation have documented a translation to improved intraoperative surgical performance. Similar progress would boost neurosurgical education, especially in highly nuanced epilepsy surgeries. This study introduces a hands-on cerebral hemispheric surgery simulator and evaluates its usefulness in teaching epilepsy surgeries.

METHODS

Initially, the anatomical realism of the simulator and its perceived effectiveness as a training tool were evaluated by two epilepsy neurosurgeons. The surgeons independently simulated hemispherotomy procedures and provided questionnaire feedback. Both surgeons agreed on the anatomical realism and effectiveness of this training tool. Next, construct validity was evaluated by modeling the proficiency (task-completion time) of 13 participants, who spanned the experience range from novice to expert.

RESULTS

Poisson regression yielded a significant whole-model fit (χ2 = 30.11, p < 0.0001). The association between proficiency when using the training tool and the combined effect of prior exposure to hemispherotomy surgery and career span was statistically significant (χ2 = 7.30, p = 0.007); in isolation, pre-simulation exposure to hemispherotomy surgery (χ2 = 6.71, p = 0.009) and career length (χ2 = 14.21, p < 0.001) were also significant. The mean (± SD) task-completion time was 25.59 ± 9.75 minutes. Plotting career length against task-completion time provided insights on learning curves of epilepsy surgery. Prediction formulae estimated that 10 real-life hemispherotomy cases would be needed to approach the proficiency seen in experts.

CONCLUSIONS

The cerebral hemispheric surgery simulator is a reasonable epilepsy surgery training tool in the quest to increase preoperative practice opportunities for neurosurgical education.

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John A. Jane, David Yashon, Donald P. Becker, R. Beatty, and O. Sugar

–105. 23. Putnam , T. J. Treatment of unilateral paralysis agitans by section of the lateral pyramidal tract. Archs Neurol. Psychiat., Chicago , 1940 , 44 : 950 – 976 . Putnam , T. J. Treatment of unilateral paralysis agitans by section of the lateral pyramidal tract. Archs Neurol. Psychiat., Chicago , 1940, 44: 950–976. 10.1001/archneurpsyc.1940.02280110024002 24. Travis , A. M. , Woolsey , C. N. Motor performance of monkeys after bilateral partial and total cerebral decortications. Am. J. phys. Med. , 1956

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Paul C. Bucy, James E. Keplinger, and Edir B. Siqueira

decortications. Amer. J. phys. Med. , 1956 , 35 : 273 – 310 . Travis , A. M., and Woolsey , C. N. Motor performance of monkeys after bilateral partial and total cerebral decortications. Amer. J. phys. Med. , 1956, 35: 273–310. 29. Verbiest , H. Personal communication, 1963 . Verbiest , H. Personal communication, 1963. 30. Walker , A. E. Cerebral pedunculotomy for the relief of involuntary movements. I. Hemiballismus. Acta psychiat., Kbh. , 1949 , 24 : 723 – 729 . Walker , A. E

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Will Lyon, Tej I. Mehta, Kelli B. Pointer, Daniel Walden, Ardem Elmayan, Kyle I. Swanson, and John S. Kuo

, Macmillan , 1968 12 Pierce C : Clinton N. Woolsey Oral History Interview Madison, WI , University of Wisconsin-Madison, University Archives Oral History Project , 1982 . 110 13 Sherrington C : The late Sir David Ferrier . Br Med J 1 : 574 – 575 , 1928 14 Stephenson L : He developed university's research program in study of nervous system. University of Wisconsin-Madison University News and Publications Service . 1975 . (press release) 15 Travis AM , Woolsey CN : Motor performance of monkeys after bilateral partial and total cerebral

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Destruction of the Pyramidal Tract in the Monkey

The Effects of Bilateral Section of the Cerebral Peduncles

Paul C. Bucy, Roongtam Ladpli, and Annette Ehrlich

.) Tower , S. S. The pyramidal tract. In: The precentral motor cortex . P. C. Bucy, Ed., Urbana, Ill.: University of Illinois Press, 1949, 2nd ed., 629 pp. (See pp. 149–172.) 84. Travis , A. M. , and Woolsey , C. N. Motor performance of monkeys after bilateral partial and total cerebral decortications. Am J. phys. Med. , 1956 , 35 : 273 – 310 . Travis , A. M., and Woolsey , C. N. Motor performance of monkeys after bilateral partial and total cerebral decortications. Am J. phys. Med. , 1956, 35: 273–310. 85

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Harvey Gass

the patients with ruptured aneurysms do not often get admitted to the institute. Professor Ugryomov has had a special interest in spinal cord injuries and was very familiar with the work of Kahn and Schneider. With respect to the early treatment of cervical fracture-dislocations, it is his practice to perform laminectomy if there has been no clinical improvement after 24 hours in traction. His ideas about spinal cord injuries in general follow. If the spinal cord in the dog is hemisectioned, there is functional recovery in two months. If then bilateral cerebral