Project Lead(s): Allan Okrainec
Issue
Hydrocephalus afflicts over 14,000 infants annually in East, Central and Southern Africa and, left untreated, it can halt infant development and is often fatal.
Treatment is surgical, and depends on the availability of equipment and trained personnel, meaning that fewer than 10% of affected children receive treatment in these regions.
Endoscopic treatment of hydrocephalus is advocated in low-resource areas, because this approach can cure up to 70% of cases without lifelong dependence on an external drain.
However, neurosurgical training in this procedure is hindered in these areas by a lack of experts for teaching.
Solution
The aim of the project was to use telesimulation – connecting two remote hospitals via Skype – so surgeons in Ghana could be educated and trained under the supervision of Canadian surgeons, to enable them to perform surgery on hydrocephalic patients.
The overarching goal of the project was to introduce a neurosurgical telesimulation training program, to support the development of skills that enable health professionals to treat their hydrocephalic patients with the endoscopic third ventriculostomy (ETV) procedure.
Outcome
Results showed that using telesimulation to train surgeons to perform surgery on hydrocephalic patients, using a virtual reality simulation model, was highly acceptable and feasible, but requires motivation and support from multiple stakeholders.
Global Rating Scales (GRS) that have been modified from previous scales in the surgical field, and validated by the team as assessment tools, were used to score trainees on the physical Burr hole model and virtual reality ETV simulator.
All but one of the 10 participants in the program were either satisfied or very satisfied with the telesimulation training program, and all participants reported that they were either likely or very likely to recommend it to a colleague.
After the program, participants indicated that they felt confident in their ETV and Burr hole procedural skills, and all agreed that training improved their ETV skills.
Knowledge on the project has been disseminated through conference presentations and publications.