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World Neurosurg. 2017 Dec;108:876-884.e4. doi: 10.1016/j.wneu.2017.08.123. Epub 2017 Aug 31.

Effects of Transcranial Direct-Current Stimulation on Neurosurgical Skill Acquisition: A Randomized Controlled Trial.

Author information

1
Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada.
2
Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
3
Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
4
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada.
5
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
6
Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada; Department of Neurosurgery, University of Calgary, Calgary, Alberta, Canada.
7
Department of Neurosurgery, University of Calgary, Calgary, Alberta, Canada.
8
Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: adam.kirton@albertahealthservices.ca.

Abstract

BACKGROUND:

Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery require extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure the acquisition of skill proficiency. Transcranial direct-current stimulation (tDCS) can enhance motor skill learning, but is untested in surgical procedural training. We aimed to determine the effects of tDCS on simulation-based neurosurgical skill acquisition.

METHODS:

Medical students were trained to acquire tumor resection skills using a virtual reality neurosurgical simulator. The primary outcome of change in tumor resection was scored at baseline, over 8 repetitions, post-training, and again at 6 weeks. Participants received anodal tDCS or sham over the primary motor cortex. Secondary outcomes included changes in brain resected, resection effectiveness, duration of excessive forces (EF) applied, and resection efficiency. Additional outcomes included tDCS tolerability.

RESULTS:

Twenty-two students consented to participate, with no dropouts over the course of the trial. Participants receiving tDCS intervention increased the amount of tumor resected, increased the effectiveness of resection, reduced the duration of EF applied, and improved resection efficiency. Little or no decay was observed at 6 weeks in both groups. No adverse events were documented, and sensation severity did not differ between stimulation groups.

CONCLUSIONS:

The addition of tDCS to neurosurgical training may enhance skill acquisition in a simulation-based environment. Trials of additional skills in high-skill residents, and translation to nonsimulated performance are needed to determine the potential utility of tDCS in surgical training.

KEYWORDS:

Medical education; Motor learning; Neurosurgery; Neurotouch; Skill; Surgery; tDCS

PMID:
28864400
DOI:
10.1016/j.wneu.2017.08.123
[Indexed for MEDLINE]
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