Avatrode LLC
Avatrode LLC
There are many surgeries that utilize Intraoperative Neurophysiologic Monitoring (IONM) but most surgery has a low incidence of potentially catastrophic neural complications. Diab et.al., reviewed adolescent idiopathic scoliosis surgery and reported a low complication rate of 0.69%.2 How does an IONM neurophysiologist gain the knowledge and skills to optimize patient safety when there are so few events that lead to paraplegia? Rodriguez-Paz comments that current medical training is insufficient and presents a source of preventable harm to patients. They propose that any training paradigm must include a medically simulated environment.
Prior studies have reported that a major advantage of simulation is “Time Compression”. Avatrode's present study constructed a virtual reality environment that includes all elements of surgical neurophysiologic monitoring from the initial patient interview up to a possible iatrogenic surgical event requiring the simulation participant to make a major decision and then explore the consequences of that decision. This process was compared to actual surgical times for a like event and essentially 1.75 hours of surgery was compressed to 6 minutes. This study showed a simulated surgery can be practiced multiple times and consequences of both good and bad decisions can be examined. It is recommended that relative to a control group, practitioners using surgical simulation be evaluated post-training for benefits in declarative knowledge, procedural knowledge, long term retention and self-efficacy.
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