Simulation Based Training for Infant Hydrocephalus Treatment

Hydrocephalus (excessive fluid in the brain) afflicts over 14,000 infants annually in East, Central and Southern Africa. Left untreated, it can halt development and is often fatal in the first years of life. However it is treatable, but the treatments are surgical, which is difficult to access due to lack of equipment and trained personnel. This results in less than 10% of affected children receiving treatment in these regions. Endoscopic treatment of hydrocephalus is advocated in low-resource areas because it can cure up to 70% of cases without lifelong dependence on an external drain. Neurosurgical training in this procedure is hindered in these areas by a lack of experts for teaching. Surgical care in developing regions is hindered by a lack of experts for teaching. Performing these procedures however, require difficult to access specialized training. This project used telesimulation, connecting two remote hospitals via Skype, so that surgeons in Ghana can be educated, trained and supervised by Canadian surgeons to enable them perform surgeries on hydrocephaus patients. Ultimately, the overarching goal of introducing a neurosurgical Telesimulation training program is to support the development of skills that enable health professionals to treat their Hydrocephalus patients with the endoscopic third ventriculostomy (ETV) procedure. Results showed that Telesimulation to train surgeons in developing countries to perform surgery on hydrocephaly patients using a virtual reality simulation model is highly acceptable and feasible, but requires the motivation and support from multiple stakeholders. 90% (10/11) of participants were either satisfied or very satisfied with the Telesimulation training program and all were either likely or very likely to recommend it to a colleague. After the program, participants indicated that they felt confident in their skills, and all either agreed that training improved their ETV skills. "