Developing Neurosurgical Non-Technical Skills: A Tactical Decision Game Approach for Medical Students

IF 2.1 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2025-08-11 DOI:10.1016/j.jsurg.2025.103637

Aaron Lawson McLean MSc, Sophie Kubon, Falko Schwarz MD, PhD, Christian Senft MD, PhD

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引用次数: 0

Abstract

Objective

Non-technical skills (NTS), such as clinical decision-making, are crucial in neurosurgery but underdeveloped in undergraduate curricula. This pilot study aimed to develop, implement, and evaluate the feasibility and perceived educational value of tactical decision games (TDGs) for enhancing NTS among medical students in neurosurgery.

Methods

A prospective, single-center pilot study was conducted with 27 fourth-year medical students during a compulsory neurosurgery module. Students, in small groups, engaged in a single 90-minute session covering three distinct, neurosurgery-specific TDG scenarios consecutively. Pre- and post-session questionnaires assessed self-perceived knowledge, decision-making confidence, and clinical readiness using 5-point Likert scales. Post-session cognitive load (Paas MERS) and qualitative feedback were also collected. Paired statistical tests compared pre/post scores, and directed content analysis was applied to free-text comments.

Results

Significant improvements were observed from pre- to post-session in perceived knowledge (median 3.0 vs 5.0, p < 0.001), decision-making confidence (mean 3.30 vs 4.37, p < 0.001), and readiness (median 3.0 vs 4.0, p < 0.001). Qualitative feedback highlighted TDGs' value in bridging theory and practice, enhancing clinical reasoning, and providing realistic simulation within a safe environment. The mean MERS score was high (7.30 ± 1.14), indicating significant cognitive demand, which was also noted in student comments acknowledging the session's intensity.

Conclusion

Single-session, multi-scenario TDGs are a feasible and well-received pedagogical tool for undergraduate neurosurgery education, significantly enhancing students' self-perceived NTS. Despite the high cognitive load associated with this intensive format, TDGs show considerable promise for developing crucial clinical skills early. Further research using objective competence assessments and exploring optimal TDG formats is warranted.

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发展神经外科非技术技能：医学生的战术决策游戏方法

目的非技术性技能（NTS），如临床决策能力，在神经外科中是至关重要的，但在本科课程中缺乏。本研究旨在发展、实施并评估战术决策游戏（tdg）在提高神经外科医学生NTS的可行性和感知教育价值。方法对27名在神经外科必修模块学习的四年级医学生进行前瞻性、单中心试点研究。学生们以小组为单位，在一个90分钟的课程中，连续学习三种不同的、神经外科特定的TDG场景。会前和会后问卷评估自我认知知识，决策信心和临床准备使用5点李克特量表。同时收集治疗后认知负荷（Paas - MERS）和定性反馈。配对统计检验比较前后得分，直接内容分析应用于自由文本评论。ResultsSignificant改进从pre -热身观察感知知识(平均3.0 vs 5.0, p & lt; 0.001),决策的信心(平均3.30 vs 4.37, p & lt; 0.001),和准备(平均3.0 vs 4.0, p & lt; 0.001)。定性反馈强调了tdg在连接理论和实践，增强临床推理以及在安全环境中提供真实模拟方面的价值。平均MERS得分很高（7.30 ± 1.14），表明认知需求显著，这也在学生评论中指出了会议的强度。结论单节课、多场景的tdg是一种可行且受欢迎的本科神经外科教学工具，可显著提高学生的NTS自我感知。尽管高认知负荷与这种密集形式相关，tdg在早期发展关键临床技能方面显示出相当大的希望。使用客观能力评估和探索最佳TDG格式的进一步研究是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.