A Delphi-based needs assessment to identify and prioritise procedural skills through consensus for simulation-based learning in neurosurgery.

Background: Training of the neurosurgeon today differs greatly from that of the past, with several well-documented challenges contributing to reduced operative time for current cohorts. The Joint Committee on Surgical Training (JCST) in the UK and Ireland have stated that simulation-based education (SBE) is part of the solution to tackle this training crisis. Our objective was to develop a prioritised list of technical skills through consensus with key opinion leaders (KOLs). This approach aimed to enhance understanding of the essential procedures that should shape a technical skills framework for neurosurgical simulation-based learning curricula.

Methods: We utilised a modified Delphi process and Copenhagen Academy for Medical Education and Simulation (CAMES) Needs Assessment Formula (NAF) to reach consensus. A total of 71 procedures were included for initial analysis, which were extracted from all phases of the JCST curriculum and subsequent brainstorming with KOLs. A five person steering group oversaw the process, to ensure a robust methodological approach was followed at all stages.

Results: For each of the three Delphi rounds, there were 32, 30, and 31 KOL responses, respectively. A prioritised list of 47 procedural skills was generated through consensus. The top three ranking procedures were patient positioning, pinning positions and flap design, intracranial pressure (ICP) probe insertion and external ventricular drain (EVD) insertion. Emphasis was placed on acute cranial trauma, degenerative spine, neuro-oncology and CSF diversion procedures as the categorical themes of highest priority.

Conclusions: We describe a multi-jurisdiction general needs assessment for technical skills in neurosurgical simulation training. This study will inform the design of future simulation-based learning curriculum in this sphere of training.