Assessment of verbal (conventional) training versus models training for head frame fixation in neurosurgery

Abstract

Cranial immobilization is an essential first step in cranial surgeries. Complications related to head fixation frames are under-reported and given less importance during training. Authors report their experience of using verbal (Conventional) training and training by models of “head fixation frame” and “wooden head” for head frame application for cranial surgeries. Models of the “Head Fixation Frame” (Mayfield clamp) and “wooden human head” were made using metal (iron) and wood, respectively. Major craniometric landmarks and dural venous sinuses were marked on the head model. A total of 15 trainee residents of >18 months (Group A, n = 4), < 18 months (Group B, n = 5), and without neurosurgical training (Group C, n = 6) were assessed for head frame application on human cadaver heads after verbal (conventional) training (n = 8) and training on models (n = 7). Various parameters, such as time taken for pin application, selection of pin site, and quadrants, were evaluated for adequacy of pin placements and position of head. Both methods were compared for assessment of better training method. Model training for head frame fixation was found better with regard to all aspects out of which time for positioning the head and for pin application, selection of quadrants of the head, site for pin insertions, and need of intervention by faculty were significant. Training on models of “head fixation frame” and “head” is better than conventional training. It is simple and safe and will prevent pin-related complications.