Despite clear evidence that monitoring neurological function during surgery decreases the incidence of neurological deficits and thus improves outcomes, this type of monitoring is not performed routinely. Monitoring equipment is readily available, but the problem facing most hospitals is the lack of trained personnel to perform the monitoring, and, in many cases, the lack of standard monitoring protocols. Those entering the neuromonitoring field come from a variety of backgrounds and the skills required are multidisciplinary. These are typical problems for a rapidly growing application area that crosses traditional medical care boundaries (surgery, neurology, anesthesia, audiology, etc.). In this project, we plan to investigate technological innovations that will address both educational issues and lack of standards. We plan to use a combination of Internet technology, 3-D computer models and animation, simulations, and a series of recorded case studies to solve these problems. Products to be produced include: a series of interactive, CD-ROM based software; surgical simulators that demonstrate the potential CNS-damaging manipulations; a library of data to illustrate a variety of patient responses; and, a simulator which will play the data into any commercial neuromonitor. We also plan to develop consensus-based guidelines where none exist. If successful, the educational aids developed will improve the quality of neuromonitoring education and accelerate the number of skilled personnel to fill the many job openings in this field and, ultimately, improve neurological outcomes from surgery. Longer term opportunities include the application of the techniques developed to a wider variety of medical education areas.
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