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Cadaver-Based Hands-On Course in Cervical Spine Surgery: A Prospective Evaluation of Surgical Confidence and Self-Perceived Autonomy
ABSTRACT
Background:
Cadaver-based training plays a crucial role in surgical education, particularly in complex and high-risk fields such as cervical spine surgery. Due to the anatomical intricacies and the potential for serious complications in cervical spine surgery, realistic off-patient training is particularly important to develop technical skills and build surgical confidence in that field.
Objective:
To investigate effects of cadaver-based surgical education, this study investigates the educational value of a cadaver-based course in cervical spine surgery.
Methods:
A three-day hands-on cadaver-based training course covering anterior and posterior cervical spine approaches was conducted in March 2024 in Sweden. All 24 participants completed pre- and post-course questionnaires, 19 out of the 24 participants completed the 6-month follow-up questionnaire. The course focused on anatomical dissection with supervised instrumentation and a 1:4 faculty-to-participant ratio. Surveys assessed prior experience, post-course satisfaction, and longitudinal changes in surgical confidence and clinical impact. Educational impact was analyzed based on Kirkpatrick’s model for evaluating training programs.
Results:
All respondents (n=23/23, 100%) reported that the course met their expectations and would recommend it. At six-month follow-up, a considerable proportion of participants indicated increased surgical independence across all practiced procedures. The highest rates of perceived improvement (Kirkpatrick level 1 – reaction) in independent surgical performance in the 6-month post-course questionnaire were observed for anterior cervical discectomy and fusion (ACDF) procedures (n=15/19, 78.9%) and laminectomies (n=13/19, 68.4%), whereas pedicle screw placement and C1–C2 fixation showed the lowest reported improvements (n=6/19, 31.6%). Improvements in general surgical competencies, such as complication management, were also frequently noted (n=11/19, 57.9%). Cadaveric hands-on training (n=13/19, 68.4%) and expert guidance (n=3/19, 15.8%) were indicated as the most valued aspects of the course.
Conclusions:
This study highlights the perceived impact (Kirkpatrick level 1 – reaction) of a three-day hands-on course in cervical spine surgery, demonstrating its effectiveness in improving surgical confidence and self-perceived autonomy among participants, contributing to an increased number of independently performed procedures. The 6-month follow-up revealed the highest increase in confidence in ACDF and laminectomy procedures. Overall, cadaver-based training on anatomical specimens represents a valuable addition to surgical education in the operating room for cervical spine surgery.
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