Operative Neurosurgery 29:418–427, 2025
Training neurosurgeons on a 3D-printed simulation model with a standardized protocol significantly improved external ventricular drain (EVD) placement accuracy, reduced variability, and increased confidence, benefitting both junior and experienced practitioners. Regular simulation-based training is recommended to maintain high clinical performance and standardize EVD procedures.
• 3D-printed head models were developed for training neurosurgical residents in external ventricular drain (EVD) placement.
• Training included pre-training, standardized protocol with neuronavigation, and post-training rounds.
• EVD placement accuracy improved significantly after training, with optimal placement rates rising from 55% to 84%.
• Distances to ideal entry and target points, as well as procedure times, were significantly reduced post-training.
• Experience alone did not predict accuracy; even senior neurosurgeons improved, and post-training results were similar across experience levels.
• Right-handed participants achieved better outcomes using their right hand for both sides; left-sided EVDs were more often misplaced.
• Participants’ confidence in EVD placement and direction increased after training.
• Regular, standardized simulation training is recommended for all neurosurgeons, regardless of experience, to maintain high clinical performance.
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