The middle cranial fossa is one of the most complex regions in neurosurgery. Understanding the skull base requires the highest level of knowledge in applied neuroanatomy. One of the greatest challenges in training medical students and neurosurgeons is the teaching of 3D-dimensional competence concerning topographical relationships in the CNS. The foundation for understanding functions and topography is based on effective teaching strategies. In this study, we address the value of digital tools in the teaching of the central skull base.

49 medical students (30 female, 19 male) of the preclinical segment were offered virtual teaching over a period of one semester in addition to classical teaching on models and cadaver plastinates: Using digitally prepared presets on a virtual dissection table, M1 (= "Physikum", equivalent to USMLE Step 1) relevant structures such as the pterygopalatine fossa were visualized in a targeted manner. Implementation of the supplementary teaching was exclusively digital: Onboarding was via QR code and teaching was given at a virtual dissection table. A performance evaluation survey was used to investigate the level of knowledge and expectations prior and after tutorial.

Our questionnaire evaluated the perfomance as followed: 1= high performance/very likely, 5=low performance/very unlikely. Evaluations have revealed the following: The usage of virtual dissecion table for self-study prior to our tutorial was estimated poorly (4,8 points). The level of knowledge in neuroanatomy was rated with 4,0 points. Post tutorial both ratings increased: Using virtual tools for self-study was now rated with 2,1 points and the level of knowledge improved (1,9 points). In general, teaching with digital features was universally accepted among students with an 2,3 rating.

Using a digital scalpel on a virtual cadaver, dissection steps can be peformed repeatedly at will and anatomical relationships can be individually designed. The brains of body donors can be virtually displayed together with vascular, nervous, osseous and other surrounding structures. Our virtual teaching shows that medical students have improved with regard to topographical competence. The use of customizable, digital tools will continue to grow in modern teaching and will pave the way for innovation in educational institutions. In conclusion, we propose this method should also find its way into the anatomical training of young neurosurgeons.