Anatomy‐Specific Virtual Reality Simulation in Temporal Bone Dissection: Perceived Utility and Impact on Surgeon Confidence

Abstract

Objective To evaluate the effect of anatomy-specific virtual reality (VR) surgical rehearsal on surgeon confidence and temporal bone dissection performance. Study Design Prospective pre- and poststudy of a novel virtual surgical rehearsal platform. Setting Academic otolaryngology-head and neck surgery residency training programs. Subjects and Methods Sixteen otolaryngology-head and neck surgery residents from 2 North American training institutions were recruited. Surveys were administered to assess subjects' baseline confidence in performing 12 subtasks of cortical mastoidectomy with facial recess. A cadaver temporal bone was randomly assigned to each subject. Cadaver specimens were scanned with a clinical computed tomography protocol, allowing the creation of anatomy-specific models for use in a VR surgical rehearsal platform. Subjects then rehearsed a virtual mastoidectomy on data sets derived from their specimens. Surgical confidence surveys were administered again. Subjects then dissected assigned cadaver specimens, which were blindly graded with a modified Welling scale. A final survey assessed the perceived utility of rehearsal on dissection performance. Results Of 16 subjects, 14 (87.5%) reported a significant increase in overall confidence after conducting an anatomy-specific VR rehearsal. A significant correlation existed between perceived utility of rehearsal and confidence improvement. The effect of rehearsal on confidence was dependent on trainee experience and the inherent difficulty of the surgical subtask. Postrehearsal confidence correlated strongly with graded dissection performance. Subjects rated anatomy-specific rehearsal as having a moderate to high contribution to their dissection performance. Conclusion Anatomy-specific virtual rehearsal improves surgeon confidence in performing mastoid dissection, dependent on surgeon experience and task difficulty. The subjective confidence gained through rehearsal correlates positively with subsequent objective dissection performance.

Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study

“…Although the majority of otologic simulators focus on temporal bone surgery, other platforms exist including a VR myringotomy simulator that recently achieved face, content, and construct validity [17,18]. Virtual reality simulators for temporal bone surgery are well documented and various groups have shown promising benefits for residency education [7,11,15,[19][20][21][22]. However, currently available commercial temporal bone simulators such as Voxel-Man® (Voxel-Man Group, Hamburg, Germany) are still prohibitively costly [23].…”

“…CardinalSim utilizes patient-specific diagnostic imaging to generate a virtual specimen, upon which users can perform repeated surgical dissection. Resident trainees have previously reported increased confidence in cadaveric drilling after using CardinalSim (an average increase of 1.58 on 10-point confidence Likert scale, p < 0.01) and positive attitudes for using the simulator for patient-specific preoperative planning [22]. The high-fidelity haptic (force feedback) environment created using CardinalSim has been previously described and shown to enhance the training experience [25].…”

Assessing the Impact of Clinically Themed Dissection-based Projects on Anatomy Knowledge in the Veterinary Pre-clinical Curriculum

“…Dissection classes are not merely aimed at training the student on the knowledge of anatomy; these classes also help develop key competencies, ethical perspectives, technical communication skills, curiosity, evidence-based understanding, functional thinking and teamwork, all of which are collectively an essential part of veterinary professional education. 3,7,[15][16][17][20][21][22][23] While a considerable number of studies have evaluated the merits of a dissection-based approach to understanding anatomy in human medicine, evidence from the veterinary curriculum is very limited. 1,2,4,7 Hence the present study was designed to capture an objective perception of student views on the merits of cadaveric dissections in the first semester of their Veterinary Medicine programme.…”

Preparing for Conjoined Twins Separation Through Virtual Reality

“…Inexpensive commercially available hardware can be setup at home [1,2], while corporations are using VR to design mechanical systems and train pilots [3,4]. However, limited application is seen in the medical field.Most medical VR simulation focus on medical training, by incorporating anatomical models, physics models, haptics, and visualization to recreate surgical procedures [4][5][6]. These simulations teach foundational technical skills and show value for preoperative planning and image-guided surgery [4,7].…”