Automated summative feedback improves performance and retention in simulation training of mastoidectomy: a randomised controlled trial

Frithioff, Andreas; Frendø, Martin; Buchwald, Josefine Hastrup von; Mikkelsen, Peter Trier; Sørensen, Mads Sølvsten; Andersen, Steven Arild Wuyts

doi:10.1017/s0022215121003352

Cited by 8 publications

(6 citation statements)

References 42 publications

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“…47 Indeed, automated summative feedback has been shown to improve performance and retention. 48 When utilising virtual reality prior to cadaveric dissection, residents displayed an improvement in performance. 49 This could be related to the lower cognitive load identified in virtual reality training compared to cadaveric training.…”

Section: Results and Analysismentioning

confidence: 99%

Virtual temporal bone simulators and their use in surgical training: a narrative review

Bolton,

Young,

Ray

et al. 2023

J. Laryngol. Otol.

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Objective Temporal bone dissection is a difficult skill to acquire, and the challenge has recently been further compounded by a reduction in conventional surgical training opportunities during the coronavirus disease 2019 pandemic. Consequently, there has been renewed interest in ear simulation as an adjunct to surgical training for trainees. We review the state-of-the-art virtual temporal bone simulators for surgical training. Materials and methods A narrative review of the current literature was performed following a Medline search using a pre-determined search strategy. Results and analysis Sixty-one studies were included. There are five validated temporal bone simulators: Voxel-Man, CardinalSim, Ohio State University Simulator, Melbourne University's Virtual Reality Surgical Simulation and Visible Ear Simulator. The merits of each have been reviewed, alongside their role in surgical training. Conclusion Temporal bone simulators have been demonstrated to be useful adjuncts to conventional surgical training methods and are likely to play an increasing role in the future.

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Section: Results and Analysismentioning

confidence: 99%

Virtual temporal bone simulators and their use in surgical training: a narrative review

Bolton,

Young,

Ray

et al. 2023

J. Laryngol. Otol.

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“…The use of summative feedback at the end of each session seems to motivate the learner and improve self-assessment. 20 Such integrated learning supports are a feature unique to VR simulation as this cannot easily be integrated in training on physical models. Further, VR simulation might lend itself to gamification strategies adopted from leisure PC gaming, which may prove further useful in future training routines for directed self-regulated learning in temporal bone surgery.…”

Section: Discussionmentioning

confidence: 99%

Learning Curves in Directed Self-Regulated Virtual Reality Training of Mastoidectomy and the Role of Repetition and Motivation

Fartoussi¹,

Sørensen²,

Andersen³

2023

Int Adv Otol

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Background: Mastoidectomy is a complex procedure which can be trained on human cadaveric temporal bones or simulation models. The number of repetitions offered in most training curricula is considerably less than what is normally required for motor skills acquisition in crafts or sports. Directed, self-regulated virtual reality simulation training may provide unlimited repetitions but the effect on learning of extended but unsupervised training is unknown. This study recorded extended learning curves of novices in virtual reality simulation mastoidectomy training. Methods: Six medical students used the visible ear temporal bone simulator at home for 100 repetitions. Virtual temporal bones were later assessed by 2 blinded experts on a 26-point modified Welling Scale. Results: Four participants completed 100 procedures each and 2 participants completed 50 procedures. Learning curves and plots of time demonstrated great variation: one participant improved gradually during the first 50 procedures and sustained a high performance; another participant achieved only 16 points after 50 procedures; a third participant demonstrated mediocre performances between 10 and 15 points but only used about 5 minutes per procedure. The remaining 3 participants achieved high but fluctuating scores with very limited time use per procedure. Their score per time exceeds the performance of experienced otosurgeons and suggests the use of save/restore gaming strategies to inflate their performance. Conclusion: Deliberate learners may reach proficiency in virtual reality simulation of mastoidectomy after 50 repetitions. However, even 100 repetitions cannot guarantee proficiency if motivation fails. Creative “gaming” behavior must be considered and opposed by motivation, supervision, testing, and certification.

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“…Sample size calculations are not well defined for repeated measures (i.e., multiple raters and procedures) (18). Based on the central limit theorem application described by Bloch and Norman (18), as well as extensive experience from previous similarly designed studies (19,20), we found that 12 participants in each group would be sufficient to detect a performance difference of 10% between groups (11).…”

Section: Sample Sizementioning

confidence: 94%

Mastoidectomy Training: Is Anatomical Variation Needed? A Randomized, Controlled Trial on Performance and Skills Transfer From Virtual Reality to a Three-Dimensional Printed Model

et al. 2022

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Objective: Virtual reality (VR) simulation-based training effectively improves novices' mastoidectomy skills. Unfortunately, learning plateaus at an insufficient level and knowledge on optimizing mastoidectomy training to overcome this plateau is needed. In this study, we aim to investigate how training on anatomically different temporal bone cases affects learning, including the effect on retention and transfer of skills. Study Design: Randomized controlled trial of an educational intervention. Setting: The Simulation Center at Copenhagen Academy for Medical Education and Simulation. Participants: Twenty-four medical students from the University of Copenhagen. Intervention: Participants were randomized to practice mastoidectomy on either 12 anatomically varying (intervention group) or 12 identical (control group) cases in a VR simulator. At the end of training and again ~3 weeks after training (retention), learners were tested on a new VR patient case and a three-dimensional printed model.Main Outcome Measure: Mastoidectomy performance evaluated by blinded expert raters using a 26-item modified Welling Scale. Results: The intervention and control groups' performance results were comparable at the end of training. Likewise, retention and transfer performances were similar between groups. The overall mean score at the end of training corresponded to approximately 70% of the possible maximum score. Conclusions: Simulation-based training using anatomical variation was equivalent to training on a single case with respect to acquisition, retention, and transfer of mastoidectomy skills. This suggests that efforts to expose novices to variation during initial training are unnecessary as this variation has limited effect, and -conversely-that educators can expose novices to naturally different anatomical variations without worry of hindered learning.

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Automated summative feedback improves performance and retention in simulation training of mastoidectomy: a randomised controlled trial

Cited by 8 publications

References 42 publications

Virtual temporal bone simulators and their use in surgical training: a narrative review

Virtual temporal bone simulators and their use in surgical training: a narrative review

Learning Curves in Directed Self-Regulated Virtual Reality Training of Mastoidectomy and the Role of Repetition and Motivation

Mastoidectomy Training: Is Anatomical Variation Needed? A Randomized, Controlled Trial on Performance and Skills Transfer From Virtual Reality to a Three-Dimensional Printed Model

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