The Effect of a Distributed Virtual Reality Simulation Training Program on Dissection Mastoidectomy Performance

Abstract

Objective: To investigate the effect on final-product performance of a distributed, virtual reality (VR) simulation training program on cadaveric dissection performance and learning curves compared with standard VR simulation training during a temporal bone course. Study Design: Educational interventional cohort study. Setting: The national Danish temporal bone courses of 2016 and 2017. Subjects: Postgraduate year 2 to 5 residents in otorhinolaryngology. Intervention: Nine participants volunteered for additional VR simulation training (intervention) before the temporal bone course, with training blocks distributed (i.e., separated). The remaining 28 participants received standard VR simulation training during the temporal bone course (control). Main Outcome Measure: VR simulation and cadaveric dissection final-product performances were analyzed by blinded raters using a 26-item modified Welling Scale. Results: Distributed VR simulation training before the temporal bone course (intervention) significantly increased dissection final-product performance by 25% compared with standard VR simulation training during the course (control) (mean scores 12.8 points versus 10.3 points, p < 0.01). Distributed and repeated VR simulation practice markedly decreased drilling time. Guidance by the simulator-integrated tutor-function significantly increased final-product performance by 2.3 points compared with nontutored procedures but at the cost of increased drilling time. Conclusion: Skills acquired in a VR simulation environment translate to cadaveric dissection skills and repeated and distributed VR simulation can be used to further increase performance compared with standard VR simulation training during a temporal bone course. Further dissemination of inexpensive VR simulators would allow all future temporal bone course participants to train locally before attending future centralized courses.

Expert sampling of VR simulator metrics for automated assessment of mastoidectomy performance

“…Data on resident performances were collected during the national Danish temporal bone courses in 2016 and 2017 in accordance with our study on the effect of structured simulation training during these courses. 25 Thirty-seven postgraduate years 2 to 5 residents contributed as reported previously; nine further completed additional repeated and distributed practice, which in the current study was used in analysis of effects of repeated practice. All residents had very limited experience with simulated and had no experience with real-life temporal bone surgery because this requires subspecialized training in Denmark.…”

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

“…no bleeding or need for suctioning), a complete transfer of skills cannot be expected. 5,40,41 A strength of our study is that our training programme was distributed (i.e. comprised multiple sessions separated by several days), which is not only an important part of directed self-regulated learning 40 but also results in better acquisition of skills in temporal bone surgery compared with massed practice.…”

“…comprised multiple sessions separated by several days), which is not only an important part of directed self-regulated learning 40 but also results in better acquisition of skills in temporal bone surgery compared with massed practice. 16,41 Validity evidence for the metrics-based score that we used for summative feedback has been established. 14 However, metrics are simulator-specific and vary between simulators, 25 and consequently, integration of metrics-based score for summative feedback in other simulators requires context-specific validity evidence to be collected.…”

Effect of 3D‐Printed Models on Cadaveric Dissection in Temporal Bone Training

“…The performances of the intervention cohort were compared with the historical performances of 66 ORL residents receiving comparable amounts of VR simulation training prior to cadaveric dissection at previous national temporal bone dissection courses held 2014 to 2017 and 2019. 7,18,19 Figure 1 shows the trial flow diagram. Simulation training took place at the Copenhagen Academy for Medical Education and Simulation, Rigshospitalet.…”

“…Sample size calculations for repeated measurements are not well defined. However, comparable studies have suggested that 16 participants would be needed in each arm to demonstrate a 10% improvement in final‐product score 19 . Eighteen participants attended the mandatory residency dissection course in 2021 and represent a sample of convenience deemed sufficient for the study purpose.…”