The effect of self‐directed virtual reality simulation on dissection training performance in mastoidectomy

Andersen, Steven Arild Wuyts; Foghsgaard, Søren; Konge, Lars; Cayé‐Thomasen, Per; Sørensen, Mads Sølvsten

doi:10.1002/lary.25710

Cited by 51 publications

(47 citation statements)

References 25 publications

(46 reference statements)

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“…39 Finally, Andersen et al also validated the use of a modified WS1 for VR assessment with the Visible Ear simulator. 35 Overall, the Welling Scale has accumulated significant validity evidence in the literature by multiple groups, similar to the Hopkins scale. Furthermore, the scale provides the unique assessment method of final product analysis in comparison to the Hopkins scale.…”

Section: Discussionmentioning

confidence: 99%

Performance Assessment for Mastoidectomy: State of the Art Review

Sethia

Kerwin

Wiet

2016

Otolaryngol.--head neck surg.

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Objective The aim of this report is to provide a review of the current literature for assessment of performance for mastoidectomy, to identify the current assessment tools available in the literature, and to summarize the evidence for their validity. Data Sources The MEDLINE database was accessed via PubMed. Review Methods Inclusion criteria consisted of English-language published articles that reported use of a mastoidectomy performance assessment tool. Studies ranged from 2007 to November 2015, and were divided into two groups: intra-operative assessments or those performed with simulation (cadaveric laboratory or virtual reality). Studies that contained specific reliability analyses were also highlighted. For each publication, validity evidence data was analyzed and interpreted based on conceptual definitions provided in a recent systematic review on the modern framework of validity evidence. Conclusions Twenty-three studies were identified that met our inclusion criteria for review including four intra-operative objective assessment studies, five cadaveric studies, ten virtual reality (VR) simulation studies, and four that used both cadaveric and VR. Implications for Practice A review of the literature revealed a wide variety of mastoidectomy assessment tools and varying levels of reliability and validity evidence. The assessment tool developed at Johns Hopkins possesses the most validity evidence of those reviewed. However, there are a number of agreed upon specific metrics which could be integrated into a standardized assessment instrument to be used nationally. A universally agreed upon assessment tool will provide a means for developing standardized benchmarks for performing mastoid surgery.

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Section: Discussionmentioning

confidence: 99%

Performance Assessment for Mastoidectomy: State of the Art Review

Sethia

Kerwin

Wiet

2016

Otolaryngol.--head neck surg.

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“…2 In temporal bone surgery, VR simulation is primarily used to supplement other training modalities, such as cadaveric dissection, and current evidence supports the effectiveness of VR simulation in training of novices to perform mastoidectomy. [3][4][5][6][7][8][9] However, performance during practice is often the only reported outcome in these studies. Nevertheless, measurement of the retention of acquired skills is a better indicator of actual learning than is performance during practice because consolidated skills and consistency of performance are the goals of surgical training.…”

mentioning

confidence: 99%

Retention of Mastoidectomy Skills After Virtual Reality Simulation Training

Andersen

Konge

Cayé‐Thomasen

et al. 2016

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEThe ultimate goal of surgical training is consolidated skills with a consistently high performance. However, surgical skills are heterogeneously retained and depend on a variety of factors, including the task, cognitive demands, and organization of practice. Virtual reality (VR) simulation is increasingly being used in surgical skills training, including temporal bone surgery, but there is a gap in knowledge on the retention of mastoidectomy skills after VR simulation training.OBJECTIVES To determine the retention of mastoidectomy skills after VR simulation training with distributed and massed practice and to investigate participants' cognitive load during retention procedures. DESIGN, SETTING, AND PARTICIPANTSA prospective 3-month follow-up study of a VR simulation trial was conducted from February 6 to September 19, 2014, at an academic teaching hospital among 36 medical students: 19 from a cohort trained with distributed practice and 17 from a cohort trained with massed practice.INTERVENTIONS Participants performed 2 virtual mastoidectomies in a VR simulator a mean of 3.2 months (range, 2.4-5.0 months) after completing initial training with 12 repeated procedures. Practice blocks were spaced apart in time (distributed), or all procedures were performed in 1 day (massed). MAIN OUTCOMES AND MEASURESPerformance of the virtual mastoidectomy as assessed by 2 masked senior otologists using a modified Welling scale, as well as cognitive load as estimated by reaction time to perform a secondary task.RESULTS Among 36 participants, mastoidectomy final-product skills were largely retained at 3 months (mean change in score, 0.1 points; P = .89) regardless of practice schedule, but the group trained with massed practice took more time to complete the task. The performance of the massed practice group increased significantly from the first to the second retention procedure (mean change, 1.8 points; P = .001), reflecting that skills were less consolidated. For both groups, increases in reaction times in the secondary task (distributed practice group: mean pretraining relative reaction time, CONCLUSIONS AND RELEVANCE Mastoidectomy skills acquired under time-distributed practice conditions were retained better than skills acquired under massed practice conditions. Complex psychomotor skills should be regularly reinforced to consolidate both motor and cognitive aspects. Virtual reality simulation training provides the opportunity for such repeated training and should be integrated into training curricula.

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“…A blind assessment was made by one assessor (CA: first author); he went to the four included centres to make the evaluation at the end of the session. We performed this prospective study with one blind assessor given the multicentric study and the standardised scale used with a substantial degree of inter‐rater reliability . The temporal bone drilling session was organised by the four other senior otologists in each centre; they gave the same guideline to their residents and did not participate in the evaluation to avoid a selection bias.…”

Section: Methodsmentioning

confidence: 99%