Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-26T20:34:39.898Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of anatomical variation on trainee performance in a virtual reality temporal bone surgery simulator

Published online by Cambridge University Press:  28 October 2016

P Piromchai ,
I Ioannou ,
S Wijewickrema ,
P Kasemsiri ,
J Lodge ,
G Kennedy  and
S O'Leary
P Piromchai*
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Thailand
I Ioannou
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia
S Wijewickrema
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia
P Kasemsiri
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Thailand
J Lodge
Affiliation:
Centre for the Study of Higher Education, University of Melbourne, Australia
G Kennedy
Affiliation:
Centre for the Study of Higher Education, University of Melbourne, Australia
S O'Leary
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia
*
Address for correspondence: Dr Patorn Piromchai, Department of Surgery (Otolaryngology), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria 3002, Australia E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate the importance of anatomical variation in acquiring skills in virtual reality cochlear implant surgery.

Methods:

Eleven otolaryngology residents participated in this study. They were randomly allocated to practice cochlear implant surgery on the same specimen or on different specimens for four weeks. They were then tested on two new specimens, one standard and one challenging. Videos of their performance were de-identified and reviewed independently, by two blinded consultant otolaryngologists, using a validated assessment scale. The scores were compared between groups.

Results:

On the standard specimen, the round window preparation score was 2.7 ± 0.4 for the experimental group and 1.7 ± 0.6 for the control group (p = 0.01). On the challenging specimen, instrument handling and facial nerve preservation scores of the experimental group were 3.0 ± 0.4 and 3.5 ± 0.7 respectively, while the control group received scores of 2.1 ± 0.8 and 2.4 ± 0.9 respectively (p < 0.05).

Conclusion:

Training on temporal bones with differing anatomies is beneficial in the development of expertise.

Keywords

Virtual RealityCochlear ImplantationTemporal BoneAnatomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Supplement S1 , January 2017 , pp. S29 - S35
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Stefanidis, D. Optimal acquisition and assessment of proficiency on simulators in surgery. Surg Clin North Am 2010;90:475–89Google Scholar
2 McGaghie, WC, Issenberg, SB, Petrusa, ER, Scalese, RJ. Effect of practice on standardised learning outcomes in simulation-based medical education. Med Educ 2006;40:792–7Google Scholar
3 Gallagher, AG, Ritter, EM, Champion, H, Higgins, G, Fried, MP, Moses, G et al. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 2005;241:364–72Google Scholar
4 Flint, PW, Haughey, BH, Lund, VJ, Niparko, JK, Richardson, MA, Robbins, KT et al. Cummings Otolaryngology: Head & Neck Surgery. Philadelphia: Mosby, 2010 Google Scholar
5 Paparella, MM. Otolaryngology. Philadelphia: Saunders, 1991 Google Scholar
6 Snow, JB, Wackym, PA, Ballenger, JJ. Ballenger's Otorhinolaryngology Head and Neck Surgery. Shelton, CT: People's Medical Pub. House/B C Decker, 2009 Google Scholar
7 Awad, Z, Ahmed, S, Taghi, AS, Ghufoor, K, Wareing, MJ, Patel, N et al. Feasibility of a synthetic temporal bone for training in mastoidectomy: face, content, and concurrent validity. Otol Neurotol 2014;35:1813–18Google Scholar
8 Agus, M, Giachetti, A, Gobbetti, E, Zanetti, G, Zorcolo, A, John, NW et al. Mastoidectomy simulation with combined visual and haptic feedback. Stud Health Technol Inform 2002;85:17–23 Google Scholar
9 Fried, MP, Sadoughi, B, Gibber, MJ, Jacobs, JB, Lebowitz, RA, Ross, DA et al. From virtual reality to the operating room: the endoscopic sinus surgery simulator experiment. Otolaryngol Head Neck Surg 2010;142:202–7Google Scholar
10 Ho, AK, Alsaffar, H, Doyle, PC, Ladak, HM, Agrawal, SK. Virtual reality myringotomy simulation with real-time deformation: development and validity testing. Laryngoscope 2012;122:1844–51CrossRefGoogle ScholarPubMed
11 Wiet, GJ, Stredney, D, Kerwin, T, Hittle, B, Fernandez, SA, Abdel-Rasoul, M et al. Virtual temporal bone dissection system: OSU virtual temporal bone system: development and testing. Laryngoscope 2012;122(suppl 1):S1–12 Google Scholar
12 Piromchai, P. Virtual reality surgical training in ear, nose and throat surgery. Int J Clin Med 2014;5:558–66Google Scholar
13 Klein, GA. The Power of Intuition: How to Use Your Gut Feelings to Make Better Decisions at Work. New York: Currency/Doubleday, 2004 Google Scholar
14 Norman, G. Expertise in medicine and surgery. In: Ericsson, K, ed. The Cambridge Handbook of Expertise and Expert Performance. Cambridge: Cambridge University Press, 2006;901Google Scholar
15 Schmidt, HG, Rikers, RM. How expertise develops in medicine: knowledge encapsulation and illness script formation. Med Educ 2007;41:1133–9Google Scholar
16 Norman, GR. Problem-solving skills, solving problems and problem-based learning. Med Educ 1988;22:279–86Google Scholar
17 Crochet, P, Aggarwal, R, Dubb, SS, Ziprin, P, Rajaretnam, N, Grantcharov, T et al. Deliberate practice on a virtual reality laparoscopic simulator enhances the quality of surgical technical skills. Ann Surg 2011;253:1216–22Google Scholar
18 Francis, DM. Surgical decision making. ANZ J Surg 2009;79:886–91CrossRefGoogle ScholarPubMed
19 Carr, MM. Program directors' opinions about surgical competency in otolaryngology residents. Laryngoscope 2005;115:1208–11CrossRefGoogle ScholarPubMed
20 Piromchai, P, Kasemsiri, P, Wijewickrema, S, Ioannou, I, Kennedy, G, O'Leary, S. The construct validity and reliability of an assessment tool for competency in cochlear implant surgery. Biomed Res Int 2014;2014:192741 Google Scholar
21 Zhao, YC, Kennedy, G, Yukawa, K, Pyman, B, O'Leary, S. Improving temporal bone dissection using self-directed virtual reality simulation: results of a randomized blinded control trial. Otolaryngol Head Neck Surg 2011;144:357–64Google Scholar
22 Zhao, YC, Kennedy, G, Yukawa, K, Pyman, B, O'Leary, S. Can virtual reality simulator be used as a training aid to improve cadaver temporal bone dissection? Results of a randomized blinded control trial. Laryngoscope 2011;121:831–7Google Scholar
23 Mangus, B, Rivas, A, Tsai, BS, Haynes, DS, Roland, JT Jr. Surgical techniques in cochlear implants. Otolaryngol Clin North Am 2012;45:69–80 Google Scholar
24 Malik, MU, Varela, DA, Park, E, Masood, H, Laeeq, K, Bhatti, NI et al. Determinants of resident competence in mastoidectomy: role of interest and deliberate practice. Laryngoscope 2013;123:3162–7Google Scholar