Evaluation of Surgical Simulation in Temporal Bone Surgical Radio-Anatomy Learning

Background
Lack of data regarding efficiency of simulation-based teaching, in particular high-fidelity virtual reality, constitutes a major drawback for its implementation in the medical training. However, it provides a structured, safe and supportive environment to familiarize with complex anatomy and practice surgical skills. We aimed to evaluate high-fidelity virtual reality simulation in learning of temporal bone radio-anatomy during ENT residency.
Materials and Methods
15 Belgian otorhinolaryngology residents completed 5 sessions of simulation in antro-mastoidectomy using VOXEL-MAN Tempo® surgical simulator. Technical mistakes and surgical parameters were recorded. Before and after training period, residents completed a temporal bone radiological anatomy test available online (http://www.radioanatomie.com). Pre- and post-simulation scores were compared as primary endpoint by non-parametric Wilcoxon test using RCmdr (https://www.r-project.org).
As secondary endpoint, residents’ surgical skills following simulation training were blindly assessed on cadaveric human temporal bones using a reproducible scale by seniors otologist surgeons of our department. Correlation between radiological testing and dissection scale were evaluated by Spearman regression. Finally, trainees completed a survey on the device itself.
Results
Performance on radiological testing significantly increased with a mean improvement of 28 ± 12.12 (Wilcoxon p = 0.0011). Surgical results on cadaveric specimens were not correlated to surgical simulation parameters. Higher results on radiological testing were associated with higher scores on dissection scale, suggesting that subjects who succeeded better at dissection were those who knew best anatomy. Among residents, 80% felt this tool suitable for early surgical education, and 84.6% queried further information on simulation techniques. 100% of trainees would integrate this tool within their learning of temporal bone's radiological and surgical anatomy.
Conclusions
High-fidelity virtual reality simulator improved temporal bone anatomy teaching and specifically increased knowledge of temporal bone radiological anatomy.
Acknowledgement
No conflict of interest.