Virtual reality surgical simulation as a tuition aid for understanding surgical temporal bone anatomy: trial on 15 ear, nose, and throat registrars

Abstract

Objective: Virtual reality (VR) surgical simulation is only a supplementary teaching tool for surgical students, and current evidence base that supports its benefits in surgical training is lacking. This study aimed to evaluate VR simulation as a tool to improve the understanding of temporal bone anatomy during Ear, Nose, and Throat residency. The primary goal was to determine whether VR simulation improved written examination performance on temporal bone radiology. Notably, 15 residents were recruited and trained by the VOXEL-MAN Tempo surgical simulator system (UKE-Voxel-man Group, Hamburg, Germany, 2009). The secondary outcome was to determine whether VR simulation improved the surgical skills of the trained residents during cadaveric dissection of temporal bone. Methods: Examination performance on temporal bone radiology anatomy was evaluated in 15 residents from the university-affiliated teaching hospital before and after 5 training sessions on the VOXEL-MAN Tempo surgical simulator. Technical skills after simulation training were assessed on cadaveric temporal bones and evaluated by blinded senior otology surgeons. Results: Residents significantly improved their examination performance on their temporal bone radiology anatomy test after completing virtual training on the simulator. Second, a significant correlation was not found between virtual simulator performances and surgical performances on cadaveric model; however, a significant correlation was shown between the anatomic examination result and the performances on the cadaveric model. Conclusion: This study suggests that a high-fidelity VR simulator improves the understanding of temporal bone anatomy and specifically increased trainees’ practical knowledge regarding radiological anatomy of the temporal bone.