title: Using a virtual reality temporal bone simulator to assess otolaryngology trainees.
abstract: OBJECTIVE
  The objective of this study is to determine the feasibility of computerized evaluation of resident performance using hand motion analysis on a virtual reality temporal bone (VR TB) simulator. We hypothesized that both computerized analysis and expert ratings would discriminate the performance of novices from experienced trainees. We also hypothesized that performance on the virtual reality temporal bone simulator (VR TB) would differentiate based on previous drilling experience.
  
  
  METHODS
  The authors conducted a randomized, blind assessment study.
  
  
  METHODS
  Nineteen volunteers from the Otolaryngology-Head and Neck Surgery training program at the University of Toronto drilled both a cadaveric TB and a simulated VR TB. Expert reviewers were asked to assess operative readiness of the trainee based on a blind video review of their performance. Computerized hand motion analysis of each participant's performance was conducted.
  
  
  RESULTS
  Expert raters were able to discriminate novices from experienced trainees (P < .05) on cadaveric temporal bones, and there was a trend toward discrimination on VR TB performance. Hand motion analysis showed that experienced trainees had better movement economy than novices (P < .05) on the VR TB.
  
  
  CONCLUSIONS
  Performance, as measured by hand motion analysis on the VR TB simulator, reflects trainees' previous drilling experience. This study suggests that otolaryngology trainees could accomplish initial temporal bone training on a VR TB simulator, which can provide feedback to the trainee, and may reduce the need for constant faculty supervision and evaluation.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wilson Centre for Research in Clinical Education, University of Toronto, Toronto, Ontario, Canada. mollyzirkle@yahoo.ca
authors.forename: Molly
authors.initials: M
authors.lastname: Zirkle
authors.forename: David W
authors.initials: DW
authors.lastname: Roberson
authors.forename: Rudolf
authors.initials: R
authors.lastname: Leuwer
authors.forename: Adam
authors.initials: A
authors.lastname: Dubrowski
mesh_terms: D002102:Cadaver; D003198:Computer Simulation; D003399:Craniotomy / Q000295:instrumentation; D005240:Feasibility Studies; D005246:Feedback; D006225:Hand / Q000502:physiology; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008416:Mastoid / Q000601:surgery; D009048:Motor Skills / Q000502:physiology; D010036:Otolaryngology / Q000193:education*; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education*; D016037:Single-Blind Method; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods; D013701:Temporal Bone / Q000601:surgery*; D014584:User-Computer Interface