title: Endoscopic endonasal surgery simulator as a training tool for ophthalmology residents.
abstract: OBJECTIVE
  Surgical training on the endoscopic endonasal surgery simulator had proven efficacy for otorhinolaryngology residents in preparation for endoscopic endonasal and sinus surgery. Its use for ophthalmology residents in preparation for endoscopic endonasal dacryocystorhinostomy has not been previously studied.
  
  
  METHODS
  Eight of 15 ophthalmology residents recruited for this experimental study underwent training on the endoscopic endonasal surgery simulator, completing the novice and intermediate modules. All 15 residents then participated in cadaver surgical training, performing defined surgical tasks including endoscopic navigation, identification of nasal anatomy, endonasal injection, and middle turbinate medialization. Performance on these tasks was videotaped and graded by 2 masked observers. Total mean scores and variance by task category were compared between subjects and controls and interobserver variance was compared between observers.
  
  
  RESULTS
  Correlation between the 2 masked observers' scores was strong (R = 0.677), with total mean scores of 2.34 and 2.38, respectively. Total mean scores were 2.79 for subjects, and 1.86 for controls (F value 0.735, p = 0.01). Residents who trained on the simulator performed significantly better during endonasal navigation (mean scores 2.58 for subjects versus 1.74 for controls, p = 0.04) and endonasal injection (mean scores 2.73 for subjects versus 1.72 for controls, p = 0.03) and minimally better at identification of nasal anatomy (mean scores 2.93 for subjects versus 1.88 for controls, p = 0.18) and middle turbinate medialization (mean scores 3.13 for subjects versus 2.78 for controls, p = 0.36).
  
  
  CONCLUSIONS
  Ophthalmology residents who trained on the surgical simulator had significantly enhanced endoscopic endonasal surgical skills for endonasal navigation and injection.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA. mweiss@aecom.yu.edu
authors.forename: Meredith
authors.initials: M
authors.lastname: Weiss
authors.forename: Simeon A
authors.initials: SA
authors.lastname: Lauer
authors.forename: Marvin P
authors.initials: MP
authors.lastname: Fried
authors.forename: Jose
authors.initials: J
authors.lastname: Uribe
authors.forename: Babak
authors.initials: B
authors.lastname: Sadoughi
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003200:Computer User Training / Q000379:methods*; D004724:Endoscopy / Q000193:education* / Q000379:methods; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D009666:Nose; D013508:Ophthalmologic Surgical Procedures / Q000193:education* / Q000379:methods; D009885:Ophthalmology / Q000193:education*