title: Development and face validity testing of a three-dimensional myringotomy simulator with haptic feedback.
abstract: BACKGROUND
  Considerable progress has been made in the development of three-dimensional temporal bone virtual reality simulators. However, very little attention has been paid to interactive simulation of middle ear surgery, including myringotomy. As the development of technical skills for middle ear surgery has a steep learning curve, this poses inherent risks to patients during the skills acquisition phase. The benefit of simulation training in the acquisition of surgical skills has been demonstrated with previous low-fidelity models. Tactile sensation is an important feedback mechanism in middle ear surgery, so a three-dimensional virtual reality myringotomy simulator with haptic feedback was developed at The University of Western Ontario.
  
  
  OBJECTIVE
  To examine the face validity of a three-dimensional myringotomy simulator with haptic feedback.
  
  
  METHODS
  The three-dimensional myringotomy simulator was calibrated with input from two otolaryngologists and one intermediate-level resident. The face validity of the resulting simulator was tested by four staff otolaryngologists and seven intermediate- or senior-level residents using a previously validated questionnaire.
  
  
  RESULTS
  The results demonstrate good to excellent face validity for the myringotomy simulator with high consistency between participants with a Cronbach alpha of .919. Favourable responses predominated for all questions with the exception of force feedback, where the average response was neutral.
  
  
  CONCLUSIONS
  The initial results from the development and testing of a three-dimensional virtual myringotomy simulator with haptic feedback are very encouraging. This simulator is the first of its kind and, with further refinement, has excellent potential to be of benefit in the training of proficient middle ear surgeons.
authors.affiliation: Department of Otolaryngology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario.
authors.forename: Leigh J
authors.initials: LJ
authors.lastname: Sowerby
authors.forename: Govind
authors.initials: G
authors.lastname: Rehal
authors.forename: Murad
authors.initials: M
authors.lastname: Husein
authors.forename: Philip C
authors.initials: PC
authors.lastname: Doyle
authors.forename: Sumit
authors.initials: S
authors.lastname: Agrawal
authors.forename: Hanif M
authors.initials: HM
authors.lastname: Ladak
mesh_terms: D003198:Computer Simulation; D004521:Educational Measurement; D005246:Feedback; D006801:Humans; D008876:Middle Ear Ventilation / Q000379:methods*; D010036:Otolaryngology / Q000193:education*; D025321:Surgery, Computer-Assisted / Q000193:education*; D011795:Surveys and Questionnaires; D014584:User-Computer Interface