title: Improving temporal bone dissection using self-directed virtual reality simulation: results of a randomized blinded control trial.
abstract: OBJECTIVE
  A significant benefit of virtual reality (VR) simulation is the ability to provide self-direct learning for trainees. This study aims to determine whether there are any differences in performance of cadaver temporal bone dissections between novices who received traditional teaching methods and those who received unsupervised self-directed learning in a VR temporal bone simulator.
  
  
  METHODS
  Randomized blinded control trial.
  
  
  METHODS
  Royal Victorian Eye and Ear Hospital.
  
  
  METHODS
  Twenty novice trainees.
  
  
  METHODS
  After receiving an hour lecture, participants were randomized into 2 groups to receive an additional 2 hours of training via traditional teaching methods or self-directed learning using a VR simulator with automated guidance. The simulation environment presented participants with structured training tasks, which were accompanied by real-time computer-generated feedback as well as real operative videos and photos. After the training, trainees were asked to perform a cortical mastoidectomy on a cadaveric temporal bone. The dissection was videotaped and assessed by 3 otologists blinded to participants' teaching group.
  
  
  RESULTS
  The overall performance scores of the simulator-based training group were significantly higher than those of the traditional training group (67% vs 29%; P < .001), with an intraclass correlation coefficient of 0.93, indicating excellent interrater reliability. Using other assessments of performance, such as injury size, the VR simulator-based training group also performed better than the traditional group.
  
  
  CONCLUSIONS
  This study indicates that self-directed learning on VR simulators can be used to improve performance on cadaver dissection in novice trainees compared with traditional teaching methods alone.
authors.affiliation: Department of Otolaryngology, University of Melbourne, Victoria, Australia. yczhao188@yahoo.com
authors.forename: Yi Chen
authors.initials: YC
authors.lastname: Zhao
authors.forename: Gregor
authors.initials: G
authors.lastname: Kennedy
authors.forename: Kumiko
authors.initials: K
authors.lastname: Yukawa
authors.forename: Brian
authors.initials: B
authors.lastname: Pyman
authors.forename: Stephen
authors.initials: S
authors.lastname: O'Leary
mesh_terms: D000328:Adult; D004210:Dissection / Q000193:education; D006801:Humans; D007721:Knowledge of Results, Psychological; D008416:Mastoid / Q000601:surgery; D010036:Otolaryngology / Q000193:education*; D013663:Teaching / Q000379:methods; D013701:Temporal Bone / Q000601:surgery*; D014584:User-Computer Interface