title: Face and content validation of a virtual reality temporal bone simulator.
abstract: OBJECTIVE
  To validate the VOXEL-MAN TempoSurg simulator for temporal bone dissection.
  
  
  METHODS
  Prospective international study.
  
  
  METHODS
  Otolaryngology departments of 2 academic health care institutions in the United Kingdom and United States.
  
  
  METHODS
  Eighty-five subjects were recruited consisting of an experienced and referent group. Participants performed a standardized familiarization session and temporal bone dissection task. Realism, training effectiveness, and global impressions were evaluated across 21 domains using a 5-point Likert-type scale. A score of 4 was the minimum threshold for acceptability.
  
  
  RESULTS
  The experienced group comprised 25 otolaryngology trainers who had performed 150 mastoid operations. The referent group comprised 60 trainees (mean otolaryngology experience of 2.9 years). Familiarization took longer in the experienced group (P = .01). User-friendliness was positively rated (mean score 4.1). Seventy percent of participants rated anatomical appearance as acceptable. Trainers rated drill ergonomics worse than did trainees (P = .01). Simulation temporal bone training scored highly (mean score 4.3). Surgical anatomy, drill navigation, and hand-eye coordination accounted for this. Trainees were more likely to recommend temporal bone simulation to a colleague than were trainers (P = .01). Transferability of skills to the operating room was undecided (mean score 3.5).
  
  
  CONCLUSIONS
  Realism of the VOXEL-MAN virtual reality temporal bone simulator is suboptimal in its current version. Nonetheless, it represents a useful adjunct to existing training methods and is particularly beneficial for novice surgeons before performing cadaveric temporal bone dissection. Improvements in realism, specifically drill ergonomics and visual-spatial perception during deeper temporal bone dissection, are warranted.
authors: Department of Otolaryngology Head and Neck Surgery, St Mary's Hospital, Imperial College Healthcare National Health Service (NHS) Trust, London, UK. asitarora@doctors.org.uk
authors: Asit
authors: A
authors: Arora
authors: Sam
authors: S
authors: Khemani
authors: Neil
authors: N
authors: Tolley
authors: Arvind
authors: A
authors: Singh
authors: James
authors: J
authors: Budge
authors: David A Diaz Voss
authors: DA
authors: Varela
authors: Howard W
authors: HW
authors: Francis
authors: Ara
authors: A
authors: Darzi
authors: Nasir I
authors: NI
authors: Bhatti
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010036:Otolaryngology / Q000193:education; D013506:Otologic Surgical Procedures / Q000193:education* / Q000295:instrumentation*; D011446:Prospective Studies; D013701:Temporal Bone / Q000601:surgery*; D014584:User-Computer Interface