Cognitive Load in Mastoidectomy Skills Training: Virtual Reality Simulation and Traditional Dissection Compared.
OBJECTIVE
The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy.


METHODS
A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary-task reaction time testing at baseline and during the procedure in both training modalities.


METHODS
The national Danish temporal bone course.


METHODS
A total of 40 novice otorhinolaryngology residents.


RESULTS
Reaction time was increased by 20% in VR simulation training and 55% in cadaveric dissection training of mastoidectomy compared with baseline measurements. Traditional dissection training increased CL significantly more than VR simulation training (p < 0.001).


CONCLUSIONS
VR simulation training imposed a lower CL than traditional cadaveric dissection training of mastoidectomy. Learning complex surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired in the VR simulation.
Department of Otorhinolaryngology-Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark. Electronic address: stevenarild@gmail.com.
Steven Arild Wuyts
SA
Andersen
Computer Graphics Lab, the Alexandra Institute, Aarhus, Denmark.
Peter Trier
PT
Mikkelsen
Center for Clinical Education, Center for HR, The Capital Region of Denmark, Copenhagen, Denmark.
Lars
L
Konge
Department of Otorhinolaryngology-Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark.
Per
P
Cayé-Thomasen
Department of Otorhinolaryngology-Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark.
Mads Sølvsten
MS
Sørensen
D000328:Adult; D002102:Cadaver; D003071:Cognition; D003198:Computer Simulation; D018592:Cross-Over Studies; D004210:Dissection / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D008416:Mastoid / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education*; D011446:Prospective Studies; D000066908:Simulation Training
Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; cognitive load; mastoidectomy; surgical skills training; temporal bone dissection; virtual reality simulation