title: Effects of anatomical variation on trainee performance in a virtual reality temporal bone surgery simulator.
abstract: OBJECTIVE
  To investigate the importance of anatomical variation in acquiring skills in virtual reality cochlear implant surgery.
  
  
  METHODS
  Eleven otolaryngology residents participated in this study. They were randomly allocated to practice cochlear implant surgery on the same specimen or on different specimens for four weeks. They were then tested on two new specimens, one standard and one challenging. Videos of their performance were de-identified and reviewed independently, by two blinded consultant otolaryngologists, using a validated assessment scale. The scores were compared between groups.
  
  
  RESULTS
  On the standard specimen, the round window preparation score was 2.7 ± 0.4 for the experimental group and 1.7 ± 0.6 for the control group (p = 0.01). On the challenging specimen, instrument handling and facial nerve preservation scores of the experimental group were 3.0 ± 0.4 and 3.5 ± 0.7 respectively, while the control group received scores of 2.1 ± 0.8 and 2.4 ± 0.9 respectively (p < 0.05).
  
  
  CONCLUSIONS
  Training on temporal bones with differing anatomies is beneficial in the development of expertise.
authors: Department of Surgery (Otolaryngology),University of Melbourne,Royal Victorian Eye and Ear Hospital,Australia.
authors: P
authors: P
authors: Piromchai
authors: Department of Surgery (Otolaryngology),University of Melbourne,Royal Victorian Eye and Ear Hospital,Australia.
authors: I
authors: I
authors: Ioannou
authors: Department of Surgery (Otolaryngology),University of Melbourne,Royal Victorian Eye and Ear Hospital,Australia.
authors: S
authors: S
authors: Wijewickrema
authors: Department of Otorhinolaryngology,Faculty of Medicine,Khon Kaen University,Thailand.
authors: P
authors: P
authors: Kasemsiri
authors: Centre for the Study of Higher Education,University of Melbourne,Australia.
authors: J
authors: J
authors: Lodge
authors: Centre for the Study of Higher Education,University of Melbourne,Australia.
authors: G
authors: G
authors: Kennedy
authors: Department of Surgery (Otolaryngology),University of Melbourne,Royal Victorian Eye and Ear Hospital,Australia.
authors: S
authors: S
authors: O'Leary
mesh_terms: D000328:Adult; D063405:Anatomic Variation; D002983:Clinical Competence; D019929:Cochlear Implantation / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010036:Otolaryngology / Q000193:education*; D000066908:Simulation Training; D013701:Temporal Bone / Q000033:anatomy & histology* / Q000601:surgery; D014584:User-Computer Interface
keywords: Anatomy; Cochlear Implantation; Temporal Bone; Virtual Reality