title: Supporting skill acquisition in cochlear implant surgery through virtual reality simulation.
abstract: To evaluate the effectiveness of a virtual reality (VR) temporal bone simulator in training cochlear implant surgery.
  
  
  
  We compared the performance of 12 otolaryngology registrars conducting simulated cochlear implant surgery before (pre-test) and after (post-tests) receiving training on a VR temporal bone surgery simulator with automated performance feedback. The post-test tasks were two temporal bones, one that was a mirror image of the temporal bone used as a pre-test and the other, a novel temporal bone. Participant performances were assessed by an otologist with a validated cochlear implant competency assessment tool. Structural damage was derived from an automatically generated simulator metric and compared between time points.
  
  
  
  Wilcoxon signed-rank test showed that there was a significant improvement with a large effect size in the total performance scores between the pre-test (PT) and both the first and second post-tests (PT1, PT2) (PT-PT1: P = 0.007, r = 0.78, PT-PT2: P = 0.005, r = 0.82).
  
  
  
  The results of the study indicate that VR simulation with automated guidance can effectively be used to train surgeons in training complex temporal bone surgeries such as cochlear implantation.
authors.affiliation: a Department of Surgery (Otolaryngology) , University of Melbourne , Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Copson
authors.affiliation: a Department of Surgery (Otolaryngology) , University of Melbourne , Australia.
authors.forename: Sudanthi
authors.initials: S
authors.lastname: Wijewickrema
authors.affiliation: a Department of Surgery (Otolaryngology) , University of Melbourne , Australia.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: a Department of Surgery (Otolaryngology) , University of Melbourne , Australia.|b Department of Otorhinolaryngology , Khon Kaen University , Thailand.
authors.forename: Patorn
authors.initials: P
authors.lastname: Piromchai
authors.affiliation: a Department of Surgery (Otolaryngology) , University of Melbourne , Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Briggs
authors.affiliation: c Department of Computing and Information Systems , University of Melbourne , Australia.
authors.forename: James
authors.initials: J
authors.lastname: Bailey
authors.affiliation: d Melbourne Centre for the Study of Higher Education, University of Melbourne , Australia.
authors.forename: Gregor
authors.initials: G
authors.lastname: Kennedy
authors.affiliation: a Department of Surgery (Otolaryngology) , University of Melbourne , Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: O'Leary
mesh_terms: D000328:Adult; D001315:Australia; D002983:Clinical Competence; D019929:Cochlear Implantation / Q000193:education* / Q000379:methods; D003054:Cochlear Implants; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D010036:Otolaryngology / Q000193:education*; D000066908:Simulation Training / Q000379:methods*; D013701:Temporal Bone / Q000601:surgery*; D000076142:Virtual Reality
keywords: Cochlear implant; Cochleostomy; ENT; Simulation; Skill aquisition; Surgery; Training; Virtual reality