Anatomy-Specific Virtual Reality Simulation in Temporal Bone Dissection: Perceived Utility and Impact on Surgeon Confidence.
Objective To evaluate the effect of anatomy-specific virtual reality (VR) surgical rehearsal on surgeon confidence and temporal bone dissection performance. Study Design Prospective pre- and poststudy of a novel virtual surgical rehearsal platform. Setting Academic otolaryngology-head and neck surgery residency training programs. Subjects and Methods Sixteen otolaryngology-head and neck surgery residents from 2 North American training institutions were recruited. Surveys were administered to assess subjects' baseline confidence in performing 12 subtasks of cortical mastoidectomy with facial recess. A cadaver temporal bone was randomly assigned to each subject. Cadaver specimens were scanned with a clinical computed tomography protocol, allowing the creation of anatomy-specific models for use in a VR surgical rehearsal platform. Subjects then rehearsed a virtual mastoidectomy on data sets derived from their specimens. Surgical confidence surveys were administered again. Subjects then dissected assigned cadaver specimens, which were blindly graded with a modified Welling scale. A final survey assessed the perceived utility of rehearsal on dissection performance. Results Of 16 subjects, 14 (87.5%) reported a significant increase in overall confidence after conducting an anatomy-specific VR rehearsal. A significant correlation existed between perceived utility of rehearsal and confidence improvement. The effect of rehearsal on confidence was dependent on trainee experience and the inherent difficulty of the surgical subtask. Postrehearsal confidence correlated strongly with graded dissection performance. Subjects rated anatomy-specific rehearsal as having a moderate to high contribution to their dissection performance. Conclusion Anatomy-specific virtual rehearsal improves surgeon confidence in performing mastoid dissection, dependent on surgeon experience and task difficulty. The subjective confidence gained through rehearsal correlates positively with subsequent objective dissection performance.
1 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA.
Garrett D
GD
Locketz
2 Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Canada.
Justin T
JT
Lui
3 Department of Computer Science, University of Calgary, Calgary, Canada.
Sonny
S
Chan
4 Department of Computer Science, Stanford University, Stanford, California, USA.
Kenneth
K
Salisbury
2 Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Canada.
Joseph C
JC
Dort
5 Division of Clinical Anatomy, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.
Patricia
P
Youngblood
1 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA.
Nikolas H
NH
Blevins
D000328:Adult; D002102:Cadaver; D002983:Clinical Competence; D003198:Computer Simulation; D004210:Dissection / Q000193:education*; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008297:Male; D010036:Otolaryngology / Q000193:education*; D011446:Prospective Studies; D000066908:Simulation Training / Q000379:methods*; D013701:Temporal Bone / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface
case-specific; anatomy-specific; operative utility; otology; patient-specific; surgeon confidence; surgical planning; surgical rehearsal; surgical training; temporal bone surgery; virtual reality simulation