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Ultra-high-fidelity virtual reality mastoidectomy simulation training: a randomized, controlled trial

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Ultra-high-fidelity (UHF) graphics in virtual reality (VR) simulation might improve surgical skill acquisition in temporal bone training. This study aims to compare UHF VR simulation training with conventional, screen-based VR simulation training (cVR) with respect to performance and cognitive load (CL).

Methods

In a randomized trial with a cross-over design, 24 students completed a total of four mastoidectomies in a VR temporal bone surgical simulator: two performances under UHF conditions using a digital microscope and two performances under conventional conditions using screen-based VR simulation. Performances were assessed by two blinded raters using an established assessment tool. In addition, CL was estimated as the relative change in secondary-task reaction time during simulation when compared with individual baseline measurements. Data were analyzed using linear mixed model analysis for repeated measurements.

Results

The mean final-product performance score was significantly lower in UHF VR simulation compared to cVR simulation [mean difference 1.0 points out of 17 points, 95% CI (0.2–1.7), p = 0.02]. The most important factor for performance during UHF simulation was the ability to achieve stereovision (mean difference = 3.4 points, p < 0.001). Under the UHF VR condition, CL was significantly higher than during cVR (28% vs. 18%, respectively, p < 0.001).

Conclusion

UHF graphics in VR simulation training reduced performance and induced a higher CL in novices than conventional, screen-based VR simulation training. Consequently, UHF VR simulation training should be preceded by cVR training and might be better suited for the training of intermediates or experienced surgeons.

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Acknowledgements

We would like to acknowledge ARRI Medical (Munich, Germany) for lending us the ARRISCOPE oculars for digital projection.

Funding

The authors received no specific funding for this work.

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Authors and Affiliations

  1. Department of Otorhinolaryngology–Head and Neck Surgery, Rigshospitalet, HovedOrtoCentret, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Andreas Frithioff, Martin Frendø, Mads Sølvsten Sørensen & Steven Arild Wuyts Andersen

  2. Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR, Copenhagen, Denmark

    Andreas Frithioff, Martin Frendø & Steven Arild Wuyts Andersen

  3. The Alexandra Institute, Aarhus, Denmark

    Peter Trier Mikkelsen

Authors
  1. Andreas Frithioff
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  2. Martin Frendø
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  3. Peter Trier Mikkelsen
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  4. Mads Sølvsten Sørensen
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  5. Steven Arild Wuyts Andersen
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Corresponding author

Correspondence to Andreas Frithioff.

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The authors declare that they have no conflict of interest.

Ethical approval

The regional ethical committee of the capital region of Denmark found this educational trial exempted (H-180042355).

Informed consent

Written consent was obtained from all the participants included in the study.

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Frithioff, A., Frendø, M., Mikkelsen, P.T. et al. Ultra-high-fidelity virtual reality mastoidectomy simulation training: a randomized, controlled trial. Eur Arch Otorhinolaryngol 277, 1335–1341 (2020). https://doi.org/10.1007/s00405-020-05858-3

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  • DOI: https://doi.org/10.1007/s00405-020-05858-3

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