Fried MP, Sadoughi B, Gibber MJ, Jacobs JB, Lebowitz RA, Ross DA, Bent JP, Parikh SR, Sasaki CT, Schaefer SD. From virtual reality to the operating room: the endoscopic sinus surgery simulator experiment.
Otolaryngol Head Neck Surg 2010;
142:202-7. [PMID:
20115975 DOI:
10.1016/j.otohns.2009.11.023]
[Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 11/12/2009] [Accepted: 11/16/2009] [Indexed: 12/15/2022]
Abstract
OBJECTIVE
Establish the feasibility of a predictive validity study in sinus surgery simulation training and demonstrate the effectiveness of the Endoscopic Sinus Surgery Simulator (ES3) as a training device.
STUDY DESIGN
Prospective, multi-institutional controlled trial.
SETTING
Four tertiary academic centers with accredited otolaryngology-head and neck surgery residency programs.
SUBJECTS
Twelve ES3-trained novice residents were compared with 13 control novice residents.
METHODS
Subjects were assessed on the performance of basic sinus surgery tasks. Their first in vivo procedure was video recorded and submitted to a blinded panel of independent experts after the panel established a minimum inter-rater reliability of 80 percent. The recordings were reviewed by using a standardized computer-assisted method and customized metrics. Results were analyzed with the Mann-Whitney U test. Internal rater consistency was verified with Pearson moment correlation.
RESULTS
Completion time was significantly shorter in the experimental group (injection P = 0.003, dissection P < 0.001), which, according to the rater panel, also demonstrated higher confidence (P = 0.009), demonstrated skill during instrument manipulation (P = 0.011), and made fewer technical mistakes during the injection task (P = 0.048) compared with the control group. The raters' post hoc internal consistency was deemed adequate (r > 0.5 between serial measurements).
CONCLUSION
The validity of the ES3 as an effective surgical trainer was verified in multiple instances, including those not depending on subjective rater evaluations. The ES3 is one of the few virtual reality simulators with a comprehensive validation record. Advanced simulation technologies need more rapid implementation in otolaryngology training, as they present noteworthy potential for high-quality surgical education while meeting the necessity of patient safety.
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