Establishing Learning Curves in Virtual Simulation Training of Mastoidectomy

Study Overview
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Brief Summary
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The purpose of this study is to establish learning curves of mastoidectomy training in virtual surgical simulation training, to establish the long-term effect of repeat simulation training and to explore the transfer of skills, the roles of an integrated tutor function, self-directed learning and cognitive load.

Detailed Description
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Repeat surgical simulation training is known to provide better learning and long-term transfer. The learning curves for the mastoidectomy procedure have not been intensively studied. The only study conducted on learning curves in mastoidectomy to date found a plateau in performance for 4 medical students after about 4 mastoidectomy procedures on separate occasions. The participants were however assessed using an unvalidated, unestablished simulator integrated overall performance score. There is therefore a need for establishing learning curves and plateau using established objective assessment scales, which could have implications for future studies and on a larger scale for the future organization of temporal bone dissection courses. The long-term effect on learning of deliberate repeat simulator training of the mastoidectomy procedure has not previously been studied. The role of cognitive load in learning complex surgical technical skills in simulation has not been studied in great detail. The relationship between time and progress/performance assessment using Final Product Analysis (FPA) has not been studied. We have previously suggested that a tutor-function with volumetric approach with green lighting of the procedural steps could have an effect on performance. The effect of the tutor function could however not be isolated.

Official Title
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Establishing Learning Curves in Virtual Simulation Training of Mastoidectomy

Conditions
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User-Computer Interface, Clinical Skills, Motor Skills, Temporal Bone, Students

Intervention / Treatment
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* Other: Tutor function on


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: medical students informed written consent Exclusion Criteria: prior training on the Visible Ear Simulator

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Tutor function off<br>The tutor function will be off for 12 out of 12 repeat simulations. | |
| Experimental: Tutor function on<br>The group will have the tutor function on for the 5 first out of 12 repeat simulation sessions. | Other: Tutor function on<br>* The simulator-integrated tutor function with volumetric green lighting of the intended volume to be drilled.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Final Product Assessment Score | Mastoidectomy final product assessment score using a modified Welling Scale for performance assessment. | 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in simulator metrics | Integrated simulator metrics on volume drilled (inside+outside target volumes), collisions with vital structures in simulation, time. | 4 months | 
| Change in reaction time | Reaction time to a visual cue (in ms) | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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virtual simulation, temporal bone, surgical training, medical education, self-directed learning, final product assessment, cognitive load, reaction time, skills training, simulator metrics