Cognitive Load in Mastoidectomy Skills Training: Virtual Reality Simulation and Traditional Dissection Compared

Area of Science:

• Medical Education
• Surgical Training
• Cognitive Psychology

Background:

• The cognitive load (CL) framework highlights working memory limitations impacting learning.
• Complex surgical training, like mastoidectomy, can cause cognitive overload, hindering skill acquisition.
• Comparing CL in traditional cadaveric dissection versus virtual reality (VR) simulation is crucial for optimizing surgical education.

Purpose of the Study:

• To compare cognitive load during mastoidectomy training in traditional cadaveric dissection versus VR simulation.
• To evaluate the impact of different training modalities on novice surgeons' cognitive processing.
• To determine the optimal sequence for integrating VR and cadaveric training for mastoidectomy.

Main Methods:

• Prospective, crossover study design involving 40 novice otorhinolaryngology residents.
• Participants underwent both cadaveric dissection and VR simulation for mastoidectomy, in a randomized order.
• Cognitive load was measured using secondary-task reaction time testing at baseline and during each training modality.

Main Results:

• Mastoidectomy training via cadaveric dissection increased cognitive load by 55%, significantly more than VR simulation (20%) compared to baseline (p < 0.001).
• VR simulation training demonstrated a significantly lower cognitive load than traditional cadaveric dissection.
• Reaction time increases indicated a greater cognitive burden during cadaveric dissection.

Conclusions:

• VR simulation training for mastoidectomy imposes a lower cognitive load on novice surgeons than traditional cadaveric dissection.
• VR simulation offers a potentially more effective initial training method for complex surgical skills due to reduced cognitive load.
• Integrating VR simulation prior to cadaveric dissection may optimize mastoidectomy skills acquisition and training efficacy.