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

Area of Science:

• Medical Simulation
• Surgical Education
• Virtual Reality Technology

Background:

• Virtual reality (VR) simulation offers a promising avenue for surgical skill acquisition.
• Ultra-high-fidelity (UHF) graphics in VR may enhance realism and training effectiveness.
• Conventional screen-based VR (cVR) is the current standard for many VR surgical training modules.

Purpose of the Study:

• To compare the efficacy of UHF VR simulation versus cVR simulation in temporal bone surgical training.
• To evaluate the impact of UHF VR on surgical performance and cognitive load (CL) in novice surgeons.

Main Methods:

• A randomized cross-over trial involving 24 students performing four mastoidectomies in a VR temporal bone simulator.
• Participants completed two procedures under UHF conditions and two under cVR conditions.
• Performance was assessed by blinded raters, and CL was measured via secondary-task reaction time changes.

Main Results:

• UHF VR simulation resulted in significantly lower mean final-product performance scores compared to cVR (p=0.02).
• Stereovision capability was a critical factor for performance in UHF simulation (p<0.001).
• Cognitive load was significantly higher in UHF VR (28%) than in cVR (18%) (p<0.001).

Conclusions:

• UHF VR simulation training currently reduces performance and increases cognitive load in novice surgeons.
• Conventional VR training should precede UHF VR training for novices.
• UHF VR may be more appropriate for training intermediate or experienced surgeons.