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Related Experiment Video

Updated: Nov 18, 2025

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Quantifying a Learning Curve for Video Head Impulse Test: Pitfalls and Pearls.

Athanasia Korda1, Thomas C Sauter2, Marco Domenico Caversaccio1

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.

Frontiers in Neurology
|February 8, 2021
PubMed
Summary

Novices can quickly learn the video head impulse test (vHIT) for vestibular function assessment with expert guidance. Simple video instructions alone are insufficient for mastering this objective diagnostic tool.

Keywords:
emergency departmenthead impulse testlearning curvevertigovideo head impulse test (vHIT)

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Area of Science:

  • Neurology
  • Otolaryngology
  • Vestibular System Diagnostics

Background:

  • The video head impulse test (vHIT) offers a fast, objective measure of vestibular function.
  • Its clinical utility is debated, often perceived as requiring expert performance.

Purpose of the Study:

  • To investigate the learning curve of novices performing vHIT.
  • To identify common errors and challenges encountered during vHIT learning.

Main Methods:

  • A prospective observational study included 10 novices performing horizontal vHIT.
  • Participants completed 10 sessions (20 impulses each) with video instruction and expert feedback.
  • Key metrics analyzed included VOR gain, HIT acceptance rate, head velocity, acceleration, excursion, and overshoot.

Main Results:

  • An 80% HIT acceptance rate was achieved after approximately 160 vHITs.
  • Head acceleration improved significantly post-video instruction (p=0.001).
  • Head excursion and overshoot improved significantly after 200 impulses (p<0.001).

Conclusions:

  • Novices can rapidly learn vHIT with structured instruction and expert feedback.
  • Video instruction alone did not yield significant improvements.
  • Insufficient head acceleration was the most frequent technical pitfall observed.