Determining the difficulty level of cases for temporal bone surgery training in virtual reality simulation.

Area of Science:

• Neurosurgery
• Surgical Education
• Virtual Reality

Background:

• Anatomical variations impact surgical difficulty, necessitating diverse training cases for mastery.
• Surgeons' subjective predictions of temporal bone difficulty may not align with trainee performance.

Purpose of the Study:

• To test the hypothesis that expert judgment of temporal bone difficulty correlates with trainee performance in a virtual reality (VR) environment.

Main Methods:

• Ten expert surgeons rated the difficulty of VR temporal bones.
• Thirty participants (medical students, ENT trainees, consultants) performed VR mastoidectomies.
• Dissections were scored by blinded experts, and correlations were analyzed.

Main Results:

• Expert difficulty ratings demonstrated high inter-rater reliability.
• Surgical performance correlated with experience: consultants > trainees > medical students.
• Trainees excelled on certain features rated as difficult by experts.

Conclusions:

• Expert-based difficulty ratings do not predict trainee temporal bone dissection performance.
• Actual surgical performance, assessable in VR or with 3D models, may be a superior metric for judging difficulty and guiding training.