Establishing Learning Curves in Virtual Simulation Training of Mastoidectomy

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.

Study Overview

• Status: Completed
• Conditions: Motor Skills; User-Computer Interface; Students; Clinical Skills; Temporal Bone
• Intervention / Treatment: Other: Tutor function on

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 43
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Copenhagen, Denmark, DK-2100
    • Rigshospitalet

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• medical students
• informed written consent

Exclusion Criteria:

• prior training on the Visible Ear Simulator

Study Plan

How is the study designed?

Design Details

• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

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

What is the study measuring?

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

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Background data	Background data from a questionnaire including questions on demographics, prior simulation training and experience and interests in computers and IT	At recruitment

Collaborators and Investigators

• Sponsor: Rigshospitalet, Denmark
• Investigators: Principal Investigator: Steven AW Andersen, MD, Rigshospitalet, Denmark

Study record dates

Study Major Dates

• Study Start: October 1, 2013
• Primary Completion (Actual): November 1, 2014
• Study Completion (Actual): November 1, 2014

Study Registration Dates

• First Submitted: October 11, 2013
• First Submitted That Met QC Criteria: October 16, 2013
• First Posted (Estimate): October 21, 2013

Study Record Updates

• Last Update Posted (Estimate): May 5, 2015
• Last Update Submitted That Met QC Criteria: May 4, 2015
• Last Verified: May 1, 2015

More Information

Terms related to this study

• Keywords: medical education; reaction time; skills training; surgical training; self-directed learning; cognitive load; virtual simulation; temporal bone; final product assessment; simulator metrics
• Other Study ID Numbers: H-4-2013-FSP-088