Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
The Simulation Centre, Copenhagen Academy for Medical Education and Simulation (CAMES), The Capital Region of Denmark, Copenhagen, Denmark.
Eur Arch Otorhinolaryngol. 2019 Oct;276(10):2783-2789. doi: 10.1007/s00405-019-05572-9. Epub 2019 Jul 26.
Virtual reality (VR) training of mastoidectomy is effective in surgical training-particularly if organized as distributed practice. However, centralization of practice facilities is a barrier to implementation of distributed simulation training. Decentralized training could be a potential solution. Here, we aim to assess the feasibility, use, and barriers to decentralized VR mastoidectomy training using a freeware, high-fidelity temporal bone simulator.
In a prospective, mixed-methods study, 20 otorhinolaryngology residents were given three months of local access to a VR mastoidectomy simulator. Additionally, trainees were provided a range of learning supports for directed, self-regulated learning. Questionnaire data were collected and focus group interviews conducted. The interviews were analyzed using thematic analysis and compared with quantitative findings.
Participants trained 48.5 h combined and mainly towards the end of the trial. Most participants used between two and four different learning supports. Qualitative analysis revealed five main themes regarding implementation of decentralized simulation training: convenience, time for training, ease of use, evidence for training, and testing.
Decentralized VR training using a freeware, high-fidelity mastoidectomy simulator is feasible but did not lead to a high training volume or truly distributed practice. Evidence for training was found motivational. Access to training, educational designs, and the role of testing are important for participant motivation and require further evaluation.
虚拟现实 (VR) 耳外科训练在手术培训中很有效——特别是如果组织为分布式实践。然而，实践设施的集中化是实施分布式模拟培训的障碍。分散式培训可能是一个潜在的解决方案。在这里，我们旨在使用免费的、高保真的颞骨模拟器评估去中心化 VR 乳突切除术训练的可行性、使用情况和障碍。
在一项前瞻性、混合方法研究中，20 名耳鼻喉科住院医师获得了三个月的本地访问 VR 乳突切除术模拟器的机会。此外，为定向、自我调节学习提供了一系列学习支持。收集了问卷调查数据并进行了焦点小组访谈。使用主题分析对访谈进行了分析，并将其与定量发现进行了比较。
参与者总共培训了 48.5 小时，主要集中在试验的后期。大多数参与者使用了两到四种不同的学习支持。定性分析揭示了去中心化模拟培训实施的五个主要主题：便利性、培训时间、易用性、培训证据和测试。
使用免费的、高保真的乳突切除术模拟器进行去中心化 VR 培训是可行的，但并未导致高培训量或真正的分布式实践。培训证据具有激励作用。培训的可访问性、教育设计以及测试的作用对于参与者的积极性很重要，需要进一步评估。
