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Resident simulation training in endoscopic endonasal surgery utilizing haptic feedback technology

  • Author Footnotes
    1 These authors have contributed equally to the manuscript.
    Jayesh P. Thawani
    Correspondence
    Corresponding author. Tel./fax: +1 215 662 3487.
    Footnotes
    1 These authors have contributed equally to the manuscript.
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • Author Footnotes
    1 These authors have contributed equally to the manuscript.
    Ashwin G. Ramayya
    Footnotes
    1 These authors have contributed equally to the manuscript.
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • Kalil G. Abdullah
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • Eric Hudgins
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • Kerry Vaughan
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • Matthew Piazza
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • Peter J. Madsen
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • Vivek Buch
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • M. Sean Grady
    Affiliations
    Department of Neurosurgery, Hospital of the University of Pennsylvania, 3 Silverstein Pavillion – Neurosurgery, Philadelphia, PA 19103, USA
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  • Author Footnotes
    1 These authors have contributed equally to the manuscript.

      Highlights

      • Virtual reality simulation using haptic technology can be used for training in surgical education.
      • Training using such technology may lead to improved performance as suggested by our data.
      • Further work is required to determine if simulation can lead to improvements in other operative tasks or settings.
      • More studies are needed to validate these methods.

      Abstract

      Simulated practice may improve resident performance in endoscopic endonasal surgery. Using the NeuroTouch haptic simulation platform, we evaluated resident performance and assessed the effect of simulation training on performance in the operating room. First- (N = 3) and second- (N = 3) year residents were assessed using six measures of proficiency. Using a visual analog scale, the senior author scored subjects. After the first session, subjects with lower scores were provided with simulation training. A second simulation served as a task-learning control. Residents were evaluated in the operating room over six months by the senior author—who was blinded to the trained/untrained identities—using the same parameters. A nonparametric bootstrap testing method was used for the analysis (Matlab v. 2014a). Simulation training was associated with an increase in performance scores in the operating room averaged over all measures (p = 0.0045). This is the first study to evaluate the training utility of an endoscopic endonasal surgical task using a virtual reality haptic simulator. The data suggest that haptic simulation training in endoscopic neurosurgery may contribute to improvements in operative performance. Limitations include a small number of subjects and adjudication bias—although the trained/untrained identity of subjects was blinded. Further study using the proposed methods may better describe the relationship between simulated training and operative performance in endoscopic Neurosurgery.

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