Virtual coach: the next tool in functional endoscopic sinus surgery education

Authors

John P. Richards, Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, AZ.
Aaron J. Done, Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, AZ.
Samuel R. Barber, Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, AZ.Follow
Saurabh Jain, Department of Systems and Industrial Engineering, University of Arizona, Tucson, AZ.
Young-Jun Son, Department of Systems and Industrial Engineering, University of Arizona, Tucson, AZ.
Eugene H. Chang, Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, AZ.

Document Type

Article

Abstract

BACKGOUND: Functional endoscopic sinus surgery (FESS) can be challenging as novices become accustomed to handling endoscopes and instruments while navigating complex sinonasal anatomy. Experts demonstrate fluid and efficient motions when addressing pathology. The training process from novice to expert relies on hands-on experience in cadaveric laboratories and preceptorship models that require significant time and expense. This study aims to validate the use of a virtual coach to guide users step-by-step through a basic FESS. METHODS: Seventeen surgeons were grouped into novice (n = 10) and expert (n = 7) based on self-reported levels of surgical experience. Users were trained using the maxillary antrostomy module in the Neurorhinological Surgery (NRS) simulator combining the physical craniofacial model with virtual reality (VR)-tracked surgical instruments in the VR operating room. The virtual coach guided the user using surgical videos, auditory, and visual cues. The coach recorded data for each subject including the number of times borders of the nasal cavity were encountered and time to completion. Users graded the usefulness of the virtual coach on a Likert questionnaire. RESULTS: Face validity of our NRS simulator was replicated by user questionnaires, and construct validity replicated by differentiation between novice and expert level surgeons (p < 0.01). Novices contacted a significantly higher number of anatomic borders (n = 17) and had a longer operative time (t = 370 seconds). All users reported high scores on the benefit and usefulness of the virtual coach. CONCLUSION: The virtual coach provides a useful tool to enhance FESS education by providing objective real-time data in a novel mixed-reality surgical environment.

Medical Subject Headings

Adult; Clinical Competence; Female; Humans; Male; Natural Orifice Endoscopic Surgery (education); Paranasal Sinuses (anatomy & histology, surgery); Reproducibility of Results; Simulation Training (methods); Virtual Reality

Publication Date

1-1-2020

Publication Title

International forum of allergy & rhinology

E-ISSN

2042-6984

Volume

10

Issue

1

First Page

97

Last Page

102

PubMed ID

31834672

Digital Object Identifier (DOI)

10.1002/alr.22452

Recommended Citation

Richards, John P.; Done, Aaron J.; Barber, Samuel R.; Jain, Saurabh; Son, Young-Jun; and Chang, Eugene H., "Virtual coach: the next tool in functional endoscopic sinus surgery education" (2020). ENT and Skull Base Surgery. 83.
https://scholar.barrowneuro.org/ent-and-skull-base-surgery/83