Development and face validity testing of a three-dimensional myringotomy simulator with haptic feedback

Abstract

Introduction: Considerable progress has been made in the development of three-dimensional temporal bone virtual reality simulators. However, very little attention has been paid to interactive simulation of middle ear surgery, including myringotomy. As the development of technical skills for middle ear surgery has a steep learning curve, this poses inherent risks to patients during the skills acquisition phase. The benefit of simulation training in the acquisition of surgical skills has been demonstrated with previous low-fidelity models. Tactile sensation is an important feedback mechanism in middle ear surgery, so a three-dimensional virtual reality myringotomy simulator with haptic feedback was developed at The University of Western Ontario.

Objective: To examine the face validity of a three-dimensional myringotomy simulator with haptic feedback.

Methods: The three-dimensional myringotomy simulator was calibrated with input from two otolaryngologists and one intermediate-level resident. The face validity of the resulting simulator was tested by four staff otolaryngologists and seven intermediate- or senior-level residents using a previously validated questionnaire.

Results: The results demonstrate good to excellent face validity for the myringotomy simulator with high consistency between participants with a Cronbach alpha of .919. Favourable responses predominated for all questions with the exception of force feedback, where the average response was neutral.

Conclusions: The initial results from the development and testing of a three-dimensional virtual myringotomy simulator with haptic feedback are very encouraging. This simulator is the first of its kind and, with further refinement, has excellent potential to be of benefit in the training of proficient middle ear surgeons.