Objective assessment of learning curves for the Voxel-Man TempoSurg temporal bone surgery computer simulator

Introduction: Simulators are becoming an increasingly important part of surgical training. Temporal bone surgery is one area in which simulators, such as the Voxel-Man TempoSurg simulator, are likely to play a significant role in training. We present learning curve data from novice trainees using this simulator to learn cortical mastoidectomy, exposure of the sigmoid sinus, and exposure of the short process of the incus. Methods: We measured the time taken to perform the procedures, the volume of reference bone removed, and the structures damaged during dissection. Results: We found improvement in a number of parameters over the course of the study. The overall scores, structural damage scores and time taken improved, to differing degrees, for each task. The volume of reference bone removed remained constant. Conclusion: These results indicate that the trainees' efficiency improved as they became more proficient at removing a given volume of reference bone.