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Presentation of automated procedural guidance in surgical simulation: results of two randomised controlled trials

  • S Wijewickrema (a1), Y Zhou (a1), I Ioannou (a1), B Copson (a1), P Piromchai (a1) (a2), C Yu (a3), R Briggs (a1), J Bailey (a4), G Kennedy (a5) and S O'Leary (a1)...

To investigate the effectiveness and usability of automated procedural guidance during virtual temporal bone surgery.


Two randomised controlled trials were performed to evaluate the effectiveness, for medical students, of two presentation modalities of automated real-time procedural guidance in virtual reality simulation: full and step-by-step visual presentation of drillable areas. Presentation modality effectiveness was determined through a comparison of participants’ dissection quality, evaluated by a blinded otologist, using a validated assessment scale.


While the provision of automated guidance on procedure improved performance (full presentation, p = 0.03; step-by-step presentation, p < 0.001), usage of the two different presentation modalities was vastly different (full presentation, 3.73 per cent; step-by-step presentation, 60.40 per cent).


Automated procedural guidance in virtual temporal bone surgery is effective in improving trainee performance. Step-by-step presentation of procedural guidance was engaging, and therefore more likely to be used by the participants.

Corresponding author
Address for correspondence: Dr Sudanthi Wijewickrema, Department of Surgery (Otolaryngology), University of Melbourne, Level 5, Royal Victorian Eye and Ear Hospital, 32, Gisborne Street, East Melbourne, VIC 3002, Australia Fax: +61 3 9663 1958 E-mail:
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Presented at the 14th Australasian Auditory Neuroscience Workshop, 4 December 2016, Hobart, Australia.

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  • EISSN: 1748-5460
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