Post Test Questionnaire and Subject Comments for Madigan Endoscopic Sinus Surgery Simulator v.2.0

note: prefixes to comments are: Subject Number then s=Staff and r=Resident.

Repeat Subjects:

0,r Difficult to distinguish between hitting virtual anatomy and hitting instrumented tools.
2,r No significant improvement on tool. Prefers them on the endoscope.
5,s Haptics are more of a hindrance than an help.

most noticeable improvements:
0,r Force Feedback, Tool Availability.

voice recognition:
0,r Took some getting used to-went to sleep too often.
2,r Usable.

inclusion of hazards:
0,r Realistic.
2,r Not realistic.

new anatomy:
0,r Better realism and detail.
2,r Very good.

realism of scope and tools (i.e. movement and handling):
0,r Much improved.
2,r Not realistic, still too many problems with the system.

realism of models:
0,r Poor distinction between Lamina and Ethmoids and difficult to visualize Maxillary Ostium.

most effective?:
2,r Anatomy.

0,r Different haptic resistance for bone vs. cartilage.
2,r Improved haptics on tool and addition of haptics to scope.

New Subjects:

1,r Had difficulty with Voice Recognition.
1,r Need haptics on Endoscope, but prefer it to be on Forceps if given the choice.
3,s Did not like haptics. Voice Recognition was not effective. Hazards were good. Very realistic anatomy. Scope and forceps movement were not as smooth as in real life.
4,s Anatomical landmarks need to be overemphasized. Voice recognition was intuitive and usable. Preferred forces off during dissection of Anterior Ethmoids.
7,r Voice recognition was intuitive and useful.

most effective?:
1,r Anatomy.
3,s Teaching eye/hand coordination.
4,s Navigation, initial dissection, selection of instruments

1,r Improve haptics-restricted access to Anterior Ethmoids. More depth of field (i.e. cut-off plane).
3,s More depth of field (i.e. cut-off plane). Ability to insert scope further into anatomy without hitting forceps. Mannequin head needs lubrication on nasal walls.
4,s Anatomy of Lamina Papyracea and Ethmoid Cells. Place haptics on the scope as well as the forceps (prefers forceps). More clearly mark dissectable regions of anatomy.
3,s and 4,s and 5,s All wanted the ability sit down and to rest their arm on a Mayo stand during the simulation (their normal posture during a procedure).
7,r More depth of field (i.e. cut-off plane). Variable table height



The haptics tended to inhibit access to certain areas (Anterior Ethmoid Cells), but were still preferable to no haptics on the instrument.

The endoscope needs to have haptics feedback to keep you from slipping through anatomy.


Looks very good, but, need more graphical distinction between Ethmoid cells and surrounding structures (Lamina Papyracea). Anatomical landmarks need to be over emphasized.

Some subjects experienced a slight delay in the update of the graphics, according to instrumented endoscope movement.

voice recognition:

Intuitive and useful for most subjects.

Had difficulty recognizing some subject's accents, had to discontinue use.


Need to have the ability to move the endoscope closer to the tool. Subjects kept running into the encoder box for the roll of the tool with the endoscope, therefore, inhibiting them from getting a comfortable view of the anatomy.

 last updated: 10/08/98