Testing Protocol for Madigan Endoscopic Sinus Surgery Simulator v.2.0

Testing Protocol

Each subject was initially introduced to the simulator and informed that we were validating it as a trainer for residents in Otolaryngology. They were introduced to the voice recognition software and were encouraged to familiarize themselves with the interface and commands by running through some of the available menus. They were informed that any voice commands they could not remember could be described to the proctor, who would then execute the command.

The instrumented endoscope was then introduced, they were informed of the availability of a 30, 45 and 70 degree scope which could be swapped for the zero degree scope they would initially be given. They were then informed of their ability to rotate the image axially, while using the angled scopes, by rotating the shaft of the instrumented endoscope, or by calling out to the voice recognition software, which would rotate the scope axially in increments of 5 degrees.

Subjects were then introduced to the instrumented forceps and informed that they would simulate the all virtual Dissection tools and virtual needle for Injection. The mechanics of the instrumented forceps (open and closed) were described as simulating the plunger for the syringe during Injection and opening and closing the jaws of the dissection tools. They were then informed of how the instrumented forceps would be positioned in the nostril opposite the one used in the trial during Navigation.

The subjects were then given a brief verbal description of the three subtasks of Model 1 (Navigation, Injection and Dissection) and what would be required of them during the trial. A video showing the endoscopic view of of Dr. Mesaros performing the trial was then started. During the video, the subject was allowed to step up to the mannequin to become familiar with the instrumentation, and the proctor described the subtasks in more detail, including what was required for completion of the trial. The "blood effects scope" was shown in the video and reasons for it were described by the proctor, along with how to relieve the problem by wiping the instrumented scope on the foam pad located on the mannequin's forehead. Subjects were encouraged to ask any questions and "think-aloud" during the procedure.

After completing Model 1, the subjects proceeded to Model 2. In this model, the subjects were required to perform a Total Ethmoidectomy, which included performing the three subtasks of Model 1 combined with virtual anatomy. Again, a video of the tasks was shown while the proctor explained, in detail, the subtasks and what was required for completion of the trial. During the video, the subjects were familiarized with the various training aids which would be guiding them through the procedure, and were shown the text labels overlaying the anatomical structures which would aid them in learning the paranasal anatomy through an endoscopic perspective, and be used as dimensional cues throughout the trial. The subject's familiarity with the procedure determined the need for further instruction by the proctor during the trial.

Subjects then proceeded to Model 3. This model required the subjects to perform a Total Ethmoidectomy and remove three polyps lateral to the Middle Turbinate without the help of the training aids. During this trial, the subjects were expected to remember the Navigation paths taken as well as where to inject and what dissect to complete a Total Ethmoidectomy. The subject's familiarity with the procedure determined the need for further instruction by the proctor during the trial.

last updated: 10/11/98