Impact of the endoscopic sinus surgical simulator on operating room performance

Objectives/Hypothesis. The aim of this study is to evaluate an endoscopic sinus surgical simulator (ESS) as a training device and to introduce a methodology to assess its impact on actual operating room performance. Study Design: Prospective evaluation of the endoscopic sinus surgical simulator as a trainer. Methods. Ten junior and senior ear, nose and throat residents served as subjects, some of whom had prior training with the simulator. The evaluation team collected several measures, which were analyzed for a statistical correlation, including simulator scores, operating room performance rating, ratings of videotaped operating room procedures, and surgical competency rating. Results. These findings suggest the ESS simulator positively affects initial operating room performance across all measures as judged by senior surgeons rating anonymous videotapes of those procedures. The two simulation-trained residents were rated consistently better than the other two residents across all measures. These differences approached statistical significance for two items: anterior ethmoidectomy (P = .06; P < .05) and surgical confidence (P = .09; P < .05). In addition, the 3 subjects with the highest overall scores on the competency evaluation also had 3 of the 4 highest cumulative simulation times. Conclusions: The endoscopic sinus surgical simulator is a valid training device and appears to positively impact operating room performance among junior otolaryngology residents.