Effect of Case Variation on Mastoidectomy Training Using 3D‐Printed Temporal Bones Models—A Prospective, Randomized Trial
Adam Omari, Andreas Frithioff, Anders Nøhr, Mads S. Sørensen, Steven A. W. AndersenAbstract
Objective
To investigate effects of repeated training with anatomically varied versus identical 3D‐printed models on skill acquisition, cognitive load, and skill retention in novice mastoidectomy trainees.
Study Design
A prospective, randomized, controlled, educational trial conducted April to September 2024 including a 3‐month retention test.
Setting
Simulation center at a single academic teaching hospital.
Methods
Twenty‐four novice medical students were randomized 1:1 into 2 groups: The Identical Models (IM) group practiced repeated procedures on identical 3D‐printed temporal bone models (control) and the Variable Model (VM) group practiced on a varied selection of models (intervention). Trainees completed 10 anatomical mastoidectomy procedures with posterior tympanotomy followed by 2 retention test procedures after 3‐months of nonpractice. The primary outcome was performance assessed with 25‐point modified Welling Scale. The secondary outcome was cognitive load estimated by relative reaction time measured on a secondary task.
Results
At end‐of‐training, the VM group scored 20.6 points (95% CI [19.2‐22.0]), outperforming the IM group who scored an average of 18.2 points (95% CI [16.7‐19.6], P = .02). At 3‑month retention testing, the VM group's scores decayed by a mean of 5.6 points on the repeated model (95% CI [−7.2 to−4.0], P < .001) and of 3.7 points when introduced to a new model (95% CI [−5.2 to−2.1], P < .001). The IM group showed no decay thereby demonstrating better skill retention which aligned with reduced relative reaction time (cognitive load) during training.
Conclusions
Educators can optimize mastoidectomy skills acquisition and retention by instructional design that prioritize repeated practice on anatomically identical models until basic skills have been acquired.