Introduction
Increased concern for patient safety and operating room efficiency, shorter workweeks and the ever-increasing complexity of the surgical cases have decreased the number of opportunities the residents have for hands-on training [Numerous studies have suggested that utilizing virtual reality (VR) technology in surgical training might be beneficial [In general, surgical training the effectiveness of VR simulators has been proved mainly in novices, with a positive effect on both laparoscopic and open procedures [While the simulators have been in the spotlight, there has been less interest in the other possibilities of VR technology. A recent meta-analysis of VR’s effectiveness on anatomical training, without the inclusion of a simulator, reported that VR increased the test scores when compared to traditional methods [Mastoidectomy (Image Overview of mastoidectomy on a cadaver temporal bone. Presently, cadaveric temporal bone training is the gold standard for learning mastoidectomy [In the future, another option for hands-on training besides VR simulators could be 3D-printed anatomical models. 3D-printed temporal bones have some possible advantages to VR simulation as the haptic feedback is presumably better and genuine equipment can be used. On the other hand, VR simulation can include the soft tissues as well and repetitions do not incur extra costs. 3D-printed temporal bones have already been investigated in a few studies [In the present study, we evaluate the validity of anatomical VR training by comparing it to the traditional way of training including anatomy books, dissection guides and expert instruction in complete novices. After the training, the participants perform a mastoidectomy and their performance is evaluated. Feedback related to the training methods is also gathered. Our main hypothesis was that the VRT group would perform better based on the presumed advantage of obtaining a better 3D understanding of the anatomy. Using three objective measures (operation time, need of assistance, and the Welling scale score [