The importance of automated real-time performance feedback in virtual reality temporal bone surgery training

© Springer Nature Switzerland AG 2019. Virtual reality (VR) is increasingly being used as a training platform in many fields including surgery. However, practice on VR simulators alone is not sufficient to impart skills. Provision of performance feedback is essential to enable skill acquisition by ensuring that mistakes are identified and corrected, strengths are reinforced, and insights into consequences of actions are provided. As such, for a simulation system to be an effective training platform and to enable self-directed learning, it is imperative that automated performance feedback is provided by the system. Although there has been increased interest in the development of feedback methodologies in VR-based surgical training in recent years, their effectiveness in practice has rarely been investigated. In this paper, we investigate the impact of performance feedback in a VR-based surgical training platform with respect to skill acquisition and retention through a randomized controlled trial. We show that feedback during training is essential for both acquisition and retention of surgical skills.