[Multimodal training concept for temporal bone surgery].

BACKGROUND: Surgical training is increasingly supported by the use of simulators. For temporal bone surgery, shown here by means of mastoidectomy, there are other training models besides cadaver specimens, such as artificial temporal bones or computer-based simulators.
OBJECTIVES: A structured training concept was created which integrates different training methods of mastoidectomy with regard to effectiveness and current learning theory in education.
METHOD: A selective literature research was conducted to compare learning-theoretical findings and the availability and effectiveness of currently existing training models.
RESULTS: To acquire surgical skills, a stepwise approach is suggested. Depending on the progress with computer-based simulation, plastic or native temporal bones should be used. To achieve a plateau of the learning curve, approximately 25 semi-autonomous preparations are recommended. Different 'Objective Structured Assessments of Technical Skills' (OSATS) are implemented to assess the learning progress at different levels. DISCUSSION: Simulation-based training is recommended until an adequate learning curve plateau is achieved. This is reasonable for patient safety, based on limited accessibility of human cadaveric temporal bones but also by findings of the learning theory.
CONCLUSION: The curriculum integrates different training models of mastoidectomy and OSATS into an overall concept. The training plan has to be continuously adapted to new findings and technical developments.