{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T10:56:10Z","timestamp":1784631370412,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:00:00Z","timestamp":1576195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007899","name":"University of Arizona","doi-asserted-by":"publisher","award":["Research Discovery Innovation\u2010Accelerate for Suc"],"award-info":[{"award-number":["Research Discovery Innovation\u2010Accelerate for Suc"]}],"id":[{"id":"10.13039\/100007899","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Backgound<\/jats:title><jats:p>Functional endoscopic sinus surgery (FESS) can be challenging as novices become accustomed to handling endoscopes and instruments while navigating complex sinonasal anatomy. Experts demonstrate fluid and efficient motions when addressing pathology. The training process from novice to expert relies on hands\u2010on experience in cadaveric laboratories and preceptorship models that require significant time and expense. This study aims to validate the use of a virtual coach to guide users step\u2010by\u2010step through a basic FESS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventeen surgeons were grouped into novice (n = 10) and expert (n = 7) based on self\u2010reported levels of surgical experience. Users were trained using the maxillary antrostomy module in the Neurorhinological Surgery (NRS) simulator combining the physical craniofacial model with virtual reality (VR)\u2010tracked surgical instruments in the VR operating room. The virtual coach guided the user using surgical videos, auditory, and visual cues. The coach recorded data for each subject including the number of times borders of the nasal cavity were encountered and time to completion. Users graded the usefulness of the virtual coach on a Likert questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Face validity of our NRS simulator was replicated by user questionnaires, and construct validity replicated by differentiation between novice and expert level surgeons (<jats:italic>p<\/jats:italic> &lt; 0.01). Novices contacted a significantly higher number of anatomic borders (n = 17) and had a longer operative time (t = 370 seconds). All users reported high scores on the benefit and usefulness of the virtual coach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The virtual coach provides a useful tool to enhance FESS education by providing objective real\u2010time data in a novel mixed\u2010reality surgical environment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22452","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T14:48:50Z","timestamp":1576248530000},"page":"97-102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Virtual coach: the next tool in functional endoscopic sinus surgery education"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0520-2448","authenticated-orcid":false,"given":"John P.","family":"Richards","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arizona College of Medicine  Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron J.","family":"Done","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arizona College of Medicine  Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Barber","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arizona College of Medicine  Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Systems and Industrial Engineering University of Arizona  Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young\u2010Jun","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Systems and Industrial Engineering University of Arizona  Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene H.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arizona College of Medicine  Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200210000-00008"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.11.015"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2016.09.007"},{"key":"e_1_2_6_5_1","first-page":"22","article-title":"100 years of surgical education: the past, present, and future","volume":"98","author":"Polavarapu HV","year":"2013","journal-title":"Bull Am Coll 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