Incorporating HTA and VR Simulation to Teach Trainees in Endoscopic Endonasal Skull Base Approaches

This study introduces a novel educational framework for endoscopic endonasal skull base surgery that integrates hierarchical task analysis (HTA) and systematic human error reduction and prediction approach (SHERPA) into an immersive virtual reality (VR) simulator. The platform deconstructs complex procedures into structured steps, identifies potential errors, and embeds decision-making prompts to enhance both technical skill and situational awareness. This structured, error-aware VR approach offers a transformative advancement in surgical training, providing a safe, repeatable, and clinically relevant learning environment.