3D volumetric temporal bone models, with segmented internal structures, taken from the VR simulator were prepared for printing using Meshmixer (Autodesk, San Rafael, Calif, USA) and FlashPrint (FlashForge 3D Printer, Jinhua City, China). Polylactic acid (PLA) was selected as the material to print the models, as a previous study showed it to have a similar appearance and physical likeness to human bone.13 (link) The models were printed in 2 colors using a Flashforge Dreamer 3D printer (FlashForge 3D Printer): white for the bone and pink for anatomical landmarks (dura, sigmoid sinus, facial nerve, and ossicles). When operating on 3D printed temporal bone (PTB) models, study participants were provided with a handheld surgical drill, irrigation, and a surgical microscope.