목적: Surgical simulation training may enhance the trainees’ understanding of the anatomy and performance. The aim of this study was to evaluate the educational value of surgical simulation training in endoscopic endonasal surgery using virtual simulation (VS) program and three- dimensional (3D) printed models. 방법:This prospective trial enrolled a total of 20 otorhinolaryngology (ORL) trainees including residents and fellows. Informed consent was obtained from all trainees, and they were randomly allocated to one of two surgical simulation training programs. Group 1 performed simulation on the VS model first, then on the 3D model, while Group 2 performed sinus surgery on the 3D model only. Before performing the surgical simulation, the trainees were briefed on the computed tomography (CT) scan used to construct the VS and 3D models, the surgical tasks needed to complete sinus surgery. A tutor with ORL board oversaw all training and measured time to completion of tasks. The trainees completed questionnaires on the educational value, anatomic fidelity of the models, and level of confidence after training. 결과:Ten trainees were each randomized into group 1 and group 2, respectively. There was no difference in sex, mean age and length of ORL training between groups. Trainees in group 1 evaluated the educational value of the program (simulation on VS model preceding 3D model) more highly than those in group 2 who only dissected the 3D models (p<0.01). Proportion of trainees who answered that the program was educational enough to replace cadaver dissection was higher in group 1 (60% vs. 20%, p=0.17). Although there was no significant difference in time needed to perform tasks in the 3D model between groups, group 1 expressed higher level of confidence after simulation training (p<0.01). 결론:VS programs and 3D models are both helpful in simulation training for endoscopic sinus surgery, and a combination of both may be synergistic in providing better simulation training for ORL trainees in endoscopic sinus surgery.