In an era where neurosurgical training must counterbalance work-hours restrictions and patient safety with highly sophisticated technical mastery, virtual reality (VR) simulation offers a viable educational alternative to the Halstedian apprenticeship model in a risk-free environment. Furthermore, residency training is moving toward the use of proficiency performance benchmarks to acquire a minimum competency standard.
VR surgical simulation allows an objective assessment of practitioner psychomotor skills. Multiple VR simulators have been implemented in neurosurgical training, incorporating varying degrees of sensory cues, immersion, and interactivity. Among the neurosurgical VR simulators that provide visual and haptic feedback, NeuroVR™ allows bimanual manipulation of cranial models and practice of standardized tasks in a stereoscopic view, providing specific metrics and quantitative measurements. Simulating the surgical procedure and measuring the performance through standardized scores, NeuroVR™ may constitute a valid and powerful tool for acquisition, improvement, and assessment of neurosurgical competencies. Several studies have already proved the reliability and validity of its training modules; future full-scale studies are needed to explore the impact on actual operating room performance, the longitudinal efficacy, and the opportunity to customize training programs in order to maximize individual psychomotor skills.
NeuroVR™ Neurosurgical education Simulation Technical skills Training modules Virtual reality
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Choudhury N, Gèlinas-Phaneuf N, Delorme S, et al. Fundamentals of neurosurgery: virtual reality tasks for training and evaluation of technical skills. World Neurosurg. 2013;80(5):9–19.CrossRefGoogle Scholar
Clark DB, D’Arcy RCN, Delorme S, et al. Virtual reality simulator: demonstrated use in neurosurgical oncology. Surg Innov. 2012;20(2):190–7.CrossRefGoogle Scholar
Delorme S, Laroche D, DiRaddo R, et al. NeouroTouch: a physics-based virtual simulator for cranial microneurosurgery training. Neurosurgery (1 Suppl Operative). 2012;71:32–42.CrossRefGoogle Scholar
Rosseau G, Bailes J, Cabral A, et al. The development of a virtual simulator for training neurosurgeons to perform and perfect endoscopic endonasal transphenoidal surgery. Neurosurgery. 2013;73(Suppl 1):85–93.CrossRefGoogle Scholar
Azarnoush H, Alzhrani G, Wnkler-Schwartz A, et al. Neurosurgical virtual reality simulation metrics to assess psychomotor skills during brain tumor resection. Int J CARS. 2015;10:603–18.CrossRefGoogle Scholar
Alotaibi FE, Alzhrani GA, Mullah MAS, et al. Assessing bimanual performance in brain tumor resection with NeuroTouch, a virtual reality simulator. Neurosurgery (Suppl 2). 2015;11(1):89–98.Google Scholar
Alzhrani G, Alotaibi F, Azarnoush H, et al. Proficiency performance benchmarks for removal of simulated brain tumors using a virtual reality simulator NeuroTouch. J Surg Educ. 2015;72(4):685–96.CrossRefGoogle Scholar
Azarnoush H, Siar S, Sawaya R, et al. The force pyramid: a spatial analysis of force application during virtual reality brain tumor resection. J Neurosurg. 2017;127:171–81.CrossRefGoogle Scholar
Gelinas-Phaneuf N, Choudry N, Al-Habib AR, et al. Assessing performance in brain tumor resection using a novel virtual reality simulator. Int J CARS. 2014;9:1–9.CrossRefGoogle Scholar
Holloway T, Lorsch ZS, Chary MA, et al. Operator experience determines performance in a simulated computer-based brain tumor resection task. Int J CARS. 2015;10:1853–62.CrossRefGoogle Scholar
Thawani JP, Ramayya AG, Abdullah KG, et al. Resident simulation training in endoscopic endonasal surgery utilizing haptic feedback technology. J Clin Neurosci. 2016;34:112–6.CrossRefGoogle Scholar
Winkler-Schwartz A, Bajunaid K, Mullah MAS, et al. Bimanual psychomotor performance in neurosurgical resident applicants assessed using NeuroTouch, a virtual reality simulator. J Surg Educ. 2016;73(6):942–53.CrossRefGoogle Scholar
NeuroVR™ user guide, 7/8/2016, CAE Healthcare, 905K540052 v1.Google Scholar
Alotaibi FE, Alzhrani GA, Sabbagh AJ, et al. Neurosurgical assessment of metrics including judgment and dexterity using virtual reality simulator NeuroTouch (NAJD metrics). Surg Innov. 2015;22(6):636–42.CrossRefGoogle Scholar
Bajunaid K, Mullah MAS, Winkler-Schwartz A, et al. Impact of acute stress on psychomotor bimanual performance during a simulated tumor resection task. J Neurosurg. 2017;126:71–80.CrossRefGoogle Scholar
Micko A, Knopp K, Knosp E, et al. Microsurgical performance after sleep interruption: a NeuroTouch simulator study. World Neurosurg. 2017;106:92–101.CrossRefGoogle Scholar