Sensory and motor skill testing in neurosurgery applicants: a pilot study using a virtual reality haptic neurosurgical simulator.
BACKGROUND
Manual skill is important for surgeons, but current methods to evaluate sensory-motor skills in applicants to a surgical residency are limited.


OBJECTIVE
To develop a method of testing sensory-motor skill using objective and reproducible virtual reality simulation.


METHODS
We designed a set of tests on a 3-dimensional surgical simulator with head and arm tracking, colocalization, and haptic feedback: (1) "trajectory planning in a simulated vertebra," ie, 3-dimensional memory and orientation; "hemostasis in the brain," ie, motor planning, sequence, timing, and precision; and "choose the softest object," ie, haptic perception. We also derived a weighted combined score for all tasks.


RESULTS
Of the 55 consecutive applicants to a neurosurgery residency approached, 46 performed at least 1 task, and 36 performed all tasks. For the trajectory planning task, the distance from target ranged from 3 to 30 mm, with 25 of 36 in the 6- to 18-mm range. In the motor planning test, the duration between cauterization attempts ranged between 5 and 22.5 seconds, peaking at 10 to 12.5 seconds in 15 of 36 participants. In the haptic perception test, linear regression demonstrated increased variability in performance with increasing difficulty of task (R = 0.6281). In all tests, performance followed a roughly bell-shaped curve. The combined weighted score of all tests demonstrated a better bell curve distribution, with scores ranging from 0.275 to 0.71 (mean, 0.47; median, 0.4775; SD, 0.1174).


CONCLUSIONS
Our study represents a first step in the direction of an objective, standard, computer-scored test of motor and haptic ability.
*University of Chicago Section of Neurosurgery, Chicago, Illinois; ‡University of Illinois at Chicago, Department of Mechanical and Industrial Engineering, Chicago, Illinois; §ImmersiveTouch Inc, Westmont, Illinois; ¶University of Texas Medical Branch at Galveston, Department of Neurosurgery, Galveston, Texas.
Ben
B
Roitberg
Pat
P
Banerjee
Cristian
C
Luciano
Martin
M
Matulyauskas
Silvio
S
Rizzi
Patrick
P
Kania
Jaime
J
Gasco
D000328:Adult; D001077:Aptitude Tests; D001863:Bone Screws; D001921:Brain / Q000601:surgery; D002983:Clinical Competence; D003196:Computer Graphics; D003198:Computer Simulation; D003627:Data Interpretation, Statistical; D005260:Female; D006487:Hemostasis; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009493:Neurosurgery / Q000379:methods*; D010865:Pilot Projects; D011597:Psychomotor Performance; D012570:School Admission Criteria; D013131:Spine / Q000033:anatomy & histology; D014584:User-Computer Interface; D014796:Visual Perception / Q000502:physiology