title: Evaluation of Sensory and Motor Skills in Neurosurgery Applicants Using a Virtual Reality Neurosurgical Simulator: The Sensory-Motor Quotient.
abstract: OBJECTIVE
  Manual skill is an important attribute for any surgeon. Current methods to evaluate sensory-motor skills in neurosurgical residency applicants are limited. We aim to develop an objective multifaceted measure of sensory-motor skills using a virtual reality surgical simulator.
  
  
  METHODS
  A set of 3 tests of sensory-motor function was performed using a 3-dimensional surgical simulator with head and arm tracking, collocalization, and haptic feedback. (1) Trajectory planning: virtual reality drilling of a pedicle. Entry point, target point, and trajectory were scored-evaluating spatial memory and orientation. (2) Motor planning: sequence, timing, and precision: hemostasis in a postresection cavity in the brain. (3) Haptic perception: touching virtual spheres to determine which is softest of the group, with progressive difficulty. Results were analyzed individually and for a combined score of all the tasks.
  
  
  METHODS
  The University of Chicago Hospital's tertiary care academic center.
  
  
  METHODS
  A total of 95 consecutive applicants interviewed at a neurosurgery residency program over 2 years were offered anonymous participation in the study; in 2 cohorts, 36 participants in year 1 and 27 participants in year 2 (validation cohort) agreed and completed all the tasks. We also tested 10 first-year medical students and 4 first- and second-year neurosurgery residents.
  
  
  RESULTS
  A cumulative score was generated from the 3 tests. The mean score was 14.47 (standard deviation = 4.37), median score was 13.42, best score was 8.41, and worst score was 30.26. Separate analysis of applicants from each of 2 years yielded nearly identical results. Residents tended to cluster on the better performance side, and first-year students were not different from applicants.
  
  
  CONCLUSIONS
  (1) Our cumulative score measures sensory-motor skills in an objective and reproducible way. (2) Better performance by residents hints at validity for neurosurgery. (3) We were able to demonstrate good psychometric qualities and generate a proposed sensory-motor quotient distribution in our tested population.
authors.affiliation: Section of Neurosurgery, The University of Chicago, Chicago, Illinois. Electronic address: broitber@surgery.bsd.uchicago.edu.
authors.forename: Ben Z
authors.initials: BZ
authors.lastname: Roitberg
authors.affiliation: Section of Neurosurgery, The University of Chicago, Chicago, Illinois.
authors.forename: Patrick
authors.initials: P
authors.lastname: Kania
authors.affiliation: Section of Neurosurgery, The University of Chicago, Chicago, Illinois.
authors.forename: Cristian
authors.initials: C
authors.lastname: Luciano
authors.affiliation: Section of Neurosurgery, The University of Chicago, Chicago, Illinois.
authors.forename: Naga
authors.initials: N
authors.lastname: Dharmavaram
authors.affiliation: Section of Neurosurgery, The University of Chicago, Chicago, Illinois.
authors.forename: Pat
authors.initials: P
authors.lastname: Banerjee
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D006801:Humans; D009048:Motor Skills; D009493:Neurosurgery / Q000193:education*; D011597:Psychomotor Performance; D012570:School Admission Criteria
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; residency applicants; simulation; skill testing; virtual reality