The effect of fidelity: how expert behavior changes in a virtual reality environment

Area of Science:

• Neurosurgery
• Medical Simulation
• Surgical Education

Background:

• Cadaveric temporal bones are the gold standard for surgical simulation.
• Virtual reality (VR) simulation offers a high-fidelity alternative for surgical training.
• Evaluating expert surgeon behavior across different simulation modalities is crucial.

Purpose of the Study:

• To compare expert surgeon behavior on cadaveric temporal bones versus a high-fidelity VR simulator.
• To determine if expert behavior changes in a virtual environment.
• To assess how simulation fidelity impacts user behavior.

Main Methods:

• Five expert otologists performed procedures on both cadaveric and VR temporal bone simulators.
• Surgical technique was analyzed using hand movement and video recordings.
• Behavioral measures were compared between the cadaveric and VR environments.

Main Results:

• Drilling time was comparable between cadaveric and VR simulations.
• Surgical strokes in VR were longer in distance and duration but proportionally similar to cadaveric.
• Differences in stroke shape metrics were observed, attributed to VR simulator modeling.

Conclusions:

• Minor differences in drill interaction in VR can measurably affect surgical technique.
• Understanding these effects is vital for designing effective VR surgical training.
• Improving VR simulator fidelity is essential for technique transfer to real-world surgery.