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The Virtual Operative Assistant: An explainable artificial intelligence tool for simulation-based training in surgery
Nykan Mirchi1, Vincent Bissonnette1,2, Recai Yilmaz1
1Department of Neurology & Neurosurgery, Neurosurgical Simulation & Artificial Intelligence Learning Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
Plos One
|February 28, 2020
Summary
This study introduces explainable artificial intelligence (AI) for surgical training, creating a Virtual Operative Assistant. The AI platform accurately distinguishes skilled from novice surgeons, offering automated feedback for improved surgical education.
Area of Science:
- Medical Education Technology
- Artificial Intelligence in Surgery
- Surgical Simulation
Background:
- Simulation-based training is crucial for psychomotor skill development in medicine.
- Artificial intelligence (AI) and machine learning offer new educational data utilization methods.
- A key criticism of AI in education is its lack of algorithmic transparency.
Purpose of the Study:
- Introduce an explainable AI framework for surgical simulation-based training.
- Validate this framework by developing the Virtual Operative Assistant, an automated educational feedback platform.
Main Methods:
- Participants (skilled surgeons and novices) performed a virtual reality brain tumor resection task.
- A support vector machine classifier was trained using performance metrics.
- The classifier was integrated into the Virtual Operative Assistant for automated feedback.
Main Results:
- The Virtual Operative Assistant achieved 92% accuracy, 82% specificity, and 100% sensitivity in classifying skilled vs. novice participants.
- A two-step feedback system provided visual performance benchmarks against expert proficiency.
- The system successfully linked expertise classification and objective feedback.
Conclusions:
- The developed educational system provides a foundation for integrating AI and virtual reality simulation in surgical education.
- This novel tool combines expertise classification, proficiency-based feedback, and instructor input for formative learning.
- Explainable AI offers a transparent approach to enhance surgical training and assessment.
