Clinical trainee performance on task-based AR/VR-guided surgical simulation is correlated with their 3D image spatial...

This paper describes a methodology for the assessment of training simulator-based computer-assisted intervention skills on an AR/VR-guided procedure making use of CT axial slice views for a neurosurgical procedure: external ventricular drain (EVD) placement. The task requires that trainees scroll through a stack of axial slices and form a mental representation of the anatomical structures in order to subsequently target the ventricles to insert an EVD. The process of observing the 2D CT image slices in order to build a mental representation of the 3D anatomical structures is the skill being taught, along with the cognitive control of the subsequent targeting, by planned motor actions, of the EVD tip to the ventricular system to drain cerebrospinal fluid (CSF). Convergence is established towards the validity of this assessment methodology by examining two objective measures of spatial reasoning, along with one subjective expert ranking methodology, and comparing these to AR/VR guidance. These measures have two components: the speed and accuracy of the targeting, which are used to derive the performance metric. Results of these correlations are presented for a population of PGY1 residents attending the Canadian Neurosurgical "Rookie Bootcamp" in 2019.