Palpation Characteristics of an Instrumented Virtual Cricothyroidotomy Simulator

Cricothyroidotomy (CCT) is a critical, life-saving procedure requiring the identification of key neck landmarks through palpation. Interactive virtual simulation offers a promising, cost-effective approach to CCT training with high visual realism. However, developing the palpation skills necessary for CCT requires a haptic interface with tactile sensitivity comparable to human fingers. Such interfaces are often represented by plastic partial mannequins, which require further adaptation to integrate into virtual environments. This study introduces an instrumented physical palpation interface for CCT, integrated into a virtual surgical simulator, and tested on ten surgeons who practiced the procedure over a training period. Data on haptic interactions collected during the training was analyzed to evaluate participants' palpation skills and explore their force modulation strategies about landmark identification scores. Our findings suggest that trainees become more precise in their exploration over time, apply greater normal forces around target areas. Initial landmark identification performance influences adjustments in the overall applied pressure.