Utilising wearable technology to enhance neurosurgical training: a systematic scoping review

Contemporary neurosurgical training faces challenges due to reduced operative exposure and the limited, inconsistent feedback provided to trainees. Wearable technologies may help address these issues by offering objective data and real-time support. This scoping review systematically evaluates the evidence of wearable technology in surgical training, analysing device types, their applications, and the supporting evidence for their effectiveness.

A systematic literature search was conducted in 10 pre-clinical and clinical databases from inception to May 2024, searching for keywords "wearable technology" AND "surgery" AND "training". The search yielded 25,806 results. After removing duplicates, papers were screened by title and abstract (n = 12,306), followed by full-text screening (n = 482).

Forty-one studies, including 985 participants, were included in the review. Head-mounted displays were predominantly used for augmented and mixed reality applications, while smart glasses facilitated telementoring and procedure recording. Other wearables enabled biomechanical analysis and ergonomic assessments. Reported outcomes varied widely, with clinician-centred metrics, such as procedural accuracy, error rates, completion times, and satisfaction, being the most frequently assessed. Devices including HTC VIVE and HoloLens were associated with improved surgical performance. Clinicians often reported enhanced visualisation and anatomical orientation, though barriers such as learning curves, technical issues, and discomfort were noted.

This review provides a comprehensive evaluation of wearable technologies in surgical training, highlighting their potential to improve performance metrics and support a range of educational uses for neurosurgical trainees. However, key challenges must be addressed to enable broader adoption and integration into surgical education.