Cognitive versus virtual reality simulation for evaluation of technical skills in neurosurgery

Abstract

OBJECTIVE Simulation is gaining momentum as a new modality of medical training, particularly in acute care settings such as surgery. In the present study, the authors aimed to compare individual cognitive skills with manual abilities as assessed by virtual reality (VR) simulation among neurosurgical residents. METHODS Participants were asked to complete a multiple-choice questionnaire assessing their surgical abilities regarding three basic neurosurgical procedures (endoscopic third ventriculostomy, cranial meningioma, and lumbar laminectomy). They subsequently performed these same three procedures on a VR simulator (NeuroTouch). RESULTS The authors found that cognitive scores correlated with self-evaluation of surgical experience and autonomy. On the contrary, VR simulation, as assessed by NeuroTouch automated scoring, did not reflect participants' cognitive or self-evaluation of their surgical proficiency. CONCLUSIONS The results of this study suggest that neurosurgical education should focus as much on cognitive simulation (e.g., careful planning and critical appraisal of actual procedures) as on VR training of visuomotor skills.