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Before the application of virtual simulations and serious games for surgical education and training becomes more widespread, there are a number of open questions and issues that must be addressed including the relationship between realism, multi-modal cue interaction, immersion, and knowledge transfer and retention. Using the serious game surgical cognitive education and training framework developed specifically for cognitive surgical skills training, here we examine the effect of sound on visual realism perception and task completion time while performing a task within a virtual environment. Our preliminary experimental results indicate that the appropriate use of sound can lead to performance improvements when performing a task within a

Fig. 1: Screenshots of the left view showing correct occlusion of the user's hands and the virtual object (a 3D textured crate). The AR marker cannot be seen because it is directly behind the virtual object.Abstract-In this work we present a novel framework for the real-time interaction with 3D models in augmented virtual reality. Our framework incorporates view-dependent stereoscopic rendering of the reconstructed environment together with user's hands and a virtual object, and high-precision gesture recognition to manipulate it. Proposed setup consists of a Creative RGB-D camera, Oculus Rift VR head mounted display (HMD), Leap Motion hands and fingers tracker and an AR marker. The system is capable of augmenting the user's hands in relation to their point of view (POV) using the depth sensor mounted on the HMD, and allows manipulation of the environment through the Leap Motion sensor. The AR marker is used to determine the location of the Leap Motion sensor to help with consolidation of transformations between the Oculus and the Leap Motion sensor. Combined with accurate information from the Oculus HMD, the system is able to track the user's head and fingers, with 6-DOF, to provide a spatially accurate augmentation of the user's virtual hands. Such an approach allows us to achieve high level of user immersion since the augmented objects occlude the user's hands properly; something which is not possible with conventional AR. We hypothesize that users of our system will be able to perform better object manipulation tasks in this particular augmented VR setup as compared to virtual reality (VR) where user's hands are not visible, or if visible, always occlude virtual objects.

Although the direct path between a sound source and a listener is often occluded, through the phenomenon of diffraction sound can still reach a listener by ''bending'' around an obstacle that lies directly in the line of straight propagation. However, modeling occlusion/diffraction effects is a difficult and computationally intensive task and thus generally ignored altogether in virtual environments and videogame applications. Our previous work saw the development of a graphics-based processing technique to approximate acoustical occlusion effects at interactive rates. Here, we build upon our previous method and present a method that better approximates real-world acoustical diffraction effects for dynamic and interactive, videogame and virtual environments.

The off-pump coronary artery bypass grafting (OP-CAB) cardiac surgical procedure allows for a blocked coronary artery to be bypassed with a healthy artery or vein from another part of the body while the heart is beating in contrast to traditional coronary artery bypass grafting (CABG) which requires the use of a cardiopulmonary pump. Eliminating the cardiopulmonary pump, leads to a reduction in the number of postoperative complications. Despite the benefits associated with OPCAB and more specifically, its non-reliance on the cardiopulmonary pump, the OPCAB procedure itself is complex and technically challenging and therefore, it has been suggested that "appropriate training" be provided before operating on patients. Here we describe the preliminary development of an interactive, multi-player serious game for the purpose of training cardiac surgeons/residents the series of steps comprising the OPCAB procedure. By learning the OPCAB procedure in a "first-person-shooter gaming environment", trainees will have a much better understanding of the procedure than by traditional learning modalities.