Human Performance Testing and Simulators

Abstract

Virtual-reality (VR) simulation offers the opportunity to practice surgical techniques and gain experience outside the operating room. Using VR simulators and tools recently developed by human performance researchers, different aspects of human performance (innate ability) can be measured objectively. These novel tools, General Systems Performance Theory, and application of nonlinear causal resource analysis (NCRA) may allow us to utilize VR simulators, not only to train physicians, but possibly to predict their performance prior to training. By analyzing objective measures of basic performance resources (BPRs) with performance models developed with NCRA, we showed that BPRs can predict a subject's ability to perform high-level tasks. Two pilot studies suggested that this approach may objectively identify limitations of the surgeons with the most worrisome performance scores. Thus, VR simulation and performance testing may help with identification and remediation of residents with poor endoscopic skills and with optimization of surgical training protocols. Although the initial observations provide encouraging results for objective prediction of surgical performance and identification of performance-limiting resources, further investigation in larger cohorts of surgical trainees appears warranted.

The predictive value of aptitude assessment in laparoscopic surgery: a meta-analysis

“…Eight studies were excluded because they used a methodology or statistical analysis incompatible with the research question of the meta-analysis or because of technical difficulties during aptitude testing (see Appendix S2 online for details). [28][29][30][31][32][33][34][35] Some studies evaluated the correlation between a simulator-based assessment and a subsequent performance on a simulator or performance in the OR. These studies were analysed separately from those using other aptitude measurements.…”

Personality traits and virtual reality performance

“…To perform a laparoscopic task successfully, visual information-processing speed, visual-spatial short-term memory, coordination, fine-manipulation dexterity, and spatial skills are described to be important [23][24][25]. Personality traits probably cannot be expected to have a direct impact on technical performance in this setting, but it must be considered that involving a greater number of participants with heterogeneous personalities (e.g., participants not involved in surgery) would yield an association.…”

The role of surgical simulation and the learning curve in robot-assisted surgery

“…Operative time and economic issues surround the transfer of surgical skills to trainees in the operating room. Having the novice surgeon obtain a level of competence in skills before attending the operating room has been proposed as a method of improving eYciency and safety in the operating room [1][2][3]. Other issues surrounding the transfer of surgical skills, including medical legal implications of surgical training, limitations in trainee working hours, and ethical considerations of learning basic skills on humans and animals, are all realities we face when teaching and learning new surgical techniques.…”