scholarly journals P.103 A spatial analysis of forces applied during virtual reality brain tumor resection: the force pyramid

2016 ◽  
Vol 43 (S2) ◽  
pp. S44-S44
Author(s):  
RF Del Maestro ◽  
H Azarnoush ◽  
S Siar ◽  
G Alzhrani ◽  
A Winkler-Schwartz ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Medical Student ◽  
Spatial Analysis ◽  
Medical Students ◽  
Tumor Resection ◽  
Study Groups ◽  
Student Groups ◽  
3 Dimensional ◽  
Force Application ◽  
Brain Tumor Resection

Background: Virtual reality simulators allow development of novel methods to analyze neurosurgical performance. Force pyramids provide visual and spatial analysis of 3 dimensional force application by any instrument used during simulated tumor resection. This study was designed to answer three questions: 1) Do study groups have distinct force pyramids? 2) Do handedness and ergonomics influence force pyramid structure? 3) Are force pyramids dependent on visual and haptic characteristics of simulated tumors? Methods: NeuroVR (formerly NeuroTouch), a virtual reality simulator, continually assessed simulated ultrasonic aspirator force application of neurosurgeon, resident and medical student groups during resection of 18 simulated brain tumors with different visual and haptic characteristics. Results: Sixteen neurosurgeons, 15 residents and 84 medical students participated. Neurosurgeon, resident and medical students groups displayed easily distinguishable 3 dimensional ‘force pyramid fingerprints’. Neurosurgeons had the lowest force pyramids, indicating application of the lowest forces, followed by resident and medical student groups. Handedness, ergonomics, visual and haptic tumor characteristics resulted in distinct well-defined 3 dimensional force pyramid patterns. Conclusions: ‘Force pyramid fingerprints’ provide 3 dimensional spatial assessment displays of instrument force application during simulated tumor resections. Neurosurgeon force utilization and ergonomics data form a basis for understanding and modulating resident force application and improving patient safety during tumor resection.

The force pyramid: a spatial analysis of force application during virtual reality brain tumor resection

2017 ◽  
Vol 127 (1) ◽  
pp. 171-181 ◽  
Author(s):  
Hamed Azarnoush ◽  
Samaneh Siar ◽  
Robin Sawaya ◽  
Gmaan Al Zhrani ◽  
Alexander Winkler-Schwartz ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Medical Student ◽  
Spatial Analysis ◽  
Medical Students ◽  
Brain Tumors ◽  
Tumor Resection ◽  
Study Groups ◽  
Student Groups ◽  
Force Application ◽  
Tier 3

OBJECTIVEVirtual reality simulators allow development of novel methods to analyze neurosurgical performance. The concept of a force pyramid is introduced as a Tier 3 metric with the ability to provide visual and spatial analysis of 3D force application by any instrument used during simulated tumor resection. This study was designed to answer 3 questions: 1) Do study groups have distinct force pyramids? 2) Do handedness and ergonomics influence force pyramid structure? 3) Are force pyramids dependent on the visual and haptic characteristics of simulated tumors?METHODSUsing a virtual reality simulator, NeuroVR (formerly NeuroTouch), ultrasonic aspirator force application was continually assessed during resection of simulated brain tumors by neurosurgeons, residents, and medical students. The participants performed simulated resections of 18 simulated brain tumors with different visual and haptic characteristics. The raw data, namely, coordinates of the instrument tip as well as contact force values, were collected by the simulator. To provide a visual and qualitative spatial analysis of forces, the authors created a graph, called a force pyramid, representing force sum along the z-coordinate for different xy coordinates of the tool tip.RESULTSSixteen neurosurgeons, 15 residents, and 84 medical students participated in the study. Neurosurgeon, resident and medical student groups displayed easily distinguishable 3D “force pyramid fingerprints.” Neurosurgeons had the lowest force pyramids, indicating application of the lowest forces, followed by resident and medical student groups. Handedness, ergonomics, and visual and haptic tumor characteristics resulted in distinct well-defined 3D force pyramid patterns.CONCLUSIONSForce pyramid fingerprints provide 3D spatial assessment displays of instrument force application during simulated tumor resection. Neurosurgeon force utilization and ergonomic data form a basis for understanding and modulating resident force application and improving patient safety during tumor resection.

Neurosurgical virtual reality simulation metrics to assess psychomotor skills during brain tumor resection

2014 ◽  
Vol 10 (5) ◽  
pp. 603-618 ◽  
Author(s):  
Hamed Azarnoush ◽  
Gmaan Alzhrani ◽  
Alexander Winkler-Schwartz ◽  
Fahad Alotaibi ◽  
Nicholas Gelinas-Phaneuf ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Tumor Resection ◽  
Psychomotor Skills ◽  
Virtual Reality Simulation ◽  
Brain Tumor Resection

Tremor Assessment during Virtual Reality Brain Tumor Resection

2020 ◽  
Vol 77 (3) ◽  
pp. 643-651
Author(s):  
Samaneh Siyar ◽  
Hamed Azarnoush ◽  
Saeid Rashidi ◽  
Rolando F. Del Maestro
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Tumor Resection ◽  
Brain Tumor Resection

scholarly journals Virtual reality simulation of robotic transsphenoidal brain tumor resection: Evaluating dynamic motion scaling in a master-slave system

2018 ◽  
Vol 15 (1) ◽  
pp. e1953 ◽  
Author(s):  
Saúl A. Heredia-Pérez ◽  
Kanako Harada ◽  
Miguel A. Padilla-Castañeda ◽  
Murilo Marques-Marinho ◽  
Jorge A. Márquez-Flores ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Tumor Resection ◽  
Slave System ◽  
Virtual Reality Simulation ◽  
Dynamic Motion ◽  
Brain Tumor Resection ◽  
Motion Scaling ◽  
Master Slave System

scholarly journals Automaticity of Force Application During Simulated Brain Tumor Resection: Testing the Fitts and Posner Model

2018 ◽  
Vol 75 (1) ◽  
pp. 104-115 ◽  
Author(s):  
Abdulgadir Bugdadi ◽  
Robin Sawaya ◽  
Duaa Olwi ◽  
Gmaan Al-Zhrani ◽  
Hamed Azarnoush ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Tumor Resection ◽  
Force Application ◽  
Brain Tumor Resection

scholarly journals Development of a performance model for virtual reality tumor resections

2019 ◽  
Vol 131 (1) ◽  
pp. 192-200 ◽  
Author(s):  
Robin Sawaya ◽  
Ghusn Alsideiri ◽  
Abdulgadir Bugdadi ◽  
Alexander Winkler-Schwartz ◽  
Hamed Azarnoush ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Medical Students ◽  
Direct Contact ◽  
Tumor Volume ◽  
Tumor Resection ◽  
Performance Model ◽  
Hypothetical Model ◽  
Study Results ◽  
And Task

OBJECTIVEPrevious work from the authors has shown that hand ergonomics plays an important role in surgical psychomotor performance during virtual reality brain tumor resections. In the current study they propose a hypothetical model that integrates the human and task factors at play during simulated brain tumor resections to better understand the hand ergonomics needed for optimal safety and efficiency. They hypothesize that 1) experts (neurosurgeons), compared to novices (residents and medical students), spend a greater proportion of their time in direct contact with critical tumor areas; 2) hand ergonomic conditions (most favorable to unfavorable) prompt participants to adapt in order to optimize tumor resection; and 3) hand ergonomic adaptation is acquired with increasing expertise.METHODSIn an earlier study, experts (neurosurgeons) and novices (residents and medical students) were instructed to resect simulated brain tumors on the NeuroVR (formerly NeuroTouch) virtual reality neurosurgical simulation platform. For the present study, the simulated tumors were divided into four quadrants (Q1 to Q4) to assess hand ergonomics at various levels of difficulty. The spatial distribution of time expended, force applied, and tumor volume removed was analyzed for each participant group (total of 22 participants).RESULTSNeurosurgeons spent a significantly greater percentage of their time in direct contact with critical tumor areas. Under the favorable hand ergonomic conditions of Q1 and Q3, neurosurgeons and senior residents spent significantly more time in Q1 than in Q3. Although forces applied in these quadrants were similar, neurosurgeons, having spent more time in Q1, removed significantly more tumor in Q1 than in Q3. In a comparison of the most favorable (Q2) to unfavorable (Q4) hand ergonomic conditions, neurosurgeons adapted the forces applied in each quadrant to resect similar tumor volumes. Differences between Q2 and Q4 were emphasized in measures of force applied per second, tumor volume removed per second, and tumor volume removed per unit of force applied. In contrast, the hand ergonomics of medical students did not vary across quadrants, indicating the existence of an “adaptive capacity” in neurosurgeons.CONCLUSIONSThe study results confirm the experts’ (neurosurgeons) greater capacity to adapt their hand ergonomics during simulated neurosurgical tasks. The proposed hypothetical model integrates the study findings with various human and task factors that highlight the importance of learning in the acquisition of hand ergonomic adaptation.

scholarly journals Prevalence of anxiety and depression among domestic and foreign medical students in Poland

2020 ◽  
Author(s):  
Aneta Anna Jaroszewska ◽  
Szymon Tyras ◽  
Martyna Dziewit ◽  
Joanna Jaroszewska ◽  
Katarzyna Podhorodecka
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Anxiety Disorders ◽  
Study Groups ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Student Group ◽  
Significant Difference ◽  
Prevalence Of Depression ◽  
Depression Disorders

Introduction: Depression and anxiety disorders are much more common among medical students than in the general population. Due to additional risk factors, foreign students may be particularly vulnerable. Despite this, there is still an insufficient number of studies analyzing the prevalence of mental disorders among foreign medical students, especially in Poland. Aim: The aim of the study was to assess and compare the prevalence of anxiety and depression disorders between domestic and foreign medical students in Poland. Material and methods: An anonymous internet survey containing questions about socio-demography and the Hospital Anxiety and Depression Scale questionnaire was distributed among students. Based on the field of study and country of origin, participants were divided into 3 groups – Polish medical student group (PMG, n = 214); foreign medical student group (FMG, n = 59) and control group, which were Polish students of other faculties (CG, n = 476). The study groups were compared using the χ2 test. Results and discussion: The prevalence of depression disorders was 30%, 31% and 28% (PMG, FMG and CG, respectively). No statistically significant difference was observed between the study groups (P = 0.77). The prevalence of anxiety disorders was 57%, 90% and 59% (PMG, FMG and CG, respectively). Anxiety disorders were more common among FMG as compared to PMG and CG (P < 0.01 in both cases). Conclusions: The prevalence of depression and anxiety among medical students in Poland is high. Foreign medical students appear to be particularly vulnerable to anxiety disorders.

scholarly journals Subjective anxiety ratings before and after stressful neurosurgical virtual reality tumor resection task

2015 ◽  
Vol 42 (S1) ◽  
pp. S42-S42
Author(s):  
A Winkler-Schwartz ◽  
J Fares ◽  
B Khalid ◽  
M Baggiani ◽  
S Christie ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Tumor Resection ◽  
Tumor Removal ◽  
Surgical Performance ◽  
Surgical Simulators ◽  
Surgical Expertise ◽  
Before And After ◽  
Operative Performance ◽  
Junior Residents

Background: The availability of virtual reality (VR) surgical simulators affords the opportunity to assess the influence of stress on neurosurgical operative performance in a controlled laboratory environment. This study sought to examine the effect of a stressful VR neurosurgical task on the subjective anxiety ratings of participants with varying levels of surgical expertise. Methods: Twenty four participants comprised of six staff neurosurgeons, six senior neurosurgical residents (PGY4-6), six junior neurosurgical residents (PGY1-3), and six senior medical students took part in a bimanual VR tumor removal task with a component of sudden uncontrollable intra-operative bleeding. State Trait Anxiety Inventory (STAI) questionnaires were completed immediately pre and post the stress stimulus. The STAI questionnaire consisted of six items (calm, tense, upset, relaxed, content and worried) measured on a Likert scale. Results: Significant increases in subjective anxiety ratings were noted in junior residents (p=0.005) and medical students (p=0.025) while no significant changes were observed for staff and senior neurosurgical residents. Conclusions: Staff and senior residents more effectively mitigate stress compared to junior colleagues in a VR operative environment. Further physiological correlates are needed to determine whether this increased anxiety is paralleled by physiological arousal and altered surgical performance.

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