Robin Sawaya1, Ghusn Alsideiri1,2, Abdulgadir Bugdadi1,3, Alexander Winkler-Schwartz1, Hamed Azarnoush4, Khalid Bajunaid1,5, Abdulrahman J Sabbagh1,6,7, Rolando Del Maestro1. 1. 1Neurosurgical Simulation Research and Training Centre, Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada. 2. 2Department of Surgery, College of Medicine, Sultan Qaboos University, Muscat, Oman. 3. 3Department of Surgery, Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia. 4. 4Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran. 5. 5Divison of Neurosurgery, Faculty of Medicine, University of Jeddah, Saudi Arabia. 6. 6Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia; and. 7. 7Division of Neurosurgery, Department of Surgery, Faculty of Medicine and Clinical Skill and Simulation Center, King Abdulaziz University, Jeddah, Saudi Arabia.
Abstract
OBJECTIVE: Previous 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. METHODS: In 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). RESULTS: Neurosurgeons 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. CONCLUSIONS: The 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.
OBJECTIVE: Previous 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. METHODS: In 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). RESULTS: Neurosurgeons 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. CONCLUSIONS: The 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.
Authors: Recai Yilmaz; Alexander Winkler-Schwartz; Nykan Mirchi; Aiden Reich; Sommer Christie; Dan Huy Tran; Nicole Ledwos; Ali M Fazlollahi; Carlo Santaguida; Abdulrahman J Sabbagh; Khalid Bajunaid; Rolando Del Maestro Journal: NPJ Digit Med Date: 2022-04-26
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