Use Of Virtual Simulation Research Articles

DIGITAL TECHNOLOGIES TO IMPROVE THE EFFICIENCY OF TRAINING OF LABOUR PROTECTION SPECIALISTS

The article examines the role of digital technologies in the current period of industrial development and the transition to Industry 4.0 (the 4th Industrial Revolution), and specifically the use of virtual simulators for training qualified personnel in the field of industrial safety at oil and gas facilities.The practice of using virtual simulators for occupational safety specialists is not yet widespread. The developed virtual simulators can simulate several types of production activities, such as working at height during the repair of a storage tank for oil products, working with lifting mechanisms and welding, and also provide an opportunity for feedback to improve the skills and knowledge of workers supervising and monitoring compliance with safety requirements in production.

From operational design domain to test cases: A methodology to include harsh weather

Background To gain widespread use, assisted and automated driving (AAD) systems will have to cope with harsh weather conditions, such as rain, fog, and snow. This affects the development and testing of perception and decision-making systems. Since the weather cannot be controlled in field tests, the availability and use of virtual simulation and test facilities that can accurately reproduce harsh weather becomes vital. Test cases subjecting the system under test to harsh conditions, covering all expected weather phenomena in both typical and challenging scenarios, must be defined to evaluate all aspects of the system. Methods State-of-the-art in scenario-based and hash weather testing for AAD systems was analysed; based on the analysis, a team with diverse expertise in AAD development and testing defined a methodology for defining a set of harsh weather test cases. Results This paper proposes, and exemplifies the use of, a methodology to develop a representative set of test cases based on the defined operational design domain and use cases for an AAD system under development, considering the possibility of reproducing tests in different test environments with a focus on harsh weather. Conclusions We believe that our proposed methodology can accelerate the overall testing process and contribute to the difficult safety assurance challenges for automated vehicles.

The relationship between virtual simulation, critical thinking, and self-directed learning abilities of nursing students in Riyadh, Saudi Arabia.

The use of virtual simulation in nursing education is an effective approach for improving nursing critical thinking and self-learning abilities, but the previous studies were limited to providing the required evidence that supports the association. This study aimed to assess the relationship between virtual simulation and critical thinking disposition and self-directed learning abilities among nursing students. This is a descriptive correlational, non-experimental study. It was conducted among 201 third- and fourth-year nursing students at the Academic Institution, Saudi Arabia. A non-probability convenience sampling technique was used to select the participants; then, an online, adapted questionnaire was sent to the participants, the data from which was analyzed by SPSS. The study findings showed that virtual simulation benefited nursing students. Most participants (56%) agreed that it helped them to think critically, and approximately 27% strongly agreed. It also enhanced their self-directed learning abilities, and the majority of the students agreed that they often review the way nursing practice is conducted. Furthermore, the results showed a significant, positive relationship between virtual simulation and the critical thinking disposition of nursing students (p-value = 0.03; correlation coefficient = 0.65), a strong positive relationship with self-directed learning abilities of nursing students (p-value = 0.004; correlation coefficient = 0.78), and a strong positive relationship between critical thinking disposition with self-directed learning abilities of nursing students (p-value = 0.01; correlation coefficient = 0.72). There are significant relationships between virtual simulation and the critical thinking disposition and self-directed learning abilities of nursing students. Furthermore, virtual simulation made the students practice critical thinking and self-learning, so, they simulate events and try to seek out and solve the problems.

The Use of Smartphone-Based Highly Realistic MCI Training as an Adjunct to Traditional Training Methods.

Training for mass casualty incident (MCI) response is critical to ensure that resource allocation and treatment priorities limit preventable mortality. Previous research has investigated the use of immersive virtual environments as an alternative to high fidelity MCI training, which is expensive and logistically challenging to implement. While these have demonstrated positive early results, they still require complex technology deployment, dedicated training facilities, and significant time from instructors and facilitators. This study explores the feasibility of a smartphone-based application for trauma care training and MCI triage to fill the gap between classroom learning and high-fidelity simulation. The goals of this investigation were to evaluate clinician perceptions of a virtual MCI training simulator's usability, acceptability, fidelity, functionality, and pacing. This study used a smartphone-based training simulation called Extensible Field and Evacuation Care Training in a Virtual Environment (EFECTIVE), which presents virtual patient scenarios in a gamified, but visually high-fidelity environment. A total of 21 participants were recruited as a convenience sample of medical students, paramedics, nurses, and emergency medicine resident and attending physicians at University of Massachusetts Memorial Medical Center, an urban tertiary care medical center. Participants completed a brief tutorial and then performed a series of virtual patient scenarios and 1 MCI scenario on the simulator, each of which was 5 minutes in duration. Then, each participant completed a survey assessing the perceived usability, acceptability, fidelity, functionality, and pacing of the virtual training simulator. The research protocol was approved by the University of Massachusetts Chan Medical School Institutional Review Board. 48% of participants disagreed that a virtual simulator could completely replace live MCI training, though 71% agreed that app-based simulations could effectively supplement live MCI training and 67% felt that they could be used to learn how to order medical interventions in care under fire scenarios. 80% of participants agreed that the simulation could be used to practice MCI triage and to gain experience with coordinating movement of casualties to casualty collection points. 67% of participants believed that use of virtual simulators would increase their MCI preparedness. 76% agreed that the clinical cases depicted were medically realistic and that the clinical cases presented accurately represented the scenarios described. In addition, despite being presented on a smartphone as opposed to virtual reality, 62% of participants rated the experience immersive. This study provides encouraging evidence that easy to deploy smartphone-based simulations may be an effective way to supplement MCI and care under fire training. Although the study is limited by a small sample size, there was strong agreement among participants from a wide variety of emergency medicine roles that such a simulation could train core topics associated with MCI triage. Because app-based simulations are easily deployable and can be executed quickly and frequently, they could be used as a more flexible training model compared to large scale live or virtual reality-based simulations. The results of this investigation also indicate that a sufficient level of medical realism can be achieved without live simulation.

Evaluating Virtual Simulation to Augment Undergraduate Nurses' Clinical Practice.

Due to the lack of clinical placements during the pandemic, virtual simulation was used to augment student practice experiences. Using Kirkpatrick's evaluation model, a program evaluation study using a mixed-methods design was implemented to assess student and faculty satisfaction and usefulness of virtual simulation, the effectiveness of meeting learning needs, and the effects of the virtual simulation resource on the development of clinical judgment (n = 70). Virtual simulation was rated as moderately useful with an overall mean of 1.7 (SD = 0.66, range 1 to 3). Only 21% to 49% of the students found online simulation either met or well met the various areas of learning needs. Qualitative data highlighted the benefits of this strategy as well as implementation factors that affected students' experience. Virtual simulation can be used in clinical courses to augment learning when implemented in a way that addresses students' needs. [J Nurs Educ. 2024;63(7):470-477.].

Effectiveness of combined virtual and clinical simulation compared with other active teaching strategies on health students' learning: a systematic review protocol.

The objective of this review is to synthesize the available evidence on the effectiveness of combined virtual and clinical simulation compared with other active teaching strategies on health students' learning. Current evidence indicates that both virtual simulation and clinical simulation are effective in assisting students to acquire clinical skills. However, there is a knowledge gap regarding the effectiveness of the combined use of both teaching strategies, which could enhance health students' learning. This review will consider experimental, quasi-experimental, and observational studies that address the combined use of virtual simulation with clinical simulation compared with other active teaching strategies in learning, clinical reasoning, clinical decision-making, and/or clinical competencies of health students. Combining different hybrid simulators to form a new one will not be considered for inclusion in the review. The databases to be searched will include Cochrane Library, MEDLINE (PubMed), CINAHL (EBSCOhost), Scopus, LILACS (VHL), Web of Science Core Collection, Embase, ERIC, and gray literature sources. Two independent reviewers will perform the study selection, critical appraisal, and data extraction using JBI tools. A narrative synthesis will be performed and, if possible, meta-analysis and risk assessment of publication bias. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach will be used to assess the certainty of the findings. PROSPERO CRD42023422410.

Comparison of Sentiment Analysis Methods Used to Investigate the Quality of Teaching Aids Based on Virtual Simulators of Embedded Systems

Virtual simulators of embedded systems and analyses of student surveys regarding their use at the early stage of the process of learning embedded systems, are presented in this article. The questionnaires were prepared in the Polish language, and the answers were automatically translated into English using two publicly available translators. The results of users’ experiences and feelings related to the use of virtual simulators are shown on the basis of detected sentiment using three chosen analysis methods: the Flair NLP library, the Pattern library, and the BERT NLP model. The results of the selected sentiment detection methods were compared and related to users reference answers, which gives information about the methods quality of the methods and their possible use in the automated review analysis process. This paper comprises detailed sentiment analysis results with a broader statistical approach for each question. Based on the students feedback and sentiment analysis, a new version of the TMSLAB v.2 virtual simulator was created.

Exploring Students’ Experiences in Using Virtual Simulation and Gamification Principles for Authentic Learning and Assessment in Criminal Psychology

This pilot study delves into the use of virtual simulation and immersive experiences coupled with game-based principles in higher education, focusing on the teaching of criminal/investigative psychology. The study showcases how virtual simulation, and specifically "CrimOPS" (Criminology Offender Profiling Simulation), enhances knowledge transfer, engagement, and learning outcomes. This interdisciplinary tool allows students to practically apply theoretical knowledge in offender profiling by investigating simulated murders in a realistic environment. Three focus groups, totaling nine participants, were conducted to assess the students’ experiences and perceptions of this learning and assessment tool. Through thematic analysis, three primary themes were constructed: experiential learning and skill development, innovative experience, and technical and immersive challenges. Participants expressed positive views on the simulation for the practical application of knowledge, skill development, and engagement. They highlighted its value in understanding profiling and practical field aspects. The study’s recommendations will guide the future development of CrimOPS.

Evaluation of the use of virtual simulators for training in problem-solving skills in university students

The objective of this article is to evaluate the effectiveness of virtual simulators in training problem-solving skills in university students, a crucial aspect for their professional performance. To carry out this evaluation, a documentary review of various surveys and case studies was carried out. Academic articles, technical reports, and student and faculty survey data were analyzed to obtain a comprehensive view of the use of virtual simulators in higher education.Research results indicate that virtual simulators not only improve students' theoretical understanding, but also allow them to apply their knowledge in controlled and safe environments, replicating real-world situations. These simulators provide an environment where students can make mistakes and learn from them without real consequences, strengthening their ability to address complex problems and make informed decisions. The case studies reviewed show specific benefits in various academic disciplines, highlighting a positive impact on academic performance and career preparation. However, challenges and limitations were identified, such as the cost of implementing the simulators and the need for adequate training for instructors. Evaluating the use of virtual simulators for training problem-solving skills in university students is a crucial area of study in contemporary education. The research reviewed highlights the growing importance of these educational technologies in promoting more interactive and practical learning, facilitating the development of skills essential for success

A Model-Based Formalization for the Development of Information Processing Units through Deep Reinforcement Learning

In today’s landscape of increasingly complex systems, designing a suitable information processing unit presents a paramount challenge for developers. This paper introduces a novel model-based formalization using the Systems Modeling Language (SysML) for the development of information processing units through deep reinforcement learning (DRL). The approach at hand offers a systematic framework that harnesses the benefits of modularity, formalization, and traceability that SysML offers with the capabilities of DRL to adapt to diverse and various tasks, with the use of virtual simulations to address design challenges. By integrating the strengths of SysML with DRL, the method enables developers to adapt their solutions to dynamic changes in system requirements, task descriptions, and operational environments. The modularity of the proposed approach, coupled with the use of virtual simulations, allows for targeted and sustainable adjustments, diminishing development time, costs, and turnaround. To validate the practicality of the proposed method, the authors present two case studies: one for initial development and another specifically focused on change management within the domain of autonomous robotics. Experimental results underscore the aforementioned benefits of the approach and its adaptability to dynamic changes. This approach shows considerable promise for enhancing model-based, DRL-driven decision-making capabilities across a range of engineering applications.

Effectiveness of Virtual Simulation on Self-Efficacy, Learning and Self-Confidence among Nursing Students in North India - A Randomised Control Trial

Though use of virtual simulation in nursing started during 2020 due to Covid pandemic, virtual simulation is burgeoning which demands for evidence for its effectiveness. A randomised control trial was conducted among nursing students to study the effectiveness of virtual simulation on self-efficacy, learning, and confidence. Multicentre, randomisation with balanced allocation [1:1], parallel-group study was conducted with 140 students from 2 institutions which were selected by using computer-generated random tables. After pretest, virtual simulation on Myocardial Infarction Management Bundle (MIMB) was given to experimental group. Post-test was conducted on 32 and 62 of pre-test using self-efficacy scale and modified learning and self-confidence scale. The study findings showed that virtual simulation was more effective in improving self-efficacy (F= 44.591, p=<0.001 and F= 111.20, p=<0.001) and learning and self-confidence (f=37.011, p=<0.001, F=104.244, p=<0.001) than traditional teaching method.

An analysis of virtual simulations from the TPACK perspective

INTRODUCTION. Virtual simulations (VS) have increased their presence in the higher education training actions during the last years and has been consolidated as a result of the COVID-19 pandemic as a powerful tool that allow us to overcome many of the limitations of the face to face simulation rooms, related to costs and replicability. However, there is a lack of studies about the use of theoretical models, such as the TPACK, for the analysis of VS. METHOD. In this article a systematic review of the literature is conducted with the main aim of analysing the characteristics of the VS used in higher education during the last decade (2012-2022) from the optic of the TPACK model. RESULTS. The main findings are the big use of VS in Health-related areas and especially in the American continent (Unite States and Canada); the screen-based and computer-based simulation played online as the most common technological features; and the Experiential learning, the Situated learning and the Problem-based learning as the most common theories for the pedagogical justification of VS in higher education. DISCUSSION. A series of relationships has been spotted among the technological, pedagogical and content features of the VS that help us to better understand this tool that has a growing use, especially in the health field. Conclusions show, on the one hand, the lack of articles that properly describe the use of VS according to the TPACK requirements and, on the other hand, the adequacy and viability of this model for the analysis and development of VS.

Just Another Patient? Student Reflections on Providing Mental Health Care to Transgender and Gender Expansive People During Simulated Encounters.

This study analyzed psychiatric-mental health nurse practitioner (PMHNP) students' reflections following a virtual simulated encounter with a patient who identified as transgender or gender expansive (TGE). To reduce mental health disparities, PMHNP students must be prepared to deliver affirming care. Engaging in and reflecting on simulated encounters with standardized patients can improve PMHNP students' affirming care competency. A thematic analysis process was used to analyze student reflections during simulation debriefings. Five themes emerged: application of affirming care principles, recognizing minority stressors, treating all patients the same, desire to learn more, and valuing authentic practice. PMHNP students' reflections on the experience of providing care to a standardized patient who identified as TGE support the use of virtual simulations to prepare future providers to deliver affirming, person-centered care.

Rapid Transformation from Face to Face to Virtual Simulation During the SARS-CoV-2 Pandemic: Impact on the Simulation Process during “The Little Room of Horrors”

Objective1. To explore the feasibility of a rapid transformation from face to face to virtual simulation and its impact on the simulation process 2. To explore the efficacy of a rapid transformation from face to face to virtual simulation and its impact on the simulation process. MethodsThe simulation process (preparation, pre-briefing, simulation, and debriefing) was investigated for feasibility and efficacy from the perspective of the educators and students. This study took place very early in the pandemic, thus highlighting the speed at which it needed to be conducted and acknowledging the limitations of technology at the time. The faculty (n = 3) involved in the virtual simulation experiment and year one medical students(n = 61) were invited to participate in the study voluntarily. The module chosen for this study was the Introduction to the Practice of Medicine, where the students were introduced to the concept of patient safety using simulation-based education. The “Little Room of Horrors” – is a simulation based educational session emphasising the importance of patient safety. Students were taken into a simulated medical ward that demonstrated common hospital-based errors. The learners were timed and asked to identify and document as many patient safety hazards as possible. The semi structured questionnaire was analysed using descriptive statistics and thematic analysis. ResultsThe Educator's perspective reflected that virtual simulation was technologically dependent and had limitations during debriefing but was also a sustainable and portable standardised process. The student's perspective revealed that the objectives were met, and the session helped them support the theory previously learned. The average rating was 4.09 on a 5-point scale. InnovationWhen resources of the simulation center like space, mannikins, and faculty cannot be accessed for reasons like social distancing during a pandemic, virtual simulation was developed and used as a feasible alternative for our students without impacting the learning objectives. ConclusionThis study demonstrates the use of virtual simulation as a valuable option for teaching when face to face simulation is challenging or not possible.

A11An evaluation of student views on the use of virtual simulation in undergraduate pharmacy education

In part due motivated by a lack of in-person placement opportunities for undergraduate pharmacy students during the COVID-19 pandemic, a UK university teaching team developed a programme of virtual simulated placement-style events to support undergraduate pharmacy students in developing skills and experience to support them in engaging with their foundation training. These experiences were developed at a time of significant change for undergraduate pharmacy training, as all new pharmacists being annotated as independent prescribers at the point of registration from 2026 onwards [1]. It has been reported that in medical students, the use of virtual patient simulation could improve clinical reasoning skills [2] but evidence of student views on the acceptability and implementation of virtual simulation in the target audience is limited and frequently not reflective of the style of self-directed simulation being utilized. This work aimed to evaluate final-year undergraduate pharmacy student views of the impact of the introduction of a programme of student-led virtual simulation on their education. In academic years 2020–2021 and 2021–2022, an electronic questionnaire was distributed to final-year students who had recently been introduced to and given access to a range of student-led virtual placement experiences in academic years. Prior to administering questionnaires to students, the study was approved by the relevant school research ethics committee. Questionnaires were formed of a mixture of qualitative and quantitative questions, and asked students about their experiences of engagement with virtual simulation and views on the potential applications of virtual simulation in the curriculum. Quantitative data were analysed by simple descriptive statistics, and a critical review of free-text responses was performed through grounded theory to identify emergent key themes. A total of 43 student questionnaires were collected, with 18 responses (41.9%) being received in the academic year 2020–2021 and 25 responses (58.1%) received in the academic year 2022. 88.4% of respondents agreed that the introduction of virtual simulation would enhance their educational experience. Four key themes emerged from qualitative data analysis: individuality and autonomy, convenience, immediacy, and control. Students most commonly believed that the second year of the 4-year Master of Pharmacy programme is the optimal time for the introduction of placement-style virtually simulated experiences. Final-year undergraduate pharmacy students believed that the introduction of a programme of student-led virtual simulation would enhance their educational experience. Students were found to value the convenience, control and autonomy of the introduction of student-led virtual simulation. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A14Does everyone see it the same? An evaluation of the alignment of perceived benefits of virtual simulation between undergraduate pharmacy students, faculty and stakeholders

In the aftermath of the COVID-19 pandemic, where access to traditional simulation environments and experiences was necessarily restricted, increasing focus has been placed on the use of technology in simulation. The use of virtual patient simulations has been shown in literature to increase interest as well as provide opportunities to practice clinical reasoning [1]. Opportunities to develop clinical reasoning are of notable importance in undergraduate pharmacy education currently owing to ongoing changes in pharmacy education, where newly qualified pharmacists will be annotated as independent prescribers from 2026 [2]. Evidence on the extent to which views on the perceived uses and benefits of virtual simulation align between different user groups is limited. In a UK university, a programme of virtual simulation has been utilized since 2020 as a part of the undergraduate pharmacy curriculum. A mixed-methods study was run which aimed to evaluate the alignment of views of students, faculty and stakeholders (who were individuals involved in the design or implementation of virtual simulation products) on the potential uses, intended learning outcomes, and perceived benefits and weaknesses of virtual simulation. Following approval by the school research ethics committee, an electronic questionnaire was sent to final-year undergraduate pharmacy students who had experienced a programme of virtual simulation including a mixture of qualitative and quantitative questions relating to student perceptions of the use of virtual simulation in the curriculum. Semi-structured interviews were conducted with faculty members and stakeholders exploring their views on virtual simulation. Quantitative data were analysed by simple descriptive statistics, and a critical review of free-text responses was performed through grounded theory to identify emergent key themes. A total of 25 responses to student questionnaires were received. A total of seven interviews were performed, including three members of academic staff familiar with virtual simulation and four stakeholders responsible for the design or implementation of virtual simulation products. Students most commonly believed that virtual simulation could benefit their development of consultation skills, clinical history taking and physical assessment. Significant alignment between the perceptions of stakeholders and students on the uses and benefits of virtual simulation was demonstrated, but faculty members articulated a more limited list of perceived uses and benefits. The views of final-year undergraduate pharmacy students aligned strongly with stakeholders involved in the design or implementation of virtual simulation. The more limited views of faculty may represent a barrier to the full implementation of virtual simulation. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Effects of the Virtual Simulation Prebriefing-Debriefing Educational Strategy on Nursing Students’ Self-Efficacy and Virtual Simulation Performance: A Quasi-Experimental Study

BackgroundThrough the use of virtual simulations nursing students are exposed to a variety of clinical scenarios that may potentially improve their learning of competencies, increase their self-efficacy (confidence), and enhance their future clinical performance. MethodsGuided by the National League for Nursing Jeffries Simulation Theory, Bandura's self-efficacy theory, and the Healthcare Simulation Standards of Best PracticeTM, this quasi-experimental, two-group, pretest/post-test educational intervention study examined the effects of the synchronous Virtual Simulation Prebriefing-Debriefing strategy on Associate Degree Nursing students’ self-efficacy perceptions and virtual simulation performance scores in the care of patients experiencing a myocardial infarction. ResultsStudy results revealed statistically significant findings concerning the effectiveness of the Virtual Simulation Prebriefing-Debriefing strategy on students’ self-efficacy perceptions (in the cognitive, psychomotor, and affective domains) and virtual simulation performance scores. Results also support that there is a small positive correlation between students' self-efficacy perceptions and virtual simulation performance scores. This study also provided evidence that the study's educational strategy caused positive changes in students’ self-efficacy perceptions and virtual simulation performance scores regardless of students’ age, previous experience with video or computer gaming, or previous healthcare work experience. ConclusionFindings suggest that a high-quality virtual simulation experience that integrates the Healthcare Simulation Standards of Best PracticeTM, including structured prebriefing and debriefing strategies, can positively influence students’ self-efficacy perceptions and virtual simulation performance scores.

Readiness to Respond: Nursing Students’ Perspectives From a Virtual Disaster-Simulated Experience

The dramatic increase in disasters and other public health emergencies presents untoward challenges for emergency support systems and reinforces the need for nursing preparedness. There is increased emphasis on the need for nurses and other healthcare professionals to be competently ready when the call arises. Nurses are at the forefront of disaster response, and preparation with the knowledge, attitudes, and skills for optimal care delivery is paramount. This qualitative study explored undergraduate nursing students’ perception of their situational knowledge, awareness, and perceived role during a virtual disaster experience. Three themes emerged from the data: increased awareness of the need to be prepared, a quest for knowledge, and improved recognition of the nurse’s role in caring for disaster victims. The findings suggest that the innovative use of virtual simulation was a promising pedagogical approach for disaster education in the nursing curriculum.

The use of simulation-based education in cancer care: a scoping review

Continuing education for cancer care providers is essential for promoting high-quality patient care. Simulation-based education can be an effective strategy to educate healthcare professionals; however, there is a lack of synthesized evidence available to inform the delivery of simulation-based education for nurses and physicians across the cancer care continuum. This scoping review aimed to collate and synthesize the literature regarding how simulation has been reported to educate nurses and physicians about cancer care. Scoping review following the JBI methodology. Medline, CINAHL, EMBASE and PsycINFO were searched until July 2021. Unpublished literature was searched using ResearchGate, OpenGrey and open access theses and dissertation databases. Articles were eligible if they discussed how simulation has been utilized to educate nurses and physicians about any aspect of cancer care. Two independent reviewers screened the references, extracted and analysed the data. In total, 19 studies were included. When compared to previous reviews, our findings showed an increase in the use of virtual simulation; however, most interventions reported in-person simulation approaches and focused on improving skills (e.g. practical, communication), knowledge, confidence or decision-making for physicians and nurses caring for patients with a wide variety of cancers. Overall, simulation demonstrated positive results in educating nurses and physicians across the cancer care continuum through improved knowledge, skills and satisfaction. However, simulation interventions can be time-consuming and require significant resources for effective implementation. Although simulation-based education demonstrated promise to educate nurses and physicians across the cancer continuum, it requires a significant allocation of resources to develop and implement these educational strategies. Educators and researchers should be aware of these challenges when planning and implementing simulation-based educational strategies.

Neurosurgical skills analysis by machine learning models: systematic review.

Machine learning (ML) models are being actively used in modern medicine, including neurosurgery. This study aimed to summarize the current applications of ML in the analysis and assessment of neurosurgical skills. We conducted this systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Google Scholar databases for eligible studies published until November 15, 2022, and used the Medical Education Research Study Quality Instrument (MERSQI) to assess the quality of the included articles. Of the 261 studies identified, we included 17 in the final analysis. Studies were most commonly related to oncological, spinal, and vascular neurosurgery using microsurgical and endoscopic techniques. Machine learning-evaluated tasks included subpial brain tumor resection, anterior cervical discectomy and fusion, hemostasis of the lacerated internal carotid artery, brain vessel dissection and suturing, glove microsuturing, lumbar hemilaminectomy, and bone drilling. The data sources included files extracted from VR simulators and microscopic and endoscopic videos. The ML application was aimed at classifying participants into several expertise levels, analysis of differences between experts and novices, surgical instrument recognition, division of operation into phases, and prediction of blood loss. In two articles, ML models were compared with those of human experts. The machines outperformed humans in all tasks. The most popular algorithms used to classify surgeons by skill level were the support vector machine and k-nearest neighbors, and their accuracy exceeded 90%. The "you only look once" detector and RetinaNet usually solved the problem of detecting surgical instruments - their accuracy was approximately 70%. The experts differed by more confident contact with tissues, higher bimanuality, smaller distance between the instrument tips, and relaxed and focused state of the mind. The average MERSQI score was 13.9 (from 18). There is growing interest in the use of ML in neurosurgical training. Most studies have focused on the evaluation of microsurgical skills in oncological neurosurgery and on the use of virtual simulators; however, other subspecialties, skills, and simulators are being investigated. Machine learning models effectively solve different neurosurgical tasks related to skill classification, object detection, and outcome prediction. Properly trained ML models outperform human efficacy. Further research on ML application in neurosurgery is needed.