Human performance metrics for a virtual reality simulator to train chest tube insertion

Nearly all U.S. medical and nursing schools have begun to incorporate simulation in their curriculum. Among various delivery technologies, virtual environments offer unique means for measuring trainee performance and providing objective feedback. Knowledge of onepsilas own performance helps in increasing level of proficiency. This work incorporates objective performance metrics into a virtual reality simulator for training the chest tube insertion procedure. The simulator is setup to represent the 3D view of a patient and utilize force feedback devices for interaction. Precise metrics for evaluating trainee actions (e.g., incision length, depth, and dexterity) are introduced, hardware and software methods to record those actions are implemented (using H3D and Python), and a state machine is built to verify trainee performance at each of the procedurepsilas 18 steps. To provide realistic interaction with a surgical cut, graphics meshes and animations are introduced in software and a new haptic interface via a Kelly clamp is built in hardware. As chest tube insertion is a life-saving procedure learned by all medical and nursing students, this simulator may have broad applicability.