Assessing an Augmented Reality Surgical Simulator

Abstract

Traditional surgical training is hampered by limited practice opportunities, arising from costly resources and restricted operating room access, and by the variable feedback of apprenticeship models, which challenges standardized skill acquisition. In this study, we evaluated the efficacy of a novel Augmented Reality (AR) application for drill-guide placement and investigated the effects of two contrasting learning frameworks: Productive Success (PS), which gradually increases the difficulty as the learner’s competence grow, and Productive Failure (PF), which intentionally introduces challenges early in training to promote deeper learning. We conducted a randomized controlled trial with 16 novice participants assigned to either learning framework (eight participants per each framework), completing both training and, after at least 24 hours, retention sessions. We assessed performance using Completion Time and Success Rate, alongside subjective measures of perceived workload (NASA-TLX) and user experience (UEQ). The results demonstrated that the AR application was highly effective at reducing Completion Time; both groups significantly reduced their Completion Time from their initial baseline to the retention session, and these skills were retained. However, a corresponding significant improvement in Success Rate was not observed within the study’s timeframe. Critically, we found no significant differences between the PS and PF groups at the retention session regarding final performance levels, perceived workload, or user experience. These findings contribute valuable evidence to the field of surgical education. Firstly, they validate the use of this AR application as an effective tool for rapidly building and retaining motor skills in novices. Secondly, they suggest that for this visuomotor task in an AR environment, the theoretical benefits of PF over PS did not manifest, with both strategies leading to comparable learning outcomes. This underscores the importance of investigating instructional designs specifically tailored to the unique context of AR-based motor training. Index Terms—Augmented Reality, Surgical Simulation, Productive Failure, Motor Learning, Instructional Design.