Spatialized Sonification for the Learning of Surgical Navigation

Abstract: Historically, the education of surgical navigation in minimally invasive neurosurgery has been constrained by several factors. Medical students have been required to physically be in the operating room to observe a teacher perform the different procedures. This restricts their opportunities to gain valuable hands-on experience in their field. An extended reality simulation system that employs auditory feedback in the form of sonification could be used to provide an inexpensive alternative to this traditional approach. Such a system would allow medical students to get practical experience with valuable insights during their initial years of training without requiring access to the operating room. In order to perform a first evaluation of the impact of sonification on neurosurgical learning using extended reality simulations, a prototype of a surgical simulation tool with six possible sonifications was implemented for the task of aligning a catheter against a target angle. The sonification types studied were spatial, psychoacoustic and direct parameter-mapping, each of which encoded the component angles either in parallel or sequentially. The sonifications were evaluated against each other and the baseline condition in a comparative mixed-design user study measuring the participants efficacy as accuracy, precision, time-to-completion and perceived workload for an assisted neurosurgical simulation task. Participants were found to be significantly slower when using the psychoacoustic sonification as compared to using no aid. Both the spatial and direct sonification showed non-significant tendencies to be slower than the baseline condition. Whilst no significant difference was found between the sonifications, the participants tended to have higher efficacy when using the spatial and direct sonifications, than with the psychoacoustic sonification. Hence these sonifications show the most promise as possible candidates for an auditory feedback system in an extended reality simulator for surgical navigation. However, further evaluation is needed to conclude the full effect of the direct and spatial sonifications on the students’ efficacy.