Roadmap for Developing Complex Virtual Reality Simulation Scenarios: The Subpial Neurosurgical Tumor Resection Model.

BACKGROUND: Advancement and evolution of current virtual reality (VR) surgical simulation technologies is integral to improve the available armamentarium of surgical skill education. This is especially important in high-risk surgical specialties. Such fields including neurosurgery are beginning to explore the utilization of virtual reality simulation in the assessment and training of psychomotor skills. An important issue facing the available VR simulation technologies is the lack of complexity of scenarios which fail to replicate the visual and haptic realities of complex neurosurgical procedures. Therefore, there is a need to create more realistic and complex scenarios with the appropriate visual and haptic realities to maximize the potential of virtual reality technology METHODS: We outline a roadmap for creating complex virtual reality neurosurgical simulation scenarios using a step-wise description of our team's subpial tumor resection project as a model. RESULTS: The creation of complex neurosurgical simulations involves integrating multiple modules into a scenario building roadmap. The components of each module are described outlining the important stages in the process of complex VR simulation creation. CONCLUSION: We have outlined a roadmap of step-wise approach for the creation of complex VR simulated neurosurgical procedures. This roadmap may also serve as a guide to aid the development of other virtual reality scenarios in a variety of surgical fields. The generation of new VR complex simulated neurosurgical procedures, by surgeons for surgeons, with the help of computer scientists and engineers may improve the assessment and training of residents and ultimately improve patient care.