An Augmented Reality-Based Simulator for Enhancing Surgical Training and Skill Acquisition

Abstract

Conventional surgical training systems are hampered by restricted case exposure, expense, and patient safety, whereas VR simulators often lack contextual and tactile realism. In this paper, an optical see-through AR simulator that overlays 3D anatomical guidance and instrument trajectory cues onto a physical phantom and provides real-time multimodal feedback and automated scoring are developed. A prospective controlled study (n=30 residents) compared AR training with a VR simulator and conventional model-based practice for a standardized orthopedic drilling task. The results were scores on completion time, placement deviation, error count, Objective Structured Assessment of Technical Skill (OSATS) global rating, confidence, decision-making accuracy, and 1-month skill retention.AR training achieved more efficient task completion (5.3±0.8 min vs 6.4±1.0 VR and 7.9±1.3 traditional; p<0.01), reduced placement error (1.5±0.3 mm vs 2.2±0.5 and 4.1±0.8; p<0.001), fewer errors, and higher OSATS scores (30.5±2.1 vs 27.8±3.0 and 23.4±3.5). Retention remained highest for AR at one month (28.9±2.5). Participants reported higher confidence (4.7/5). Therefore, AR can combine the physical fidelity of hands-on practice with in-situ guidance to accelerate skill acquisition and improve retention, supporting integration of AR simulation into surgical curricula.