The Effect of Haptic Feedback in an Immersive Microsurgery Simulator on VR Training and Skill Transfer

With the increasing use of immersive simulators in surgical training, there is an emerging emphasis on providing realistic haptic feedback. Although haptic feedback is recognized as necessary for surgical skill acquisition, its role in transferring those skills to real-life situations still needs to be explored. Our study aims to investigate the impact of haptic feedback on basic microsurgery skill acquisition, transfer, and retention, as well as on the user experience during VR training. An immersive simulator was developed to practice a microgrid task under magnification with and without haptic feedback. A similar physical setup with a binocular microscope was also designed to measure skills transfer to the real world. Thirty-three volunteers ($N=33$) were randomly divided into three participant groups: the haptic feedback group (HG), the no-haptic feedback group (NG), and the control group (CG). All participants performed the task on the physical setup during the pre-post-retention tests. After the pre-test, the first two groups performed six training trials on the immersive simulator, with the HG group receiving haptic feedback while performing the task. The control group did not receive any training. The results show that the HG and NG groups significantly improved their learning curve during training, with no significant differences between them. On the Other hand, the haptic feedback led to significantly higher usability and possibility of examination scores than those without haptic feedback. Finally, all the groups improved their time performance on the physical simulator. In addition, the haptic group participants showed a more significant gain in performance in terms of accuracy and error rates. These findings confirm the effectiveness of immersive environments combined with haptic feedback as a valuable training tool, facilitating the transfer of technical skills to realworld applications. Moreover, the results indicate that haptic feedback can also improve the user experience in immersive surgical simulators.