Neurosurgical Resident Selection Using NeuroTouch, a Virtual Reality Simulator Alexander Winkler-Schwartz MD, CM; Khalid M. Bajunaid MD; Muhammad Mullah MSc; Fahad E Alotaibi MD; Jawad Fares BSc; Ibrahim Marwa; Marta Baggiani; gmaan Al Zharni MD, MA; Abdulrahman J Sabbagh MBBS FRCSC; Rolando Del Maestro Neurosurgical Simulation Research and Training Center, Department of Neurosurgery, Montreal Neurological Institute Introduction: Tier 1 metrics of neurosurgical applicants Advanced tier 2 metrics of neurosurgical applicants Current selection methods for neurosurgical residents fail to include objective measurements of bimanual psychomotor performance. This pilot study was designed to answer three questions: • What is the distribution of bimanual psychomotor performance among neurosurgical residency applicants using NeuroTouch? • Are there exceptionally skilled medical students in the applicant cohort? • Is there an influence of previous surgical exposure on surgical performance? Simulated Task Tier 2 metrics of neurosurgical applicants Univariate and Multivariate Regression Analysis of Applicant Factors with Performance Metrics A: Operator view of sucker in non-dominant hand and ultrasonic aspirator in dominant hand B: Haptic instruments used by participants C: Model performing task. Playing musical instruments, self-evaluated technical Methods: skills and operative room confidence, number of skin Seventeen medical students attending neurosurgery closures and weeks of neurosurgical exposure residency interviews at McGill University were asked to influenced performance. participate. Applicants performed the resection of three virtual brain tumors with simulated bleeding. Validated tier 1, tier 2, and advanced tier 2 metrics were utilized to assess Conclusions: bimanual psychomotor performance. means (+/-SD) organized into top, middle and bottom quartile groups along with Simulation technology identifies neurosurgical individual medical student (n=16) values. Bar represents p<0.05 between two applicants at extremes of technical ability. Extrinsic and indicated groups. Red Color bars indicate top group, blue bars, middle group and Results: yellow bars bottom performance intrinsic applicant factors appear to influence Sixteen of 17 neurosurgical applicants (94%) participated. performance. We propose Technical Abilities • Performances clustered in a definable top, middle, and Customized Training (TACT) programs which bottom performing group with significant differences maximize resident bimanual psychomotor training between groups for all metrics dependant on continuously updated and validated metrics..