Traditional spinal surgery procedures are carried out with limited direct visualization and augmented with
generous use of fluoroscopic imaging. This imposes limitations on the surgeon’s ability to place screws into the
spine and exposes the staff to large amounts of cumulative radiation. The Mazor Renaissance robotic system was
developed to both improve the accuracy of insertion of the pedicle screw and to reduce the amount of energy
exposure to staff and patients. The robot offers a significant advancement in the technology used in spinal
surgery, which calls for very specialized training and education programs for surgeons seeking to adopt it. The
current standard of training and employment of this device comes with significant constraints on both the
trainees and trainers.
Currently, the training must be conducted at specialized training centers that can provide clinical equipment
which includes Operating Room (OR) tables and lights, fluoroscopic imaging equipment, cadaveric tissue,
surgical instrumentation, certified radiation technicians, tissue storage, and video recording capabilities. These
requirements create a learning experience, which can only be supplied to a surgeon a single time and do not
support surgeon-initiated refresher training. This suggests that a simulation-based solution may be a valuable
supplement to the current training and education model.
This paper describes efforts to apply the theories of human-systems integration (HSI), instructional system
design, and simulator engineering to define the requirements for a simulator of a specific robotic surgery system.
Specifically, the aim of this project was to outline the instructional opportunities through several instructional
analyses that can be filled with a spinal simulator while considering human performance concerns and
constraints during the research and design phases of the system. From this, an instructional plan was conducted,
to which a HSI driven design document for a simulation system was developed.