Surgical simulation with haptic feedback and visual and tactile reality is an emerging field that has the potential to revolutionize research and training in all surgical specialities because of its ability to develop metrics which can assess, quantify and train technical skills, lessen human error and therefore improve patient outcomes.

Assessment is an essential element in the evaluation of psychomotor skills during surgical training. Proficiency-based training and assessment implies that the trainee has to achieve a set of predefined criteria during their training to move to the next level in a safe and controlled learning environment. While proficiency-based training is practiced in many disciplines, for neurosurgery and other surgical specialties technical skills learning is linked to chronology; e.g. skills learned during the specific period of time spent in a residency program and in the operating room (6-7 years) in a novice/expert apprenticeship model. Proficiency-based training ensures that specific criteria have been met while chronological-based training does not guarantee that a resident has achieved a degree of skill commiserate with competency in the surgical care of patients.