Effects of interface layouts on cognitive performance for pedicle screw placement simulator in immersive environments

Many medical procedures, including pedicle screw placement, require intricate hand-sight coordination. In recent years, immersive virtual reality (VR) technologies have gained traction in supporting training of such complex tasks. To effectively perform the task, the ability to see the screw position from different angles during the procedure is crucial, as it meets the user's need for comprehensive spatial information to guide their actions. Yet, current literature lacks guidelines for designing view layouts for VR simulators in this context. We conducted a repeated measure experiment investigating various layout parameters (8 layouts and 2 view sizes). We gathered behavioral metrics, eye-tracking data, and subjective ratings from 27 participants. We found that layout design significantly impacts task performance, with placing views on the left of the visual field in a vertical arrangement reducing task response time. Furthermore, we found the effects of view arrangements on the flow of visual search patterns. Our study provides design guidelines to inform future design of VR pedicle screw placement simulators and other types of simulators requiring the combination of manual tasks and multiple-perspective views.