Machine Learning Algorithms Improved Technical Performance and Learning Outcomes During Sham Brain Tumor Ablation

The COVID-19 pandemic has presented both challenges and opportunities for medical education. Distance learning technology has become increasingly important in several areas. A new study reveals that in a remote environment, an artificial intelligence (AI)-based tutoring system can outperform expert human instructors.

The Neuro’s Neurosurgical Simulation and Artificial Intelligence Learning Center (Neurological Institute-Montreal Hospital) recruited seventy medical students to perform virtual ablations of brain tumors on a neurosurgical simulator. Students were randomly assigned to receive instruction and feedback from an AI tutor or remote expert instructor, with a third control group receiving no instruction.

An AI-powered tutor called Virtual Operative Assistant (VOA) used a machine learning algorithm to teach safe and efficient surgical technique and provided personalized feedback, while an intelligent system of continuous expertise monitoring (ICEMS) and a panel of experts evaluated student performance. .

In the other group, the remote instructors watched a live stream of the surgical simulations and provided feedback based on the student’s performance.

Researchers found that students who received instruction and feedback from the VOA learned surgical skills 2.6 times faster and performed 36% better than those who received instruction and feedback from instructors from a distance. And while the researchers expected VOA-instructed students to experience more stress and negative emotions, they found no significant difference between the two groups.

Surgical skills play an important role in patient outcomes during and after brain surgery. VOA can be an effective way to increase the performance of neurosurgeons, improve patient safety while reducing the burden on human instructors.

“Artificially intelligent tutors like the VOA could become a valuable tool in training the next generation of neurosurgeons,” says Dr. Rolando Del Maestro, lead author of the study. “The VOA has greatly enhanced expertise while fostering an excellent learning environment. Ongoing studies are evaluating how in-person instructors and AI-powered smart tutors can be used most effectively together to improve neurosurgical skill proficiency.

“Intelligent tutoring systems can use a variety of simulation platforms to provide nearly unlimited opportunities for repetitive practice without the constraints imposed by the availability of supervision,” says Ali Fazlollahi, first author of the study. “With continued research, increased development and dissemination of intelligent tutoring systems, we can be better prepared for the ever-changing challenges of the future.”

This study, published in the Journal of the American Medical Association (JAMA Network Open) on February 22, 2022, was funded by the Franco Di Giovanni Foundation, the Royal College of Physicians and Surgeons of Canada and the Brain Tumor Foundation of Canada Tumor Research Grant with The Neuro. The cognitive assessment was led by Dr. Jason Harley of McGill University’s Department of Surgery.

The Neuro

The Neuro – The Montreal Neurological Institute-Hospital – is a world-renowned bilingual destination for brain research and advanced patient care. Since its founding in 1934 by renowned neurosurgeon Dr. Wilder Penfield, The Neuro has become the largest clinical and research center specializing in neuroscience in Canada, and one of the largest in the world. The seamless integration of research, patient care and the training of the world’s best minds places The Neuro in a unique position to have a significant impact on the understanding and treatment of disorders of the nervous system. In 2016, The Neuro became the first institute in the world to fully embrace the philosophy of open science, creating the Tanenbaum Open Science Institute. The Montreal Neurological Institute is a research and teaching institute of McGill University. The Montreal Neurological Hospital is part of the Neuroscience Mission of the McGill University Health Centre. For more information, please visit

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Materials provided by McGill university. Note: Content may be edited for style and length.

Sharon D. Cole