Limitations
This study has some limitations. One limitation is the number of surgeons in the skilled group and their range of experience in neuro-oncological surgery. However, most participants in the skilled group primarily practiced cranial neurosurgery, and subpial resection is a fundamental technique that is mastered throughout postgraduate training.Students in the VOA group were limited to only post-hoc performance feedback provided by the AI tutor, which lacks important contextual and directional components. For example, unidirectional instructions to reduce force or acceleration at the end of each attempt are likely to result in cumulative rather than time-specific behavioral changes.