A FUZZY LOGIC BASED ASSESSMENT TOOL FOR VR SIMULATED MEDICAL ENVIRONMENTS Alysson D. Santos 1 , Renata G. S. Gomes 2 , Ronei M. Moraes 3 , Liliane S. Machado 4 Abstract Virtual Reality (VR) systems allows the design of interactive and immersive environments for the simulation of a wide range of situations. These features has been exploited to build realistic applications in order to provide study and training in several areas, particularly in medicine. In this sense, the addition of techniques to assess the actions of users can provide simulations based on virtual reality more efficient for medical training, especially by helping the measure of users' skills after the execution of procedures in such virtual environments. This work details the implementation and integration of an assessment module based on fuzzy logic to a framework for development of virtual reality applications for medical training. Tests to measure the performance of the assessment module were designed over a gynecological examination simulator based on VR. Index Terms  fuzzy logic, medical simulation, skill assessment, virtual reality INTRODUCTION In recent decades, the Virtual Reality (VR) has proven its power as a tool for education and training in various fields such as aviation, business management and oil, nuclear and military industries [1]. Simulations based on VR intends to recreate immersive and interactive environments which can be used to provide training and learning through a personal experience [2]. An important feature related to VR systems for simulation and training is the ability to monitor the user’s actions in the system. It allows the use of the interaction informations for many purposes, like the quantification of the understanding, the usability and user’s skill assessment [5,6]. Usually, this process is supported by some type of assessment method which computes the classification of collected data from user’s interaction. It can be seen an increasing importance given to assessment methods in the context of VR simulations [5,7-9]. In this work is carried out a study of the basic concepts related to monitor and assess user’s actions in the context of VR simulations focused on teaching and training of medical procedures. Additionally, it is detailed the implementation, integration and testing of a module for assessment based on fuzzy logic to a framework for development of applications based on VR for medicine, named CyberMed [15]. The module introduces a new assessment method in the framework, which allows reusability and utilization in a wide context of applications. VIRTUAL REALITY MEDICAL SIMULATORS VR is a high-end user-computer interface that involves real- time simulation and interactions through multiple sensorial channels. In this sense, VR worlds are 3D environments, created by computer graphics techniques, where one or more users are immersed totally or partially to interact with virtual elements [3]. The immersive, interactive and multisensory nature of VR applications have allowed the conception of systems which recreate real life situations, as education or training in risky procedures [12]. Over the years, VR environments have been proposed to simulate various medical procedures, such as puncture procedures, palpation tests and complex surgical procedures (Figure 1) [9]. The benefits of using simulation systems based on VR include: the improvement of training processes, once that initial mistakes could occur in virtual models instead of real patients, training of rare and unusual situations, possibility of creating tasks and scenarios on demand, repetition of procedures as many as necessary, and objective assessment of user’s skills [4]. ASSESSMENT IN MEDICAL SIMULATORS The assessment of simulations is necessary to monitor the training quality and provide some feedback about the user performance [13]. This feedback is used to assess the users' skills and, according to their performance, inform their dexterity degree to perform the real procedure. In addition, various types of training cannot be classified as good or bad, due to its complexity. In such cases the existence of an assessment tool built into a VR based simulation system is important to serve as an auxiliary tool for decision-making about the success or failure in the transmission of knowledge to the student [5]. 1 Alysson Diniz dos Santos, alyssondiniz@yahoo.com.br 2 Renata Grigório Silva Gomes, renatagrigorio@gmail.com 3 Ronei Marcos de Moraes, Department of Statistics, Federal University of Paraíba. Cidade Universitária s/n, Castelo Branco, João Pessoa-PB. 58051-900. Brazil. ronei@de.ufpb.br 4 Liliane dos Santos Machado, Department of Informatics, Federal University of Paraíba. Cidade Universitária s/n, Castelo Branco, João Pessoa-PB, Brazil. 58051-900. liliane@di.ufpb.br