Virtual reality training simulations to acquire surgical skills are important for increasing patient safety and save valuable resources, e.g., cadavers, supervision and operating room time. However, as surgery is a craft, simulators must not only provide a high degree of visual realism, but especially a realistic haptic behavior. While such simulators exist for surgeries like laparoscopy or arthroscopy, other surgical fields, especially where large forces need to be exerted, like total hip arthroplasty (THA; implantation of a hip joint protheses), lack realistic VR training simulations. In this paper we present for the first time a novel VR training simulation for the five steps of THA (from femur head resection to stem implantation) with realis-tic haptic feedback. To achieve this, a novel haptic hammering device, an upgraded version of the Virtuose 6D haptic device from Haption, novel algorithms for collision detection, haptic rendering, and material removal are introduced. In a study with 17 surgeons of diverse experience levels, we confirmed the realism, usefulness and usability of our novel methods.

With highly automated vehicles (HAVs), the human role shifts from active driver to mostly passive passenger, which has an impact on the perceived comfort while being driven. A number of factors need to be taken into account when designing an automated driving style (ADS) with the aim to minimize human discomfort. In this paper, the authors build on seven empirical studies to determine first, if a generally comfortable ADS exists and second, whether such an ADS should be designed depending on situational driving dynamics or individual user characteristics such as users’ manual driving styles. The results give an overview of the ADS- and user-related factors causing human discomfort in automated driving and provide potential strategies to overcome potential discomfort. Drawing on the data, upcoming challenges in the field of human discomfort in HAVs for both research and practice are presented.