The "VM size" refers to virtual memory, a system of putting information in RAM or caching it to your hard disk as needed. Thus Mac OS X can "virtually" use more memory than the amount of RAM you have. The hard disk is much slower than RAM, so the virtual memory system automatically distributes information between disk space and RAM for efficient performance. "Page ins/outs" refers to the number of times Mac OS X has moved information between RAM and disk space.