Distribution of innate ability for surgery amongst medical students assessed by an advanced virtual reality surgical simulator

AbstractBackground Surgery is a craft profession requiring individuals with specific, well-documented innate aptitude for manipulative skills. Yet in most countries, the current selection process of surgical trainees does not include aptitude testing for the psychomotor and manipulative skills of candidates.MethodsA total of 125 participants (121 medical students and four expert surgeons) performed all 26 exercises of the da Vinci Skills Simulator, with six exercises being identified as metrics of aptitude for manipulative and psychomotor skills. The expert surgeons were enrolled as the control group to validate the performance of the most talented students.ResultsEight students (6.6 %) significantly outperformed the remaining 113, obtaining a median value of the sum of weighted overall score on the six selected exercises of 52.7 % versus 21.0 % (p < 0.001). In contrast, 14 students (11.6 %) performed significantly worse and well below the performance of the other 107, with a median value of overall score of 8.7 % versus 24.1 (p < 0.001). There was no statistically significant difference between expert surgeons (control group) and the eight talented students (62.1 % vs. 52.7 %, respectively; p = 0.368). No significant correlation between exposure to video games and overall score (ρ = 0.330) was observed.ConclusionsIn terms of innate aptitude for manipulative and psychomotor abilities, the present investigation has documented two subpopulations that fall outside the norm for the group of medical students recruited for the study: (i) a small group (6.6 %) with a high level and (ii) a larger cohort (11.6 %) with low level (significantly below the norm) innate aptitude for surgery. Exposure to video game experience did not appear to influence performances on the da Vinci Skills Simulator.

[1]  A D K Hill,et al.  Video gaming enhances psychomotor skills but not visuospatial and perceptual abilities in surgical trainees. , 2011, Journal of surgical education.

[2]  R. Reznick,et al.  Surgeons and astronauts: so close, yet so far apart. , 2008, Canadian journal of surgery. Journal canadien de chirurgie.

[3]  A. Gallagher,et al.  Correlation between Perceptual, Visuo-spatial, and Psychomotor Aptitude to Duration of Training Required to Reach Performance Goals on the MIST-VR Surgical Simulator , 2005, The American surgeon.

[4]  A. Gallagher,et al.  NOVEL METHOD FOR ASSESSMENT AND SELECTION OF TRAINEES FOR HIGHER SURGICAL TRAINING IN GENERAL SURGERY , 2008, ANZ journal of surgery.

[5]  J. Baillie,et al.  Assessment of innate ability and skills for endoscopic manipulations by the advanced Dundee endoscopic psychomotor tester: predictive and concurrent validity. , 2000, Gastrointestinal endoscopy.

[6]  R. Satava,et al.  Virtual reality as a metric for the assessment of laparoscopic psychomotor skills , 2002, Surgical Endoscopy And Other Interventional Techniques.

[7]  P. Dasgupta,et al.  Current status of validation for robotic surgery simulators – a systematic review , 2013, BJU international.

[8]  Anthony G. Gallagher,et al.  Objective psychomotor skills assessment of experienced and novice flexible endoscopists with a virtual reality simulator. , 2003 .

[9]  R. Aggarwal,et al.  Systematic review of predictors of surgical performance , 2012, The British journal of surgery.

[10]  DARON H. COPE,et al.  ASSESSMENT OF LAPAROSCOPIC PSYCHOMOTOR SKILLS IN INTERNS USING THE MIST VIRTUAL REALITY SIMULATOR: A PREREQUISITE FOR THOSE CONSIDERING SURGICAL TRAINING? , 2008, ANZ journal of surgery.

[11]  Adrian Furnham,et al.  Trait complexes and academic achievement: old and new ways of examining personality in educational contexts. , 2011, The British journal of educational psychology.

[12]  R. M. Satava,et al.  PicSOr: An objective test of perceptual skill that predicts laparoscopic technical skill in three initial studies of laparoscopopic performance , 2003, Surgical Endoscopy And Other Interventional Techniques.

[13]  A. Cuschieri,et al.  What do master surgeons think of surgical competence and revalidation? , 2001, American journal of surgery.

[14]  Anthony G Gallagher,et al.  Role and feasibility of psychomotor and dexterity testing in selection for surgical training , 2009, ANZ journal of surgery.

[15]  Jie Cai,et al.  Concurrent and predictive validation of a novel robotic surgery simulator: a prospective, randomized study. , 2012, The Journal of urology.

[16]  W. V. Bingham.  Aptitudes and aptitude testing , 1937 .

[17]  D. Gentile,et al.  The impact of video games on training surgeons in the 21st century. , 2007, Archives of surgery.

[18]  C. Lallas,et al.  Face, content, and construct validation of the da Vinci Skills Simulator. , 2012, Urology.

[19]  R. M. Satava,et al.  Metrics for objective Assessment , 2003, Surgical Endoscopy And Other Interventional Techniques.

[20]  A. Gallagher,et al.  An Objective Evaluation of a Multi-Component, Competitive, Selection Process for Admitting Surgeons into Higher Surgical Training in a National Setting , 2014, World Journal of Surgery.

[21]  J. Rosser,et al.  Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. , 1998, Archives of surgery.

[22]  Erlend Fagertun Hofstad,et al.  A study of psychomotor skills in minimally invasive surgery: what differentiates expert and nonexpert performance , 2013, Surgical Endoscopy.

[23]  A. Cuschieri.  Whither minimal access surgery: tribulations and expectations. , 1995, American journal of surgery.

[24]  Pablo Lamata,et al.  Methods and tools for objective assessment of psychomotor skills in laparoscopic surgery. , 2011, The Journal of surgical research.

[25]  A. Gallagher,et al.  Objective assessment of surgical performance and its impact on a national selection programme of candidates for higher surgical training in plastic surgery. , 2009, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[26]  A. Gallagher,et al.  Objective Psychomotor Skills Assessment of Experienced, Junior, and Novice Laparoscopists with Virtual Reality , 2001, World Journal of Surgery.

[27]  M. Bridges,et al.  The financial impact of teaching surgical residents in the operating room. , 1999, American journal of surgery.

[28]  D Duane Baldwin,et al.  Prior video game exposure does not enhance robotic surgical performance. , 2007, Journal of endourology.

[29]  L. Aiken.  Psychological testing and assessment , 1976 .

[30]  T. Hammond,et al.  Video games and surgical ability: a literature review. , 2010, Journal of surgical education.

[31]  Barbara M A Schout,et al.  da Vinci skills simulator for assessing learning curve and criterion-based training of robotic basic skills. , 2013, Urology.

[32]  Lars Enochsson,et al.  Perceptual, visuospatial, and psychomotor abilities correlate with duration of training required on a virtual-reality flexible endoscopy simulator. , 2006, American journal of surgery.