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

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Abstract

Background

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.

Methods

A 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.

Results

Eight 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.

Conclusions

In 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.

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References

  1. Bridges M, Diamond DL (1999) The financial impact of teaching surgical residents in the operating room. Am J Surg 177:28–32

    Article  CAS  PubMed  Google Scholar 

  2. Bingham WV (1937) Aptitudes and aptitude testing. Harper and Brothers Publishers, New York

    Google Scholar 

  3. Cuschieri A (1995) Whither minimal access surgery: tribulations and expectations. Am J Surg 169:9–19

    Article  CAS  PubMed  Google Scholar 

  4. Gallagher AG, O’Sullivan GC, Neary PC, Carroll SM, Leonard G, Bunting BP et al (2013) An objective evaluation of a multi-component, competitive, selection process for admitting surgeons into higher surgical training in a national setting. World J Surg. doi:10.1007/s00268-013-2302-4

    Google Scholar 

  5. Carroll SM, Kennedy AM, Traynor O, Gallagher AG (2009) Objective assessment of surgical performance and its impact on a national selection programme of candidates for higher surgical training in plastic surgery. J Plast Reconstr Aesthet Surg 62:1543–1549

    Article  PubMed  Google Scholar 

  6. Gallagher AG, Neary P, Gillen P, Lane B, Whelan A, Tanner WA et al (2008) Novel method for assessment and selection of trainees for higher surgical training in general surgery. ANZ J Surg 78:282–290

    Article  PubMed  Google Scholar 

  7. Ackerman PL, Chamorro-Premuzic T, Furnham A (2011) Trait complexes and academic achievement: old and new ways of examining personality in educational contexts. Br J Educ Psychol 81(Pt 1):27–40

    Article  PubMed  Google Scholar 

  8. Ball CG, Kirkpatrick AW, Feliciano DV, Reznick R, McSwain NE (2008) Surgeons and astronauts: so close, yet so far apart. Can J Surg 51:247–250

    PubMed Central  PubMed  Google Scholar 

  9. Cuschieri A, Francis N, Crosby J, Hanna GB (2001) What do master surgeons think of surgical competence and revalidation? Am J Surg 182:110–116

    Article  CAS  PubMed  Google Scholar 

  10. Aiken RL (2006) Psychological testing and assessment. Pearson Publishers, Upper Saddle River (NJ)

    Google Scholar 

  11. Kennedy AM, Boyle EM, Traynor O, Walsh T, Hill AD (2011) Video gaming enhances psychomotor skills but not visuospatial and perceptual abilities in surgical trainees. J Surg Educ 68:414–420

    Article  CAS  PubMed  Google Scholar 

  12. Macmillan AI, Cuschieri A (1999) Assessment of innate ability and skills for endoscopic manipulations by the Advanced Dundee Endoscopic Psychomotor Tester: predictive and concurrent validity. Am J Surg 177:274–277

    Article  CAS  PubMed  Google Scholar 

  13. Maan ZN, Maan IN, Darzi AW, Aggarwal R (2012) Systematic review of predictors of surgical performance. Br J Surg 99:1610–1621

    Article  CAS  PubMed  Google Scholar 

  14. Gallagher AG, Leonard G, Traynor OJ (2009) Role and feasibility of psychomotor and dexterity testing in selection for surgical training. ANZ J Surg 79:108–113

    Article  PubMed  Google Scholar 

  15. Hofstad EF, Våpenstad C, Chmarra MK, Langø T, Kuhry E, Mårvik R (2013) A study of psychomotor skills in minimally invasive surgery: what differentiates expert and nonexpert performance. Surg Endosc 27:854–863

    Article  PubMed  Google Scholar 

  16. Rosser JC Jr, Rosser LE, Savalgi RS (1998) Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. Arch Surg 133:657–661

    Article  PubMed  Google Scholar 

  17. Gallagher AG, Satava RM (2002) Virtual reality as a metric for the assessment of laparoscopic psychomotor skills: learning curves and reliability measures. Surg Endosc 16:1746–1752

    Article  CAS  PubMed  Google Scholar 

  18. Oropesa I, Sánchez-González P, Lamata P, Chmarra MK, Pagador JB, Sánchez-Margallo JA et al (2011) Methods and tools for objective assessment of psychomotor skills in laparoscopic surgery. J Surg Res 171:e81–e95

    Article  PubMed  Google Scholar 

  19. Satava RM, Cuschieri A, Hamdorf J (2003) Metrics for objective assessment. Surg Endosc 17:220–226

    Article  CAS  PubMed  Google Scholar 

  20. Abboudi H, Khan MS, Aboumarzouk O, Guru KA, Challacombe B, Dasgupta P et al (2013) Current status of validation for robotic surgery simulators: a systematic review. BJU Int 111:194–205

    Article  PubMed  Google Scholar 

  21. Kelly DC, Margules AC, Kundavaram CR, Narins H, Gomella LG, Trabulsi EJ et al (2012) Face, content, and construct validation of the da Vinci Skills Simulator. Urology 79:1068–1072

    Article  PubMed  Google Scholar 

  22. Hung AJ, Patil MB, Zehnder P, Cai J, Ng CK, Aron M et al (2012) Concurrent and predictive validation of a novel robotic surgery simulator: a prospective, randomized study. J Urol 187:630–637

    Article  PubMed  Google Scholar 

  23. Brinkman WM, Luursema JM, Kengen B, Schout BM, Witjes JA, Bekkers RL (2013) da Vinci Skills Simulator for assessing learning curve and criterion-based training of robotic basic skills. Urology 81:562–566

    Article  PubMed  Google Scholar 

  24. Bailey M. Evolution of aptitude testing in the RAF. RTO MP-55 (1999). http://ftp.rta.nato.int/public//PubFulltext/RTO/MP/RTO-MP-055///MP-055-25.pdf. Accessed 18 Sep 2013

  25. Ritter EM, McClusky DA 3rd, Gallagher AG, Enochsson L, Smith CD (2006) Perceptual, visuospatial, and psychomotor abilities correlate with duration of training required on a virtual-reality flexible endoscopy simulator. Am J Surg 192:379–384

    Article  PubMed  Google Scholar 

  26. Ritter EM, McClusky DA 3rd, Lederman AB, Gallagher AG, Smith CD (2003) Objective psychomotor skills assessment of experienced and novice flexible endoscopists with a virtual reality simulator. J Gastrointest Surg 7:871–877

    Article  PubMed  Google Scholar 

  27. Gallagher AG, Cowie R, Crothers I, Jordan-Black JA, Satava RM (2003) PicSOr: an objective test of perceptual skill that predicts laparoscopic technical skill in three initial studies of laparoscopic performance. Surg Endosc 17:1468–1471

    Article  CAS  PubMed  Google Scholar 

  28. Gallagher AG, Richie K, McClure N, McGuigan J (2001) Objective psychomotor skills assessment of experienced, junior, and novice laparoscopists with virtual reality. World J Surg 25:1478–1483

    Article  CAS  PubMed  Google Scholar 

  29. McClusky DA 3rd, Ritter EM, Lederman AB, Gallagher AG, Smith CD (2005) Correlation between perceptual, visuo-spatial, and psychomotor aptitude to duration of training required to reach performance goals on the MIST-VR surgical simulator. Am J Surg 71:13–20

    Google Scholar 

  30. Cope DH, Fenton-Lee D (2007) Assessment of laparoscopic psychomotor skills in interns using the MIST Virtual Reality Simulator: a prerequisite for those considering surgical training? ANZ J Surg 78:291–296

    Article  Google Scholar 

  31. Rosser JC Jr, Lynch PJ, Cuddihy L, Gentile DA, Klonsky J, Merrell R (2007) The impact of video games on training surgeons in the 21st century. Arch Surg 142:181–186

    Article  PubMed  Google Scholar 

  32. Harper JD, Kaiser S, Ebrahimi K, Lamberton GR, Hadley HR, Ruckle HC et al (2007) Prior video game exposure does not enhance robotic surgical performance. J Endourol 21:1207–1210

    Article  PubMed  Google Scholar 

  33. Lynch J, Aughwane P, Hammond TM (2010) Video games and surgical ability: a literature review. J Surg Educ 67:184–189

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank staff at the Multidisciplinary Robotic Center at the Cisanello University Hospital of Pisa for their assistance during the tests.

Disclosures

Drs. Andrea Moglia, Vincenzo Ferrari, and Luca Morelli, and Professors Mauro Ferrari, Franco Mosca, and Alfred Cuschieri have no conflict of interests. Dr. Franca Melfi is Official Proctor at the Multidisciplinary Center of Robotic Surgery at Cisanello Hospital in Pisa, Italy.

Funding

Study partly funded by Regione Toscana.

Author information

Authors and Affiliations

  1. EndoCAS, Center for Computer Assisted Surgery, University of Pisa, Edificio 102, via Paradisa 2, 56124, Pisa, Italy

    Andrea Moglia, Vincenzo Ferrari, Luca Morelli & Mauro Ferrari

  2. Multidisciplinary Center of Robotic Surgery, University Hospital of Pisa, 56124, Pisa, Italy

    Luca Morelli & Franca Melfi

  3. Cisanello University Hospital of Pisa, 56124, Pisa, Italy

    Franco Mosca

  4. Scuola Superiore Sant’Anna of Pisa, 56124, Pisa, Italy

    Alfred Cuschieri

  5. Institute for Medical Science and Technology, University of Dundee, Dundee, DD2 1FD, UK

    Alfred Cuschieri

Authors
  1. Andrea Moglia
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  2. Vincenzo Ferrari
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  3. Luca Morelli
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  4. Franca Melfi
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  5. Mauro Ferrari
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  6. Franco Mosca
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  7. Alfred Cuschieri
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Corresponding author

Correspondence to Andrea Moglia.

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Moglia, A., Ferrari, V., Morelli, L. et al. Distribution of innate ability for surgery amongst medical students assessed by an advanced virtual reality surgical simulator. Surg Endosc 28, 1830–1837 (2014). https://doi.org/10.1007/s00464-013-3393-6

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  • DOI: https://doi.org/10.1007/s00464-013-3393-6

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