Surgical Endoscopy

, Volume 28, Issue 6, pp 1830–1837 | Cite as

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

  • Andrea MogliaEmail author
  • Vincenzo Ferrari
  • Luca Morelli
  • Franca Melfi
  • Mauro Ferrari
  • Franco Mosca
  • Alfred Cuschieri



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.


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.


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.


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.


Innate aptitude Ability Psychomotor aptitude tests Selection of surgical trainees Surgical skills and competence da Vinci Skills Simulator 



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.


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.


Study partly funded by Regione Toscana.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Andrea Moglia
    • 1
    Email author
  • Vincenzo Ferrari
    • 1
  • Luca Morelli
    • 1
    • 2
  • Franca Melfi
    • 2
  • Mauro Ferrari
    • 1
  • Franco Mosca
    • 3
  • Alfred Cuschieri
    • 4
    • 5
  1. 1.EndoCAS, Center for Computer Assisted SurgeryUniversity of PisaPisaItaly
  2. 2.Multidisciplinary Center of Robotic SurgeryUniversity Hospital of PisaPisaItaly
  3. 3.Cisanello University Hospital of PisaPisaItaly
  4. 4.Scuola Superiore Sant’Anna of PisaPisaItaly
  5. 5.Institute for Medical Science and TechnologyUniversity of DundeeDundeeUK

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