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Systematic Video Game Training in Surgical Novices Improves Performance in Virtual Reality Endoscopic Surgical Simulators: A Prospective Randomized Study



Previous studies have shown a correlation between previous video game experience and performance in minimally invasive surgical simulators. The hypothesis is that systematic video game training with high visual-spatial demands and visual similarity to endoscopy would show a transfer effect on performance in virtual reality endoscopic surgical simulation.


A prospective randomized study was performed. Thirty surgical novices were matched and randomized to five weeks of systematic video game training in either a first-person shooter game (Half Life) with high visual-spatial demands and visual similarities to endoscopy or a video game with mainly cognitive demands (Chessmaster). A matched control group (n = 10) performed no video game training during five weeks. Performance in two virtual reality endoscopic surgical simulators (MIST-VR and GI Mentor II) was measured pre- and post-training. Before simulator training we also controlled for students’ visual-spatial ability, visual working memory, age, and previous video game experience.


The group training with Half Life showed significant improvement in two GI Mentor II variables and the MIST-VR task MD level medium. The group training with Chessmaster only showed an improvement in the MIST-VR task. No effect was observed in the control group. As recently shown in other studies, current and previous video game experience was important for simulator performance.


Systematic video game training improved surgical performance in advanced virtual reality endoscopic simulators. The transfer effect increased when increasing visual similarity. The performance in intense, visual-spatially challenging video games might be a predictive factor for the outcome in surgical simulation.

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This is an independent study fully supported by unrestricted grants from Karolinska Institutet and Marianne and Marcus Wallenberg Foundation.

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Correspondence to Marcus Kolga Schlickum.

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Schlickum, M.K., Hedman, L., Enochsson, L. et al. Systematic Video Game Training in Surgical Novices Improves Performance in Virtual Reality Endoscopic Surgical Simulators: A Prospective Randomized Study. World J Surg 33, 2360 (2009).

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  • Virtual Reality
  • Video Game
  • Transfer Effect
  • Half Life
  • Surgical Simulator