Skip to main content
SpringerLink
Log in

Visual working memory influences the performance in virtual image–guided surgical intervention

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

This study addresses for the first time the relationship between working memory and performance measures in image-guided instrument navigation with Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) and GI Mentor II (a simulator for gastroendoscopy). In light of recent research on simulator training, it is now prime time to ask why in a search for mechanisms rather than show repeatedly that conventional curriculum for simulation training has effect.

Methods

The participants in this study were 28 Swedish medical students taking their course in basic surgery. Visual and verbal working memory span scores were assessed by a validated computer program (RoboMemo) and correlated with visual–spatial ability (MRT-A test), total flow experience (flow scale), mental strain (Borg scale), and performance scores in manipulation and diathermy (MD) using Procedicus MIST-VR and GI Mentor 11 (exercises 1 and 3).

Results

Significant Pearson’s r correlations were obtained between visual working memory span scores for visual data link (a RoboMemo exercise) and movement economy (r = −0.417; p < 0.05), total time (r = −0.495; p < 0.01), and total score (r = −0.390; p < 0.05) using MIST-MD, as well as total time (r = −0.493; p < 0.05) and efficiency of screening (r = 0.469; p < 0.05) using GI Mentor 11 (exercise 1). Correlations also were found between visual working memory span scores in rotating data link (another RoboMemo exercise) and both total time (r = −0.467; p < 0.05) and efficiency of screening (r = −0.436; p < 0.05) using GI Mentor 11 (exercise 3). Significant Pearson’s r correlations also were found between visual–spatial ability scores and several performance scores for the MIST and GI Mentor II exercises.

Conclusions

Findings for the first time demonstrate that visual working memory for surgical novices may be important for performance in virtual simulator training with two well-known and validated simulators.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.

Similar content being viewed by others

References

  1. Morrow DG, Menard WE, Ridolfo HE, Stine-Morrow EAL, Teller T, Bryant D (2003) Expertise, cognitive ability, and age effects on pilot communication. Int J Aviation Psychol 13: 345–371

    Article  Google Scholar 

  2. Wiener EL (1988) Cockpit automation. In: Wiener EL, Nagel DC (eds) Human factors in aviation. Academic Press, San Diego, CA pp 433–461

    Google Scholar 

  3. Baddeley A (2002) Is working memory still working? European Psychol 7: 85–97

    Article  Google Scholar 

  4. Healey N, Sevdalis N, Vincent CA (2006) Measuring intraoperative interference from distraction and interruption observed in the operating theatre. Ergonomics 49: 589–604

    Article  PubMed  CAS  Google Scholar 

  5. Salas E, Cannon-Bowers JA (2001) The science of training: a decade of progress. Annual Rev Psychol 52: 471–499

    Article  PubMed  CAS  Google Scholar 

  6. 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  PubMed  CAS  Google Scholar 

  7. Wanzel KR, Hamstra SJ, Caminiti MF, Anastakis DJ, Grober ED, Reznick RK (2003) Visual–spatial ability correlates with efficiency of hand motion and successful surgical performance. Surgery 134: 750–757

    Article  PubMed  Google Scholar 

  8. Ström P, Kjellin A, Hedman L, Wredmark T, Fellander-Tsai L (2004) Training in tasks with different visual–spatial components does not improve virtual arthroscopy performance. Surg Endosc 18: 115–120

    Article  PubMed  Google Scholar 

  9. Hedman L, Ström P, Andersson P, Kjellin A, Wredmark T, Felländer-Tsai, L (2006). High-level visual–spatial ability for novices correlates with performance in a visual–spatial complex surgical simulator task. Surg Endosc 20: 1275–1280

    Article  PubMed  CAS  Google Scholar 

  10. Ritter EM, McClusky DA, 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 

  11. Enochsson L, Isaksson B, Tour R, Kjellin A, Hedman L, Wredmark T, Felländer-Tsai L (2004) Visuospatial skills and computer game experience influence the performance of virtual endoscopy. J Gastrointest Surg 8: 874–880

    Article  Google Scholar 

  12. Smith EE, Jonides J (1996) Working memory in humans: neuropsychological evidence. In: Gazzaniga M (ed) The cognitive neurosciences. MIT Press, Cambridge, MA pp 1009–1020

    Google Scholar 

  13. Cabeza R, Nyberg L (2000) Neural bases of learning and memory: functional neuroimaging evidence. Curr Opin Neuro 13: 415–421

    Article  CAS  Google Scholar 

  14. Ericsson KA, Krampe RT, Tesch-Römer C (1993) The role of deliberate practice in the acquisition of expert performance. Psychol Rev 100: 363–406

    Article  Google Scholar 

  15. Klingberg T, Fernell E, Olesen PJ, Johnson M, Gustafsson P, Dahlstrom K, Gillberg CG, Forssberg H, Westerberg H (2005) Computerized training of working memory in children with ADHD: a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 44: 177–186

    Article  PubMed  Google Scholar 

  16. Louis TA, Lavori PW, Bailar JC, Polansky M (1984) Crossover and self-controlled designs in clinical research. N Engl J Med 5: 24–31

    Article  Google Scholar 

  17. Peters M, Laeng B, Latham K, Jackson M, Zaiyouna R, Richardson C (2000) A redrawn Vandenberg and Kuse mental rotation test: different versions and factors that affect performance. Brain Cogn 28: 39–58

    Article  Google Scholar 

  18. Klingberg K, Forssberg H, Westerberg H (2002) Training of working memory in children with ADHD. J Clin Exp Neuropsychol 24: 781–791

    Article  PubMed  Google Scholar 

  19. Ghani JA, Deshpande PD (1994) The characteristics and the experience of optimal flow in human–computer interaction. J Psychol 128: 381–391

    Google Scholar 

  20. Borg G (1998) Borg’s perceived exertion and pain scales. In: Human kinetics. Champaign, IL pp 30–67

  21. Hedman L, Klingberg T, Kjellin A, Wredmark T, Enochsson L, Felländer-Tsai L (2006) Working memory and image-guided surgical simulation. Stud HealthTechnol Informatics 119: 188–193

    Google Scholar 

  22. Olesen P, Westerberg H, Klingberg T (2004) Increased prefrontal and parietal brain activity after training of working memory. Nature Neurosci 7: 75–79

    Article  PubMed  CAS  Google Scholar 

  23. Enochsson L, Westman B, Ritter EM, Hedman L, Kjellin A, Wredmark T, Felländer-Tsai L (2006) Objective assessment of visuospatial and psychomotor ability and flow of residents and senior endoscopists in simulated gastroscopy. Surg Endosc 20: 895–899

    Article  PubMed  CAS  Google Scholar 

  24. Bandura A (1997) Self-efficacy: the exercise of control. Freeman, New York

    Google Scholar 

  25. Roethlisberger FJ, Dickson WJ (1946) Management and the worker. Harvard Univ Press, Oxford, England p 615

    Google Scholar 

Download references

Acknowledgments

This research was supported by unconditional research funds at the Karolinska Institutet and grant no. 220-155600 from European Commission Goal 1: North of Sweden.

Author information

Authors and Affiliations

  1. Department for Clinical Science Intervention and Technology (CLINTEC), Division of Orthopaedics, Karolinska Institutet and Center for Advanced Medical Simulation at Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden

    L. Hedman & L. Felländer-Tsai

  2. Department of Psychology, Skill Acquisition Lab, Umeå University, SE-901 87, Umeå, Sweden

    L. Hedman

  3. Department of Neuropediatrics, Karolinska Institutet, SE-171 76, Stockholm, Sweden

    T. Klingberg

  4. Division of Surgery, CLINTEC, Karolinska Institutet and Center for Advanced Medical Simulation, SE-141 86, Stockholm, Sweden

    L. Enochsson & A. Kjellin

Authors
  1. L. Hedman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Klingberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Enochsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Kjellin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Felländer-Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. Hedman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hedman, L., Klingberg, T., Enochsson, L. et al. Visual working memory influences the performance in virtual image–guided surgical intervention. Surg Endosc 21, 2044–2050 (2007). https://doi.org/10.1007/s00464-007-9287-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-007-9287-8

Keywords

Search

Navigation