Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons



Findings have shown that music affects cognitive performance, but little is known about its influence on surgical performance. The hypothesis of this randomized controlled trial was that arousing (activating) music has a beneficial effect on the surgical performance of novice surgeons in the setting of a laparoscopic virtual reality task.


For this study, 45 junior surgeons with no previous laparoscopic experience were randomly assigned to three equal groups. Group 1 listened to activating music; group 2 listened to deactivating music; and group 3 had no music (control) while each participant solved a surgical task five times on a virtual laparoscopic simulator. The assessed global task score, the total task time, the instrument travel distances, and the surgeons’ heart rate were assessed.


All surgical performance parameters improved significantly with experience (task repetition). The global score showed a trend for a between-groups difference, suggesting that the group listening to activating music had the worst performance. This observation was supported by a significant between-groups difference for the first trial but not subsequent trials (activating music, 35 points; deactivating music, 66 points; no music, 91 points; p = 0.002). The global score (p = 0.056) and total task time (p = 0.065) showed a trend toward improvement when participants considered the music pleasant rather than unpleasant.


Music in the operating theater may have a distracting effect on novice surgeons performing new tasks. Surgical trainers should consider categorically switching off music during teaching procedures.

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Conflict of Interest

The corresponding author discloses on behalf of all authors any conflict of interest including any financial interests and relationships. There was no sponsoring for this study.

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Correspondence to D. Miskovic.

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Miskovic, D., Rosenthal, R., Zingg, U. et al. Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons. Surg Endosc 22, 2416–2420 (2008). https://doi.org/10.1007/s00464-008-0040-8

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  • Laparoscopy
  • Music
  • Performance
  • Simulation
  • Surgical training/courses