Elsevier

Journal of Surgical Education

Volume 67, Issue 3, May–June 2010, Pages 184-189
Journal of Surgical Education

Review
Video Games and Surgical Ability: A Literature Review

https://doi.org/10.1016/j.jsurg.2010.02.010Get rights and content

Objective

Surgical training is rapidly evolving because of reduced training hours and the reduction of training opportunities due to patient safety concerns. There is a popular conception that video game usage might be linked to improved operating ability especially those techniques involving endoscopic modalities. If true this might suggest future directions for training.

Methods

A search was made of the MEDLINE databases for the MeSH term, “Video Games,” combined with the terms “Surgical Procedures, Operative,” “Endoscopy,” “Robotics,” “Education,” “Learning,” “Simulators,” “Computer Simulation,” “Psychomotor Performance,” and “Surgery, Computer-Assisted,”encompassing all journal articles before November 2009. References of articles were searched for further studies.

Results

Twelve relevant journal articles were discovered. Video game usage has been studied in relationship to laparoscopic, gastrointestinal endoscopic, endovascular, and robotic surgery.

Conclusions

Video game users acquire endoscopic but not robotic techniques quicker, and training on video games appears to improve performance.

Section snippets

Background

There has been a postulated link between video games and surgical ability for many years. Game consoles involve the manipulation of 3-dimensional (D) objects via a 2-D screen and require dexterity of the wrist and hand. Intuitively these skills seem analogous to newer surgical techniques such as laparoscopy. The link between video games and surgical skills is of more than theoretical importance. In recent years operating experience for trainees has been curtailed due to a cut in working hours,

Theoretical Basis for Cognitive Enhancements with Video Game Use

Playing video games would not be much fun if the player did not improve on subsequent attempts. This is known as “perceptual learning” and involves mechanisms such as “attentional weighting” — the heightened awareness of important aspects of the task and decreased awareness of irrelevant aspects.7 Perceptual learning is usually specific to the trained task and generalization to other tasks is not often observed. However, there is evidence that video game playing may refine a range of generic

Methods of Literature Search

A search was made of the MEDLINE database for the MeSH term “Video Games,” combined with the terms, “Surgical Procedures, Operative,” “Endoscopy,” “Robotics,” “Education,” “Learning,” “Simulators,” “Computer Simulation,” “Psychomotor Performance,” and “Surgery, Computer-Assisted,” encompassing all journal articles before November 2009. References of the identified trials were also searched to identify further clinical trials. All prospective and retrospective trials were included if they

Novice Surgeons

Evaluating the surgical ability of novice surgeons in relation to video game usage helps to determine whether the skill-set of surgery and video game playing overlaps. If this is the case it strengthens the theory that practicing video games would improve basic skills which can then be applied to surgery. Rosenberg et al. compared video game aptitude with laparoscopic skill in 11 medical students.12 Participants were evaluated on their performance playing a selection of games followed by

Does Training on Video Games Improve Surgical Skill?

Three studies have assessed whether short courses of “training” on video games increases surgical ability. The second part of the study performed by Rosenberg et al. (previously described) randomized 11 medical students into two groups, one of which was instructed to play video games and the other to abstain.12 After two weeks the groups were tested again and there was no significant difference observed between them in terms of laparoscopic ability on porcine bowel. Two studies performed by

Suggestions for Further Study

The benefits of past video game usage and of “training” on video games have yet to be studied in subjects operating on humans. Such a study would obviously be more difficult to conduct however it would be the best proof that such a relationship exists. Patient safety puts restrictions on the testing of novice surgeons on human subjects. As previously mentioned the ideal endpoint would be patient outcome, and to measure this would require surgeons randomized to video game exposure and follow-up

Conclusions

There is evidence from multiple studies of a correlation between video game playing and increased initial performance with laparoscopic, endovascular, gastrointestinal endoscopic, but not robotic, techniques. However this gap seems to close with increased complexity of task, revealing perhaps that cognitive benefits are soon outweighed by the specific details of the surgical modality. There is some evidence that training on video games over short periods can improve laparoscopic ability. This

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