title: Can tonic accommodation predict surgical performance?
abstract: BACKGROUND
  Pilots undergo many visual tests for both selection and assessment, and we know that there are many similarities between pilots and surgeons. Hence, it would not be unreasonable to bring similar visual tests into surgery. Tonic accommodation (TA) is a stable parameter that is adopted by the eye in the absence of any stimulation. Over recent years, surgery has undergone change from traditional open surgery to minimally invasive procedures, bringing many advantages. However, not every surgeon has the ability to perform under conditions where the operative field is represented on a flat monitor.
  
  
  METHODS
  We determined the TA values in medical students and then correlated this with their performance on a virtual reality surgical simulator.
  
  
  RESULTS
  We found that TA values predicted the number of errors made with the dominant hand, accounting for 27% of the variance.
  
  
  CONCLUSIONS
  The data suggest that TA may play a role in the individual differences that are noted when surgeons perform laparoscopic surgery. Further studies are needed to evaluate the exact role of TA in surgical performance.
authors.affiliation: Academic Surgical Unit, Imperial College School of Medicine, St. Mary's Hospital, Praed Street, London W2 1NY, United Kingdom. jyoti.shah@ic.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Shah
authors.forename: I
authors.initials: I
authors.lastname: Paul
authors.forename: D
authors.initials: D
authors.lastname: Buckley
authors.forename: H
authors.initials: H
authors.lastname: Davis
authors.forename: J P
authors.initials: JP
authors.lastname: Frisby
authors.forename: A
authors.initials: A
authors.lastname: Darzi
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation / Q000592:standards; D003194:Computer-Assisted Instruction / Q000379:methods; D004521:Educational Measurement / Q000379:methods; D018961:Educational Technology / Q000295:instrumentation; D007839:Functional Laterality; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000193:education* / Q000592:standards*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011597:Psychomotor Performance; D013337:Students, Medical