title: PicSOr: an objective test of perceptual skill that predicts laparoscopic technical skill in three initial studies of laparoscopic performance.
abstract: BACKGROUND
  Laparoscopic surgery requires surgeons to infer the shape of 3-D structures, such as the internal organs of patients, from 2-D displays on a video monitor. Recent evidence indicates that the issue is not resolved by the use of contemporary 3-D camera systems. It is therefore crucial to find ways of measuring differences in aptitude for recovering 3-D structure from 2-D images, and assessing its impact on performance. Our aim was to test empirically for a relationship between laparoscopic ability and the perceptual skill of recovering information about 3-D structures from 2-D monitor displays.
  
  
  METHODS
  Participants in three studies completed a simulated laparoscopic cutting task as well as the Pictorial Surface Orientation (PicSOr)3 Test. In studies 1 (n = 48) and 2 (n = 32) both groups were laparoscopic novices, and in study 3 (n = 34) 18 of the participants were experienced laparoscopic surgeons.
  
  
  RESULTS
  All three studies showed that PicSOr consistently predicted the laparoscopic performance of participants on the laparoscopic cutting task (study 1, r = 0.5, p < 0.0003; study 2, r = 0.5, p < 0.004; and study 3, r = 0.42, p = 0.017). Furthermore, it was also a significant predictor of laparoscopic surgeons' performance (r = 0.54, p = 0.047).
  
  
  CONCLUSIONS
  This is the first objective perceptual psychometric test to reliably predict laparoscopic technical skills. PicSOr provides a tool for assessing which trainees have the potential to learn minimal access surgery.
authors.affiliation: Queen's University Endoscopic Research Laboratory, Queen's University of Belfast, Ireland, United Kingdom.
authors.forename: A G
authors.initials: AG
authors.lastname: Gallagher
authors.forename: R
authors.initials: R
authors.lastname: Cowie
authors.forename: I
authors.initials: I
authors.lastname: Crothers
authors.forename: J-A
authors.initials: JA
authors.lastname: Jordan-Black
authors.forename: R M
authors.initials: RM
authors.lastname: Satava
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D002983:Clinical Competence; D003626:Data Display; D003867:Depth Perception; D005260:Female; D007839:Functional Laterality; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008328:Man-Machine Systems; D008953:Models, Anatomic; D009483:Neuropsychological Tests; D010820:Physicians / Q000523:psychology*; D011597:Psychomotor Performance