Visual-spatial ability correlates with efficiency of hand motion and successful surgical performance.
BACKGROUND
This study examines the influence of visual-spatial ability and manual dexterity on surgical performance across 3 levels of expertise.


METHODS
Dental students, surgical residents, and staff surgeons completed standardized tests of manual dexterity and visual-spatial ability and were assessed objectively while performing the rigid fixation of an anterior mandible on bench model simulations. Outcome variables included expert assessment of technical performance and efficiency of hand motion during the procedure (recorded using electromagnetic sensors).


RESULTS
Visual-spatial scores correlated significantly with surgical performance scores within the group of dental students (r=.40 to.73), but this was not the case for residents or staff surgeons. For all groups, manual dexterity did not correlate with hand motion parameters. There were no differences between groups in visual-spatial ability or manual dexterity, but highly significant differences were seen in surgical performance scores (P<.001), in that surgeons outperformed residents, who in turn outperformed students.


CONCLUSIONS
Among novices, visual-spatial ability is associated with skilled performance on a spatially complex surgical procedure. However, advanced trainees and experts do not score any higher on carefully selected visual-spatial tests, suggesting that practice and surgical experience may supplant the influence of visual-spatial ability over time. Thus, the use of these tests for the selection of residents is not currently recommended; they may be of more use in identifying those novice trainees (ie, those with lower test scores) who might benefit most from brief supplementary instruction on specific technical tasks.
Wanzel
Kyle R
KR
Department of Surgery, Faculty of Medicine, University of Toronto, 100 College Street, Toronto, Ontario, Canada M5G 1L5.
Hamstra
Stanley J
SJ
Caminiti
Marco F
MF
Anastakis
Dimitri J
DJ
Grober
Ethan D
ED
Reznick
Richard K
RK
D002983:Clinical Competence; D006225:Hand / Q000502:physiology*; D006801:Humans; D007396:Internship and Residency; D009048:Motor Skills; D010560:Personnel Selection; D013028:Space Perception; D013514:Surgical Procedures, Operative; D014796:Visual Perception