title: Objective assessment of visuospatial and psychomotor ability and flow of residents and senior endoscopists in simulated gastroscopy.
abstract: BACKGROUND
  Advanced medical simulators have predominantly been used to shorten the learning curve of endoscopy for medical students and young residents. Rarely have the effects of visuospatial ability and attitudes of intermediately experienced and experienced specialists been studied with regard to simulator training. The aim of this study was to assess the effects of visuospatial ability and attitude on performance in simulator training.
  
  
  METHODS
  Eighteen surgical residents were included in the study. Prior to the simulated gastroscopy task, they performed a visuospatial test (the card rotation test). After the simulated gastroscopy task, they completed a questionnaire regarding flow experiences. Their results were compared with those of 11 expert endoscopists who performed the same tests.
  
  
  RESULTS
  Total gastroscopy time was significantly shorter for the expert endoscopists compared to residents (2 min 11 sec, p = 0.003). There was also a trend of more mucosa inspected (p = 0.088) and higher efficiency of screening (p = 0.069) by the experts. The residents made fewer errors in the card rotation test than the expert endoscopists (2.5 +/- 0.8 vs 5.5 +/- 1.2, respectively; p = 0.034), and their visuospatial card rotation test results correlated better with their performance in the simulated gastroscopy.
  
  
  CONCLUSIONS
  A virtual gastroscopy task presents more of an emotional as well as a psychomotoric challenge to intermediately experienced endoscopists than to senior experts. Our study demonstrates that these differences can be objectively assessed by the use of visuospatial ability tests, flowsheets, and an endoscopic simulator.
authors.affiliation: Department of Clinical Science Intervention and Technology, Division of Surgery, Karolinska Institutet and Center for Advanced Medical Simulation at Karolinska University Hospital Huddinge, Stockholm, Sweden. Lars.Enochsson@karolinska.se
authors.forename: L
authors.initials: L
authors.lastname: Enochsson
authors.forename: B
authors.initials: B
authors.lastname: Westman
authors.forename: E M
authors.initials: EM
authors.lastname: Ritter
authors.forename: L
authors.initials: L
authors.lastname: Hedman
authors.forename: A
authors.initials: A
authors.lastname: Kjellin
authors.forename: T
authors.initials: T
authors.lastname: Wredmark
authors.forename: L
authors.initials: L
authors.lastname: Felländer-Tsai
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003198:Computer Simulation; D004724:Endoscopy / Q000193:education*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011597:Psychomotor Performance; D012985:Software Design; D013028:Space Perception; D013997:Time Factors; D014584:User-Computer Interface; D014796:Visual Perception