title: Prior video game exposure does not enhance robotic surgical performance.
abstract: OBJECTIVE
  Prior research has demonstrated that counterintuitive laparoscopic surgical skills are enhanced by experience with video games. A similar relation with robotic surgical skills has not been tested. The purpose of this study was to determine whether prior video-game experience enhances the acquisition of robotic surgical skills.
  
  
  METHODS
  A series of 242 preclinical medical students completed a self-reported video-game questionnaire detailing the frequency, duration, and peak playing time. The 10 students with the highest and lowest video-game exposure completed a follow-up questionnaire further quantifying video game, sports, musical instrument, and craft and hobby exposure. Each subject viewed a training video demonstrating the use of the da Vinci surgical robot in tying knots, followed by 3 minutes of proctored practice time. Subjects then tied knots for 5 minutes while an independent blinded observer recorded the number of knots tied, missed knots, frayed sutures, broken sutures, and mechanical errors.
  
  
  RESULTS
  The mean playing time for the 10 game players was 15,136 total hours (range 5,840-30,000 hours). Video-game players tied fewer knots than nonplayers (5.8 v 9.0; P = 0.04). Subjects who had played sports for at least 4 years had fewer mechanical errors (P = 0.04), broke fewer sutures (P = 0.01), and committed fewer total errors (P = 0.01). Similarly, those playing musical instruments longer than 5 years missed fewer knots (P = 0.05).
  
  
  CONCLUSIONS
  In the extremes of video-game experience tested in this study, game playing was inversely correlated with the ability to learn robotic suturing. This study suggests that advanced surgical skills such as robotic suturing may be learned more quickly by athletes and musicians. Prior extensive video-game exposure had a negative impact on robotic performance.
authors.affiliation: Division of Urology, Loma Linda University Medical Center, Loma Linda, California 92354, USA.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Harper
authors.forename: Stefan
authors.initials: S
authors.lastname: Kaiser
authors.forename: Kamyar
authors.initials: K
authors.lastname: Ebrahimi
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Lamberton
authors.forename: H Roger
authors.initials: HR
authors.lastname: Hadley
authors.forename: Herbert C
authors.initials: HC
authors.lastname: Ruckle
authors.forename: D Duane
authors.initials: DD
authors.lastname: Baldwin
mesh_terms: D002983:Clinical Competence; D006801:Humans; D012371:Robotics / Q000379:methods*; D013337:Students, Medical; D013514:Surgical Procedures, Operative / Q000379:methods*; D011795:Surveys and Questionnaires; D013537:Sutures / Q000706:statistics & numerical data; D018910:Video Games / Q000523:psychology*