title: Does video gaming affect orthopaedic skills acquisition? A prospective cohort-study.
abstract: BACKGROUND
  Previous studies have suggested that there is a positive correlation between the extent of video gaming and efficiency of surgical skill acquisition on laparoscopic and endovascular surgical simulators amongst trainees. However, the link between video gaming and orthopaedic trauma simulation remains unexamined, in particular dynamic hip screw (DHS) stimulation.
  
  
  OBJECTIVE
  To assess effect of prior video gaming experience on virtual-reality (VR) haptic-enabled DHS simulator performance.
  
  
  METHODS
  38 medical students, naïve to VR surgical simulation, were recruited and stratified relative to their video gaming exposure. Group 1 (n = 19, video-gamers) were defined as those who play more than one hour per day in the last calendar year. Group 2 (n = 19, non-gamers) were defined as those who play video games less than one hour per calendar year. Both cohorts performed five attempts on completing a VR DHS procedure and repeated the task after a week. Metrics assessed included time taken for task, simulated flouroscopy time and screw position. Median and Bonett-Price 95% confidence intervals were calculated for seven real-time objective performance metrics. Data was confirmed as non-parametric by the Kolmogorov-Smirnov test. Analysis was performed using the Mann-Whitney U test for independent data whilst the Wilcoxon signed ranked test was used for paired data. A result was deemed significant when a two-tailed p-value was less than 0.05.
  
  
  RESULTS
  All 38 subjects completed the study. The groups were not significantly different at baseline. After ten attempts, there was no difference between Group 1 and Group 2 in any of the metrics tested. These included time taken for task, simulated fluoroscopy time, number of retries, tip-apex distance, percentage cut-out and global score.
  
  
  CONCLUSIONS
  Contrary to previous literature findings, there was no correlation between video gaming experience and gaining competency on a VR DHS simulator.
authors.affiliation: MSk Lab, Imperial College London, Charing Cross Hospital, London, United Kingdom.
authors.forename: Chetan
authors.initials: C
authors.lastname: Khatri
authors.affiliation: MSk Lab, Imperial College London, Charing Cross Hospital, London, United Kingdom.
authors.forename: Kapil
authors.initials: K
authors.lastname: Sugand
authors.affiliation: MSk Lab, Imperial College London, Charing Cross Hospital, London, United Kingdom.
authors.forename: Sharika
authors.initials: S
authors.lastname: Anjum
authors.affiliation: MSk Lab, Imperial College London, Charing Cross Hospital, London, United Kingdom.
authors.forename: Sayinthen
authors.initials: S
authors.lastname: Vivekanantham
authors.affiliation: MSk Lab, Imperial College London, Charing Cross Hospital, London, United Kingdom.
authors.forename: Kash
authors.initials: K
authors.lastname: Akhtar
authors.affiliation: MSk Lab, Imperial College London, Charing Cross Hospital, London, United Kingdom.
authors.forename: Chinmay
authors.initials: C
authors.lastname: Gupte
mesh_terms: D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D009985:Orthopedics / Q000193:education* / Q000592:standards*; D011446:Prospective Studies; D014584:User-Computer Interface; D018910:Video Games