title: Predictive value of background experiences and visual spatial ability testing on laparoscopic baseline performance among residents entering postgraduate surgical training.
abstract: BACKGROUND
  Emerging evidence suggests that despite dedicated practice, not all surgical trainees have the ability to reach technical competency in minimally invasive techniques. While selecting residents that have the ability to reach technical competence is important, evidence to guide the incorporation of technical ability into selection processes is limited. Therefore, the purpose of the present study was to evaluate whether background experiences and 2D-3D visual spatial test results are predictive of baseline laparoscopic skill for the novice surgical trainee.
  
  
  METHODS
  First-year residents were studied. Demographic data and background surgical and non-surgical experiences were obtained using a questionnaire. Visual spatial ability was evaluated using the PicSOr, cube comparison (CC) and card rotation (CR) tests. Technical skill was assessed using the camera navigation (LCN) task and laparoscopic circle cut (LCC) task. Resident performance on these technical tasks was compared and correlated with the questionnaire and visual spatial findings.
  
  
  RESULTS
  Previous experience in observing laparoscopic procedures was associated with significantly better LCN performance, and experience in navigating the laparoscopic camera was associated with significantly better LCC task results. Residents who scored higher on the CC test demonstrated a more accurate LCN path length score (r s(PL) = -0.36, p = 0.03) and angle path (r s(AP) = -0.426, p = 0.01) score when completing the LCN task. No other significant correlations were found between the visual spatial tests (PicSOr, CC or CR) and LCC performance.
  
  
  CONCLUSIONS
  While identifying selection tests for incoming surgical trainees that predict technical skill performance is appealing, the surrogate markers evaluated correlate with specific metrics of surgical performance related to a single task but do not appear to reliably predict technical performance of different laparoscopic tasks. Predicting the acquisition of technical skills will require the development of a series of evidence-based tests that measure a number of innate abilities as well as their inherent interactions.
authors.affiliation: University of Toronto, Toronto, ON, Canada. marisa.louridas@mail.utoronto.ca.|St. Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada. marisa.louridas@mail.utoronto.ca.
authors.forename: Marisa
authors.initials: M
authors.lastname: Louridas
authors.affiliation: Li Ka Shing Knowledge Institute, Toronto, ON, Canada.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Quinn
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Teodor P
authors.initials: TP
authors.lastname: Grantcharov
mesh_terms: D000328:Adult; D002170:Canada; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D010820:Physicians; D013647:Task Performance and Analysis
keywords: Laparoscopy; Surgical education; Technical skill; Visual spatial