Perceptual Speed and Psychomotor Ability Predict Laparoscopic Skill Acquisition on a Simulator.
OBJECTIVE
Performing minimally invasive surgery puts high demands on a surgeon's cognitive and psychomotor abilities. Assessment of these abilities can be used to predict a surgeon's learning curve, to create individualized training programs, and ultimately in selection programs for surgical training. The aim of this study was to examine the influence of cognitive and psychomotor ability on the training duration and learning rate.


METHODS
A prospective quasiexperimental field study regarding the influence of cognitive and psychomotor ability, baseline measures of time to complete task, damage to tissue, and efficiency of movement, age, and gender on the number of sessions needed to reach a predefined performance level on a laparoscopy simulator. The same variables were investigated as predictors of the learning rate.


METHODS
The study was performed at the Experimental Center for Technical Medicine at the University of Twente, The Netherlands.


METHODS
In all, 98 novices from the Master program of Technical Medicine followed a proficiency-based basic laparoscopic skills training.


RESULTS
Perceptual speed (PS) predicted training duration (hazard ratio = 1.578; 95% CI = 1.084, 2.300; p = 0.017). Cognitive (b = -0.721, p = 0.014) and psychomotor ability (b = 0.182, p = 0.009) predicted the learning rate of time to complete the task. Also, the learning rate for participants with higher levels of PS was lower (b = 0.167, p = 0.036). Psychomotor ability also predicted the learning rate for damage to tissue (b = 0.194, p = 0.015) and efficiency of movement (b = 0.229, p = 0.004). Participants with better psychomotor ability outperformed other participants across all sessions on all outcome measures.


CONCLUSIONS
PS predicted training duration in a basic laparoscopic skills training and the learning rate for the time to complete the task. Psychomotor ability predicted the learning rate for laparoscopic skill acquisition in terms of time to complete task, damage to tissue, and efficiency of movements. These results indicate early automation of basic laparoscopic skill. Careful selection of the cognitive abilities tests is advised for use in training programs and to identify individuals who need more training.
Department of Technical Medicine, University of Twente, Enschede, The Netherlands. Electronic address: m.groenier@utwente.nl.
Marleen
M
Groenier
Department of General Practice, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Klaas H
KH
Groenier
Department of Technical Medicine, University of Twente, Enschede, The Netherlands.
Heleen A T
HA
Miedema
Department of Technical Medicine, University of Twente, Enschede, The Netherlands; Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands.
Ivo A M J
IA
Broeders
D002983:Clinical Competence; D003071:Cognition; D005260:Female; D005544:Forecasting; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D008297:Male; D011446:Prospective Studies; D011597:Psychomotor Performance; D000066908:Simulation Training; D055815:Young Adult
Practice-Based Learning and Improvement; aptitude; laparoscopy; learning curve; psychomotor performance