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J Minim Invasive Gynecol. 2018 Feb 5. pii: S1553-4650(18)30106-7. doi: 10.1016/j.jmig.2018.01.031. [Epub ahead of print]

Visuospatial Aptitude Testing Differentially Predicts Simulated Surgical Skill.

Author information

1
Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: emhinchcliff@mdanderson.org.
2
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN.
3
Department of Obstetrics and Gynecology, Mayo Clinic, Jacksonville, FL.
4
Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
5
Harvard Medical School, Boston, MA; Department of General Surgery, Brigham and Women's Hospital, Boston, MA.

Abstract

OBJECTIVE:

To determine if visuospatial perception (VSP) testing is correlated to simulated or intraoperative surgical performance as rated by the American College of Graduate Medical Education (ACGME) milestones.

DESIGN:

Classification II-2 SETTING: Two academic training institutions PARTICIPANTS: 41 residents, including 19 Brigham and Women's Hospital and 22 Mayo Clinic residents from three different specialties (OBGYN, general surgery, urology).

INTERVENTION:

Participants underwent three different tests: visuospatial perception testing (VSP), Fundamentals of Laparoscopic Surgery (FLS®) peg transfer, and DaVinci robotic simulation peg transfer. Surgical grading from the ACGME milestones tool was obtained for each participant. Demographic and subject background information was also collected including specialty, year of training, prior experience with simulated skills, and surgical interest. Standard statistical analysis using Student's t test were performed, and correlations were determined using adjusted linear regression models.

MEASUREMENTS AND MAIN RESULTS:

In univariate analysis, BWH and Mayo training programs differed in both times and overall scores for both FLS® peg transfer and DaVinci robotic simulation peg transfer (p<0.05 for all). Additionally, type of residency training impacted time and overall score on robotic peg transfer. Familiarity with tasks correlated with higher score and faster task completion (p= 0.05 for all except VSP score). There was no difference in VSP scores by program, specialty, or year of training. In adjusted linear regression modeling, VSP testing was correlated only to robotic peg transfer skills (average time p=0.006, overall score p=0.001). Milestones did not correlate to either VSP or surgical simulation testing.

CONCLUSIONS:

VSP score was correlated with robotic simulation skills but not with FLS skills or ACGME milestones. This suggests that the ability of VSP score to predict competence differs between tasks. Therefore, further investigation is required into aptitude testing, especially prior to its integration as an entry examination into a surgical subspecialty.

KEYWORDS:

simulation; surgical aptitude; visuospatial test

PMID:
29421248
DOI:
10.1016/j.jmig.2018.01.031
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