Effect of fine-motor-skill activities on surgical simulator performance

Abstract

To determine the effect of fine motor activity and nondominant-hand training on cataract surgical simulator (Eyesi) performance. Departments of Ophthalmology, University of Iowa, and Veterans Affairs Health Care Systems, Iowa City, Iowa, USA. Prospective controlled trial. Medical students completed a questionnaire and baseline microsurgical dexterity evaluation using the following 3 surgical simulator tasks: navigation, forceps, and bimanual. Participants were randomized to control (16) or intervention (17) consisting of writing, completing a labyrinth, eating, and brushing teeth once per day with their nondominant hand. Participants returned 4weeks after baseline evaluation for follow-up simulator testing. Of the 33 students, regular video game players had greater baseline scores than nonplayers on navigation (P=.021) and bimanual tasks (P=.089). All participants showed statistically significant improvements in all 3 tasks at follow-up after a single baseline evaluation on the surgical simulator (navigation: P=.004; forceps: P<.001; bimanual: P=.004). Nondominant-hand training with daily activities did not show statistically significant differences for dominant hands or nondominant hands. The intervention group (n=17) trended toward greater improvement than the control group (n=16) in navigation (14.78 versus 7.06; P=.445) and bimanual tasks (15.2 versus 6.0; P=.324) at follow-up. Regular video game play enhanced baseline microsurgical performance measured on the surgical simulator. Simulation performance improved significantly in the intervention group and control group after 1 session on the simulator. Although not statistically significant, training the nondominant hand with daily activities showed a trend toward improved navigation and bimanual performance.