Fine Motor Skills Task Experience and Laparoscopic Vaginal Cuff Suturing Performance after Training with Two Laparoscopic Simulators

Abstract

Study Objective To determine if prior video gaming or fine motor skills task experience was associated with improved performance on a vaginal cuff suturing task following training with two laparoscopic simulators. Design Randomized controlled trial incorporating block randomization and a masked design. Setting Participants were trained and tested during a four-hour session in the Northwestern Center for Advanced Surgical Education simulation lab. Patients or Participants 45 surgically naive premedical and preclinical medical students were recruited from June-November 2019. Interventions Participants were randomized into two laparoscopic simulator groups – Essentials in Minimally Invasive Gynecology or Fundamentals of Laparoscopic Surgery – then underwent training on relevant simulation tasks for 2.5 hours. Measurements and Main Results Demographic information was collected for all participants, including fine motor skills task and video gaming experience. Participants completed a video-recorded pre-test and post-test on a laparoscopic vaginal cuff suturing model. Videos were masked then graded using a modified version of the Global Operative Assessment of Laparoscopic Skills (GOALS) tool by high-volume minimally invasive gynecologic surgeons. Two sample t-tests with unequal variances were employed to compare GOALS scores. Significant differences were noted in baseline pre-test composite GOALS scores for participants with prior experience playing instruments (diff=2.7, p=0.007), sewing (diff=2.3, p=0.03) and completing artistic tasks (diff=3.05, p=0.01). However, the mean difference between post- and pre-test composite GOALS scores was not different for participants with prior video gaming or fine motor skills task experience. Conclusion Participants with prior fine motor skills task experience performed better at baseline on the pre-test vaginal cuff model. However, after training, these same participants did not perform better when compared to those without prior fine motor task skill experience, regardless of simulation group. These results suggest that prior fine motor skills task experience may not predispose surgically naive learners to improved performance with certain laparoscopic simulation tasks.