Mental rotation ability predicts the acquisition of basic endovascular skills

Annegret Glathe,Niels A Taatgen,Peter Lanzer,Arno Villringer,Christopher J Steele,Katja I Paul,Fokie Cnossen

doi:10.1038/s41598-021-00587-x

Abstract

Due to the increasing complexity of diseases in the aging population and rapid progress in catheter-based technology, the demands on operators’ skills in conducting endovascular interventions (EI) has increased dramatically, putting more emphasis on training. However, it is not well understood which factors influence learning and performance. In the present study, we examined the ability of EI naïve medical students to acquire basic catheter skills and the role of pre-existing cognitive ability and manual dexterity in predicting performance. Nineteen medical students practised an internal carotid artery angiography during a three-day training on an endovascular simulator. Prior to the training they completed a battery of tests. Skill acquisition was assessed using quantitative and clinical performance measures; the outcome measures from the test battery were used to predict the learning rate. The quantitative metrics indicated that participants’ performance improved significantly across the training, but the clinical evaluation revealed that participants did not significantly improve on the more complex part of the procedure. Mental rotation ability (MRA) predicted quantitative, but not clinical performance. We suggest that MRA tests in combination with simulator sessions could be used to assess the trainee’s early competence level and tailor the training to individual needs.

Highlights

Since the introduction of endovascular interventions (EI) in the 1 960s1 and 1 970s2 they have become standard practice in cardiology and medicine[3] as they are far less invasive and far more versatile than open surgery
We examined whether pre-existing cognitive abilities and manual dexterity play a role in acquiring these skills
In order to gain insight into participants’ training-related improvement we evaluated performance quantitatively and clinically

Summary

Introduction

Since the introduction of endovascular interventions (EI) in the 1 960s1 and 1 970s2 they have become standard practice in cardiology and medicine[3] as they are far less invasive and far more versatile than open surgery. Knowledge of the extent to which EI performance depends on pre-existing ability, theorized here as primarily cognitive ability and manual dexterity, is expected to be important If such abilities provide an advantage in acquiring endovascular skill, testing for them could benefit the individual training needs of candidates for endovascular medicine. Earlier studies on minimally invasive procedures have found significant correlations between cognitive ability and manual dexterity tests and multiple simulator performance p arameters[9,10,11,12,13,14]. As minimally invasive procedures are complex spatial tasks that require coordinated use of imaging and that are often associated with challenging spatial dilemmas, such as the fulcrum effect or inferring 3D structures from 2D images[13], it is no surprise that tests of visual-spatial ability (VSA) predict performance ( see[4] for a systematic review). The authors concluded that dexterousness is crucial in laparoscopy, and that the mental rotation test used captured the VSA that is necessary to perform laparoscopy

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