Three-dimensional microscope skill acquisition: A randomised controlled study comparing two-dimensional laboratory microscope training, video gaming and virtual reality gaming

Abstract

IntroductionFine microsurgical motor skill acquisition can be challenging. With increasing technological innovation the method of microsurgical skills acquisition may change. Studies show that laboratory-based microsurgical training programs on a 2D microscope significantly improves novice’s microsurgical skill acquisition. However, are these skills transferable to a 3D microscope or is gaming agility more important? We present a randomised control trial of three interventions, namely laboratory tabletop microscope training (LM), high-fidelity video gaming (Sony PlayStation 4 console) (VG) and high-fidelity virtual reality gaming (Sony PlayStation VR console) (VR) versus a control group. MethodsForty novice medical students were block randomised to four groups: control (no intervention) n=10, LM n=10, VG n=10 and VR n=10. Participants performed chicken femoral artery anastomosis using the Aesculap Aeos® 3D microscope platform at baseline and again after intervention. Performance was evaluated using a modified structured assessment of microsurgery skills (mSAMS) score, time taken to complete anastomosis and time for suture placement by two blinded independent assessors. ResultNo statistically significant difference was noted between the groups at baseline. There was a statistically significant improvement in the LM arm between baseline and post-training for mSAMS score and time for suture placement. In the VG, VR and control groups no statistically significant difference was observed. ConclusionOur study demonstrates that during early microsurgical training, an intense laboratory-based microsurgical training program significantly improves novice’s anastomotic performance on a 2D microscope, and these skills are transferable when a 3D anastomosis is carried out. However, focussed gaming had no significant effect, and the results were akin to the non-intervention group.