Positive trend between video game warm-up and surgical simulation performance

Surgery is a skill-dependent practice. Surgeons may benefit from the use of video games as they rely highly on hand–eye coordination. Ophthalmology surgery is one such discipline that requires a high degree of depth perception, precise hand–eye coordination and higher order of visual-spatial skills that are essentially obtained during residency training. Cataract surgery is the most common ophthalmic surgery performed and proficiency in cataract extraction is a critical part of residency training given an aging population. The use of surgical simulators is a frequent means of resident training and has been shown to improve intraoperative performance. Within ophthalmology, the Eyesi Surgical simulator has gained popularity and has been validated as an effective surgical training tool, even as effective as wet lab training. The Eyesi equips residents with basic surgical techniques while reducing surgeon anxiety, surgeon fatigue, and errors in the operating room, thereby improving patient safety.

While there is evidence of the benefits of long-term video game use, there is little reported evidence of short term or warm-up video game use. This pilot study by Khimani et al primarily evaluated the effects of video game warm-up on Eyesi Ophthalmic Surgical Simulator performance. Secondary objectives included evaluation of prior video game or musical instrument experience on surgical simulator performance.

Twenty medical students with no prior surgical simulation experience were recruited for the study. Information regarding prior video game experience was gathered, and half of the participants were then randomly assigned to play a video game session prior to Eyesi performance. All subjects completed three sets of Eyesi modules, and the scores and time to completion were recorded.

The warm-up group scored higher in Navigation, Bimanual, and Forceps modules (33.6, 39.7, 7.2, respectively) compared to non-warm-up group (27.3, 27.3, 3.6, respectively). In addition, average times (sec) were lower (310.5, 117.4, 229.2, respectively) compared to non-warm-up group (321.9, 163.3, 235.8, respectively). It was also observed that significantly more participants in the warm-up group had reported a history of spending >15 hours per week playing video games compared to the non-warm-up group (80% vs 20%, p=0.0402).

This pilot study evaluated the effects of preoperative video game warm-up on performance on the Eyesi Ophthalmic Surgical Simulator. The study found a trend showing participants in the video game warm-up group with higher scores and less completion time for all three modules (Navigation, Bimanual, and Forceps) on the Eyesi simulator. Since no significant difference was observed between the two groups, it cannot be reliably concluded that video game warm-up improves Eyesi simulation performance.

Although the results of the study were not statistically significant due to low power, a positive trend was found which can be considered consistent with prior studies reporting enhanced simulator performance in the context of prior video game experience. The positive trend can also be explained by a greater collective video game experience within the warm-up group, which introduced an important confounding. Other explanations include mechanical factors (increased flexibility and grip strength after playing video games) and feeling more relaxed after the video game warm-up. However, the technical skills of laparoscopic simulation differ from microsurgical ophthalmic simulation and may not be completely comparable. No prior studies have evaluated the effects of video game experience on ophthalmic surgical training specifically. Future studies with more participants as well as longer trial periods could be beneficial in providing more significant results.

Source: Khimani et al; Clinical Ophthalmology 2022:16

https://doi.org/10.2147/OPTH.S369697