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Surgical Endoscopy
Published in: Surgical Endoscopy 12/2011

Open Access 01-12-2011

Gaze training enhances laparoscopic technical skill acquisition and multi-tasking performance: a randomized, controlled study

Authors: Mark R. Wilson, Samuel J. Vine, Elizabeth Bright, Rich S. W. Masters, David Defriend, John S. McGrath

Published in: Surgical Endoscopy | Issue 12/2011

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Abstract

Background

The operating room environment is replete with stressors and distractions that increase the attention demands of what are already complex psychomotor procedures. Contemporary research in other fields (e.g., sport) has revealed that gaze training interventions may support the development of robust movement skills. This current study was designed to examine the utility of gaze training for technical laparoscopic skills and to test performance under multitasking conditions.

Methods

Thirty medical trainees with no laparoscopic experience were divided randomly into one of three treatment groups: gaze trained (GAZE), movement trained (MOVE), and discovery learning/control (DISCOVERY). Participants were fitted with a Mobile Eye gaze registration system, which measures eye-line of gaze at 25 Hz. Training consisted of ten repetitions of the “eye-hand coordination” task from the LAP Mentor VR laparoscopic surgical simulator while receiving instruction and video feedback (specific to each treatment condition). After training, all participants completed a control test (designed to assess learning) and a multitasking transfer test, in which they completed the procedure while performing a concurrent tone counting task.

Results

Not only did the GAZE group learn more quickly than the MOVE and DISCOVERY groups (faster completion times in the control test), but the performance difference was even more pronounced when multitasking. Differences in gaze control (target locking fixations), rather than tool movement measures (tool path length), underpinned this performance advantage for GAZE training.

Conclusions

These results suggest that although the GAZE intervention focused on training gaze behavior only, there were indirect benefits for movement behaviors and performance efficiency. Additionally, focusing on a single external target when learning, rather than on complex movement patterns, may have freed-up attentional resources that could be applied to concurrent cognitive tasks.
Footnotes
1
We originally ran a mixed design 3 (group) × 3 (condition) ANOVA, but were persuaded to simplify the analysis procedure by a reviewer. Note that similar effects were shown in both analyses, although we now cannot compare changes over time for each group using the one-way ANOVA.
 
2
Note that while we only report total path length data, the other tool control measures from the LapMentor software suite (Number of movements and Economy of movement), provided similar non-significant effects (all p’s > .600) across the three conditions.
 
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Metadata
Title
Gaze training enhances laparoscopic technical skill acquisition and multi-tasking performance: a randomized, controlled study
Authors
Mark R. Wilson
Samuel J. Vine
Elizabeth Bright
Rich S. W. Masters
David Defriend
John S. McGrath
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 12/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-1802-2

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