Visuo-spatial ability in colonoscopy simulator training

Abstract

Visuo-spatial ability is associated with a quality of performance in a variety of surgical and medical skills. However, visuo-spatial ability is typically assessed using Visualization tests only, which led to an incomplete understanding of the involvement of visuo-spatial ability in these skills. To remedy this situation, the current study investigated the role of a broad range of visuo-spatial factors in colonoscopy simulator training. Fifteen medical trainees (no clinical experience in colonoscopy) participated in two psycho-metric test sessions to assess four visuo-spatial ability factors. Next, participants trained flexible endoscope manipulation, and navigation to the cecum on the GI Mentor II simulator, for four sessions within 1 week. Visualization, and to a lesser degree Spatial relations were the only visuo-spatial ability factors to correlate with colonoscopy simulator performance. Visualization additionally covaried with learning rate for time on task on both simulator tasks. High Visualization ability indicated faster exercise completion. Similar to other endoscopic procedures, performance in colonoscopy is positively associated with Visualization, a visuo-spatial ability factor characterized by the ability to mentally manipulate complex visuo-spatial stimuli. The complexity of the visuo-spatial mental transformations required to successfully perform colonoscopy is likely responsible for the challenging nature of this technique, and should inform training- and assessment design. Long term training studies, as well as studies investigating the nature of visuo-spatial complexity in this domain are needed to better understand the role of visuo-spatial ability in colonoscopy, and other endoscopic techniques.

Visuospatial ability factors and performance variables in laparoscopic simulator training

“…Correlations with surgical performance for this factor differ. Tests for this factor show positive correlations with surgical performance in some research (Gibbons, Baker, & Skinner, 1986;Steele, Walder, & Herbert, 1992) but not in others (Luursema et al, 2010;Schueneman et al, 1984). 5.…”

“…Visuospatial ability has been successfully linked to a variety of surgical and medical skills (an overview is published by Hegarty et al, 2007). Visuospatial ability is interesting over other cognitive abilities for two reasons: first, contrary to other cognitive ability factors, visuospatial ability has not been selected for during the academic phase of the medical curriculum, and thus may largely account for differences in performance in medical procedures with a spatial emphasis (Luursema, Buzink, Verwey, & Jakomiwicz, 2010); second, there is some evidence that whereas general cognitive ability is especially important during early learning, visuospatial ability remains important throughout training, due to non-automating task specific aspects of laparoscopic tasks (Keehner et al, 2006).…”

“…The relationship between Visualization and surgical performance is relatively well charted, and positive (e.g. Hedman et al, 2006;Keehner et al, 2006;Luursema et al, 2010;Risucci, Geiss, Gellman, Pinard, & Rosser, 2001;Schueneman, Pickleman, Hesslein, & Freeark, 1984;Wanzel et al, 2003). 2.…”

The role of cognitive abilities in laparoscopic simulator training

“…The constraints of MIS place a higher demand on a surgeon's perceptual and visuo-spatial abilities to control the instruments appropriately, increasing the learning curve needed to practice safe and efficient MIS (Department of Health, 2011). A surgeon's cognitive aptitude, including perceptual and visuo-spatial abilities, is related to the learning curve for MIS Luursema et al, 2010).…”

“…Assessment of these abilities could help to predict individual learning curves for MIS Luursema et al, 2010) and to design individualized training programs.…”