Visuospatial ability factors and performance variables in laparoscopic simulator training

Visuospatial ability has been shown to be important to several aspects of laparoscopic performance, including simulator training. Only a limited subset of visuospatial ability factors however has been investigated in such studies. Tests for different visuospatial ability factors differ in stimulus complexity, in their emphasis on identifying visual stimuli in a cluttered context, and in the demands they make on speed of processing. To help clarify the involvement of visuospatial ability factors in laparoscopic performance the current study investigated the role of four such factors in laparoscopic simulator performance. Twenty four students participated in a two-month course, consisting of eight weekly, half-hour laparoscopic simulator training sessions. Before the start of this course four visuospatial ability factors were measured. Learning curves were based on the simulator performance variables of (task) Duration, Motion efficiency, and Damage. The visuospatial ability factor Visualization impacted Damage and Motion efficiency. The factor Spatial relations impacted Damage. Visuospatial ability factors measuring the ability to mentally manipulate complex to moderately complex stimuli are more important than other visuospatial ability factors during basic laparoscopic simulator training. A finding relevant to theories of skill development is that the impact of Visualization on learning curves for Damage and Motion efficiency was most evident during early- and late (but not middle) training, which may be an indicator of a switch between different phases of skills learning. Learning curves and repeated measures analyses indicated damage control should be emphasized in laparoscopic skills training.