THE ROLE OF VISUAL-SPATIAL ABILITY AND WORKING MEMORY IN IMAGE GUIDED SIMULATOR PERFORMANCE

Abstract: Numerous studies have analyzed the critical factors for training in surgical endoscopy to ensure high performance and increased patient safety. There are, however, surprisingly few studies that focus on the role of cognitive abilities, especially considering the fact that an estimated 50% of allmedical errors that lead to permanent disability and death are the result of cognitive failures (Gawande, Zinner, Studdert & Biennen, 2003). This thesis provides initial outlines of two cognitive abilities that may underlie endoscopic simulator performance. In study 1 we addressed how high-level visual-spatial ability of surgical novices is related to performance of two simulatortasks with and without anatomical graphics and haptic feedback, differing in visual-spatial complexity. In study 2 we investigated whether visual and verbal working memory are related to the outcome of task performance scores in simulated laparoscopic cholecystectomy and gastroscopy training. Taken together, the results suggest that visual-spatial ability and working memory are significantly related to endoscopic simulator performance scores and that anincreased cognitive workload enhances the individual differences found. These findings can be used to better implement endoscopic surgical curriculum since novice trainees can be identified early and they might benefit from supplementary education in specific surgical tasks.