Background

The lack of depth cues and haptic feedback makes minimally invasive surgery a cognitive challenge. It is therefore important to know which individuals are expected to perform well in minimally invasive surgery. In cognitive psychology, methods are available with which one can measure different cognitive thinking styles. It is well known that these cognitive styles correlate with many different tasks. We investigated whether this method can also predict performance on a box trainer (Lübeck Toolbox^®), a device for training laparoscopic surgery. If so, the method might help to select and train those people who will most likely develop high skills in minimally invasive surgery.

Methods

Thirty medical students and thirty non-medical students performed five laparoscopic surgical tasks on a box trainer. We measured the time required and the errors participants made on each task. Their cognitive style was measured with a method from cognitive psychology that distinguishes between people who think visually, spatially, or verbally. Furthermore, all students completed a subset of a standard intelligence test (Wechsler Adult Intelligence Scale) and three subtests of the German Medical University Admission Test (TMS).

Results

Participants with spatial thinking styles performed best on the box trainer. Visual and verbal cognitive styles impeded box trainer performance. Performance on the box trainer could also be predicted by the TMS and IQ scores.

Conclusions

The study shows for the first time that a standard method from cognitive psychology can be used to distinguish between different cognitive styles in surgical education and that these different cognitive styles affect performance on a box trainer. Since the correlation between box trainer performance and surgical proficiency is well documented, the method might be an efficient way to reduce errors and to elevate patient safety in laparoscopic surgery.

中文翻译：

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不同的认知方式会影响腹腔镜手术技能培训的表现

背景

缺乏深度提示和触觉反馈使微创手术成为认知挑战。因此，重要的是要知道哪些人有望在微创手术中表现良好。在认知心理学中，可以使用一种方法来衡量不同的认知思维方式。众所周知，这些认知方式与许多不同的任务相关。我们研究这个方法是否也可以预测在一个盒子教练（吕贝克工具箱性能^®），用于训练腹腔镜手术的设备。如果是这样，该方法可能有助于选择和培训那些最有可能在微创手术中发展高技能的人。

方法

30名医学生和30名非医学生在盒装教练机上执行了五项腹腔镜手术任务。我们测量了所需的时间以及参与者在每个任务上所犯的错误。他们的认知风格是通过认知心理学中的一种方法进行测量的，该方法可以区分视觉，空间或口头思考的人。此外，所有学生都完成了标准智力测验（韦氏成人智力测验）的子集和德国医科大学入学考试（TMS）的三个子测验。

结果

具有空间思维风格的参与者在盒装教练上表现最佳。视觉和言语的认知方式阻碍了拳击教练的表现。箱式教练机上的表现也可以通过TMS和IQ分数来预测。

结论

该研究首次表明，可以采用认知心理学的标准方法来区分外科手术教育中的不同认知方式，并且这些不同的认知方式会影响盒式教练机的性能。由于箱式教练机性能和手术熟练程度之间的相关性已得到充分证明，因此该方法可能是减少错误并提高腹腔镜手术患者安全性的有效方法。