Gamers: Harder, Better, Faster, Stronger

Article, Katelyn Procci No Comments

Katelyn Procci | December 21, 2012

All of those hours spent with a controller in your hand might make you better suited for learning certain tasks in the medical profession. Last Month, Wired UK published an article in which they reported on a study by Dr. Sami Kilic from the University of Texas Medical Branch, in which he and his colleagues found that gamers may learn how to perform robotically-assisted surgery faster than their non-gamer peers.

Robotic surgery is minimally-invasive. Rather than creating large incisions to allow a surgeon to manually manipulate tools, smaller incisions are used to insert devices that are operated by the surgeon, often remotely. Depending on the surgery, this means that the surgeon could be using anything from very long handles or facsimile tools to joysticks, often in conjunction to some sort of viewing apparatus, to get the job done. The da Vinci Surgical System is one example of how robots can be used to assist surgery. A surgeon looks into a viewing device and uses the controls at his station, while the robotic arms, guided by others, perform the surgery based on the surgeon’s inputs.

da Vinci Surgical System
the da Vinci Surgical System from Intuitive Surgical

Kilic and colleagues’ study pitted US high school and college students against residents studying surgery. Both groups completed a series of tasks in a da Vinci Surgical System training simulator. Those high school students that spent at least 2 hours a day gaming, and those college students that spent at least 4 hours a day gaming, were just as surgically-adept as the residents, sometimes more-so. When the simulated task was switched to non-robotically-assisted surgery, a task that requires surgical skill and knowledge rather than hand-eye coordination and control, the residents easily outperformed the high school and college students.

The robotically-assisted laparoscopic surgical simulator featured several training exercises (which you’ll see in the video below are more like minigames to learn how to use the controls) before the actual test of skill in a simulated laparoscopic surgery. It may be that those who play games around 2 hours a day are able to pick up on this training faster than others due to their gaming experience. As suggested below, having residents play games for 2 hours a day may help train the skills needed to more easily master robotic surgery.


So does being a gamer actually give you improved hand-eye coordination and fine motor skills, which in turn gives you an edge when learning a task such as robotically-assisted surgery? Maybe.

It’s difficult to dig into this study. According to a press release, the findings were presented at the American Gynecologic Laparoscopists’ 41st Annual Global Congress on Minimally Invasive Gynecology in Las Vegas this past November, but I can’t find a way to actually read the paper itself (it might have only been a presentation). I am only able to rely on press releases, YouTube videos, and pop psychology articles to give you this information. But still, there is a history in the literature of similar findings related to motor skill acquisition for tasks specific to this type of surgery and gamers.

PC gamers are faster at completing tasks in surgical simulators. In a study of individual differences, (e.g., gender, visuospatial skills, and gaming experience) on performance in a virtual endoscopy training simulator, PC gamers were found to be better at one of the skills tested and completed the virtual endoscopy tasks nearly a minute and a half faster than non-gamers [1].

Experience with gaming positively correlates with laparoscopic surgical skill. This study was conducted in a sample of 33 surgeon and included both experienced attending physicians (average number of laparoscopic surgeries under their belts = 239) and learning residents (average number of surgeries = 46). Surgeons who were classified as game players, whether they had played in the past or were still active gamers, made fewer errors and completed training tasks in the simulator in less time than those who did not play games at all. As a side note, those who played in the past had slightly fewer errors than those who were current players. Still, it seems that those with gaming experience, regardless of when, were able to train faster and better than those without [2].

Gamers reach proficiency faster in training simulators. Surgeons who were classified as gamers were compared to non-gamers in a laparoscopic surgery training simulator. Their time to meet benchmark proficiency in the simulator was recorded. Gamers were able to become proficient in the simulator on training tasks faster than non-gamers. Even more interesting was that female non-gamers performed worse than male non-gamers, however there was no difference between genders in gamers. Perhaps gaming experience not only reduces the time to reach proficiency in laparoscopy training simulators, but it also may mitigate some sort of gender-based training effect [3].

Training with games first can improve performance during training on laparoscopic training simulators. A sample of medical students that had never trained on a virtual reality-based endoscopy training simulator completed training and surgical procedures as a baseline assessment in two different laparoscopic training simulators. Then they were either assigned to only play Half-Life, to only play Chessmaster, or to not play games at all. Previous gaming experience was distributed evenly throughout all three groups and it was not a variable of interest in this study. Those in the game-playing conditions had to play their game between 30 and 60 minutes a day, five days a week, for five consecutive weeks. After this training period, the medical students once again used two laparoscopic training simulators. They all received verbal instruction, followed by a 45-minute familiarization period, before completing procedures within the simulation. In one of the simulators, both groups who played games had improvement over their baseline performance compared to those that did not play games (they did not improve at all). In the second simulator test, only those in the Half-Life group improved, while those in the Chessmaster and control group did not. So, regardless of previous experience, there was a slight increase in performance during training for those who played games, with Half-Life potentially having an edge over Chessmaster [4].

While a single study is never a definitive statement, there may be something to the idea that being a gamer does potentially give learners an edge in surgical training simulators in that they are able to complete training tasks faster and better than their non-gamer peers. Furthermore, simply training with games may be an effective way to prepare learners to use these simulators. More research is needed to replicate current findings (especially in larger samples), to clarify the role of previous gaming experience in reducing time to train, and to determine the return-on-investment for a game-playing pre-training intervention. Lastly, longitudinal studies that control for previous gaming experience (as well as potentially manipulate game pre-training) that measure not only performance during training in the simulator but track actual patient outcomes from surgeries would also be helpful in determining if gaming not only results in faster training, but also better surgeons. A researcher’s work is never over.


1. Enochsson, L., Isaksson, B., Tour, R., Kjellin, A., Hedman, L., Wredmark, T., & Tsai-Fellander, L. (2004). Visuospatial skills and computer game experience influence the performance of virtual endoscopy. Journal of Gastrointestinal Surgery, 8(7), 874-880.

2. Rosser, J. C., Lynch, P. J., Cuddihy, L., Gentile, D. A., Klonsky, J., & Merrell, R. (2007). The impact of video games on training surgeons in the 21st century. Archives of Surgery, 142, 181-186.

3. Shane, M. D., Pettitt, B. J., Morgenthal, C. B., & Smith, C. D. (2008). Should surgical novices trade their retractors for joysticks? Videogame experience decreases the time needed to acquire surgical skills. Surgical Endoscopy, 22(5), 1294-1297.

4. Schlickum, M. K., Hedman, L., Enochsson, L., Kjellin, A., & Fellander-Tasi, L. (2009). Systematic video game training in surgical novices improves performance in virtual reality endoscopic surgical simulators: A prospective randomized study. World Journal of Surgery, 33(11), 2360-2367.

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