Effect of fine-motor-skill activities on surgical simulator performance.

PURPOSE: To determine the effect of fine motor activity and nondominant-hand training on cataract surgical simulator (Eyesi) performance. SETTING: Departments of Ophthalmology, University of Iowa, and Veterans Affairs Health Care Systems, Iowa City, Iowa, USA. DESIGN: Prospective controlled trial. METHODS: Medical students completed a questionnaire and baseline microsurgical dexterity evaluation using the following 3 surgical simulator tasks: navigation, forceps, and bimanual. Participants were randomized to control (16) or intervention (17) consisting of writing, completing a labyrinth, eating, and brushing teeth once per day with their nondominant hand. Participants returned 4 weeks after baseline evaluation for follow-up simulator testing. RESULTS: Of the 33 students, regular video game players had greater baseline scores than nonplayers on navigation (P = .021) and bimanual tasks (P = .089). All participants showed statistically significant improvements in all 3 tasks at follow-up after a single baseline evaluation on the surgical simulator (navigation: P = .004; forceps: P < .001; bimanual: P = .004). Nondominant-hand training with daily activities did not show statistically significant differences for dominant hands or nondominant hands. The intervention group (n = 17) trended toward greater improvement than the control group (n = 16) in navigation (14.78 versus 7.06; P = .445) and bimanual tasks (15.2 versus 6.0; P = .324) at follow-up. CONCLUSIONS: Regular video game play enhanced baseline microsurgical performance measured on the surgical simulator. Simulation performance improved significantly in the intervention group and control group after 1 session on the simulator. Although not statistically significant, training the nondominant hand with daily activities showed a trend toward improved navigation and bimanual performance.

Ophthalmoscopy using an eye simulator model.

BACKGROUND: Ophthalmoscopy is an important skill for the medical student to master. Students have difficulty visualising the retina, and are hesitant to practise with patients. Our study aim was to demonstrate that an eye simulation experience would be beneficial for developing ophthalmoscopy skills. DESIGN: This study was designed for second-year medical students who elected to participate. Students were observed and instructed on the correct use of the ophthalmoscope. Both normal and pathological retinas were used. The students matched what they observed with printed photographs to verify what they had actually seen. A pre- and post-session questionnaire, with comments, was completed. The study was conducted over 4 years. Three of the years were structured as outlined above. One year, the students used the simulator but without an instructor being present. Students were surveyed as senior medical students and asked to rate the value of the simulator experience for preparing them for their clinical years. RESULTS: A total of 64 per cent of the students elected to participate when a faculty member was present to instruct them, whereas only 12 per cent of the class elected for the experience without instruction. The self-rating results from the pre- versus post-session questionnaire showed statistically significant improvement for all items. Student comments reflected that they felt strongly that the experience was valuable to them. CONCLUSIONS: This simulation ophthalmoscopy experience was valuable for increasing confidence and skill. This experience is most valued when an instructor is present. The simulator experience was valuable to students as they applied their ophthalmoscopy skills clinically.