The Effect of Video Games on Laparoscopic Skills: A Prospective Randomized Controlled Trial and Quality Improvement Project

Study Objective

To compare medical students’ performance on LapMentor^TM skills tests with and without the use of a video game warmup with different controllers and to determine the effect of a video game on the frequency of simulator use in OB/GYN residents.

Design

Prospective RCT combined with a QI project.

Setting

Department of OB/GYN at Creighton University School of Medicine.

Patients or Participants

Medical students and OB/GYN residents.

Interventions

First, students were randomized into groups: Group 1 (warm-up with Underground^TM game using standard WiiU^TM video game controller), Group 2 (warm-up with Underground^TM game using custom-made laparoscopic controller), and Group 3 (no warm-up). Students completed a pretest and posttest on a validated laparoscopic simulator (LapMentor^TM) according to their assigned group. Next, a pre-test questionnaire on the use of simulators for laparoscopic skills was given to OB/GYN residents. They completed a post-test questionnaire after being provided with a WiiU^TM videogame system that included a custom controller and Underground^TM video game.

Measurements and Main Results

Two analyses were performed for the first part of the project: ANCOVA, which used data from the pretest and posttest, and the mixed model, which included participants who did not return for the posttest. Subgroup analysis was conducted on all participants and only those who completed every LapMentor^TM task. A statistically significant (p<0.001) decrease from pretest to posttest was constant across groups, regardless of analysis, with no between-group differences at time of pretest and posttest. For the second part of the project, there was a statistically significant increase in laparoscopic simulator use after providing residents with a WiiU^TM video game system as compared to prior (p=0.027).

Conclusion

The use of a video game warm-up is associated with faster completion of laparoscopic skills tests in medical students regardless of controller type. Additionally, providing OB/GYN residents with access to the Underground^TM video game is associated with increased use of the laparoscopic simulator.