Video game experience affects performance, cognitive load, and brain activity in laparoscopic surgery training

BACKGROUND Video games can be a valuable tool for surgery training. Individuals who interact or play video games, tend to have a better visuospatial ability when compared to non-gamers. Numerous studies suggest that video game experience is associated with faster acquisition, greater sharpening, and longer retention of laparoscopic skills. Given the neurocognitive complexity of surgery skill, multimodal approaches are required to understand how video game playing enhances laparoscopy skill. METHODS Data from thirteen surgeons with varying levels of laparoscopy experience and no video game experience, and 27 students with no laparoscopy experience and varying levels of video game experience performed standard laparoscopic training tasks. Their performance, subjective cognitive loading, and prefrontal cortical activity were recorded and analyzed. RESULTS The surgeons performed the tasks significantly faster, had significantly lower cognitive load as well as less left prefrontal activation, relative to the non-gamer novices. In gamer novices, the task completion time decreased significantly with increasing game experience. The cognitive load decreased significantly with increasing gaming experience in gamer novices and with laparoscopy experience in surgeons. CONCLUSION Our results suggest that along the dimensions of performance, cognitive load, and brain activity, the effects of video gaming experience on novice laparoscopy trainees are similar to those of real-world laparoscopy experience on surgeons. We believe that the neural underpinnings of surgery skill and its links with gaming experience need to be investigated further using wearable functional brain imaging.