In the current study, we could not demonstrate significant superior baseline psychomotor skills for endoscopic surgery in schoolchildren with extensive videogame experience, although there was a trend toward better performance.
Videogame experience did correlate with better psychomotor scores at adult age in a group of interns. Interns with videogame experience had higher overall scores and performed better on the efficiency and speed-related scores. For total scores, efficiency and speed children with experience attained equal scores as adults without.
These results are consistent with previous investigations regarding videogame experience in adults [13
]. Rosser et al. showed that videogame players (residents and surgeons) had better overall scores, were faster, and made fewer errors in the Rosser Top Gun Laparoscopic Skills and Suturing Program (Top Gun) [17
]. They also found a correlation between higher scores in videogames and higher scores in the Top Gun program. Moreover, Rosenberg et al. also demonstrated a relationship between videogame performance and time-related scores in laparoscopic skills [16
Kolga Schlickum et al. and Enochsson et al. also showed a transfer of skills when training with challenging visual-spatially videogames [12
]. Grantcharov et al. did show a correlation, but videogame experience was associated with less errors only and no difference was shown in terms of time or unnecessary movement scores [13
Fewer studies are in contrast to our results. Madan et al. reported that videogame experience and other nonsurgical skills were not associated with better performance in baseline endoscopic skills [15
]. Sharma et al. concluded that, although even psychologists report a relationship between videogame experience and laparoscopic skills, larger studies are needed before video gaming could be accepted as good practice [23
This study found a statistically significant difference in scores between men and women on a VR trainer. In this group, 18 participants were included, of which only 7 were men. Due to this small sample size, no firm conclusions could be made from this result. Grantcharov et al. [13
], as well as our results, showed no difference in overall performance between men and women and, therefore, we suggest that gender is not contributing to differences in endoscopic surgical skills.
Theoretically, a difference in gender with regard to performance might play a role in the results. We cannot investigate this role with our data due to a type 1 or 2 error (90–100% are men in the groups with videogame experience).
The performance scores of the schoolchildren were significantly inferior to the scores of the interns. This could be explained by the fact that schoolchildren’s psychomotor abilities are not fully developed yet. Voelcker-Rehage et al. compared the motor performance of a juggling task with both three scarves and three balls in 1,206 subjects in different age groups (6–89 years) [24
]. The pretest result of the juggling performance across the lifespan shows that the age group of 20–24 years perform best. There is an increase in performance from the age of 5–9 years until the age of 20–24 years. After the age of 24, the pretest performance declines. Additionally schoolchildren seemed to be more easily distracted while conducting the different tasks. When during an exercise a blood vessel was ripped and started bleeding, they started splashing the blood instead of solving the problem of a ripped blood vessel by clipping the vessel. Other schoolchildren saw the blood at another computer and were easily distracted by this. They watched their schoolmate, playing with a pool of blood, instead of concentrating on their own exercise. This example also shows another possible contributor to the low scores of the schoolchildren. Also the interns seemed to understand the meaning and clinical relevance of the exercises better.
In conclusion, although our study results did not predict an advantage of videogame experience in children with regard to superior psychomotor skills for endoscopic surgery at adult age, a difference in favor of gaming seems to be present. The difference in psychomotor development between the ages of 12 and 24 years might blur the advantage resulting from videogame experience derived at a young age. This hypothesis is supported by the fact that gaming children perform as good as nongaming adults with respect to total scores, efficiency, and speed. The next generation of surgeons might benefit from videogame experience.