Gaze training improves performance in a virtual reality laparoscopic surgery task

Abstract

The aim of the current study was to examine the utility of a gaze training intervention in protecting technical laparoscopic skills under distracting multi-tasking conditions. Thirty medical trainees with no laparoscopic experience were divided randomly into one of three treatment groups: A gaze training (GAZE), a movement training (MOVE), and a no-instruction (CONTROL) group. The GAZE and MOVE groups watched a video model revealing expert gaze control or tool control respectively, and received matched video feedback on subsequent attempts. Participants were fitted with a Mobile Eye gaze registration system, which measures eye-line of gaze at 25Hz.Training consisted of ten repetitions of an 'eye-hand coordination' task from the LAP Mentor VR laparoscopic surgical simulator. After training, all participants completed a retention test (designed to assess learning) and a transfer test, in which they completed the procedure while performing a concurrent tone counting task. The results revealed that the GAZE trained group completed the task more quickly in the retention test and did not show impaired performance under concurrent task conditions (cf. both other groups). These results suggest that gaze training provides indirect benefits for the self-organization of motor skill (without direct coaching of the motor behavior), in a manner that may be less attentionally demanding. By focusing on a single external target, rather than on complex movement patterns, resources may be more efficiently applied to a concurrent cognitive task. As surgical performance relies on decision-making and judgement, as well as technical proficiency, this finding has interesting clinical utility.