Distribution of innate psychomotor skills recognized as important for surgical specialization in unconditioned medical undergraduates

Andrea Moglia, Luca Morelli, Vincenzo Ferrari, Mauro Ferrari, Franco Mosca, Alfred Cuschieri

There is an increasing interest for a test assessing objectively the innate aptitude for surgery as a craft specialty to complement the current selection process of surgical residents. The aim of this study was to quantify the size of individuals with high, average, and low level of innate psychomotor skills among medical students. A volunteer sample of 155 medical students, without prior experience with surgical simulator, executed five tasks at a virtual simulator for robot-assisted surgery. They had to reach proficiency twice consecutively in each before moving to the next one. A weighting based on time and number of attempts needed to reach proficiency was assigned to each task. Nine students (5.8%) out of 155 significantly outperformed all the others on median (i.q.r.) weighted time [44.7 (42.2-47.3) min vs. 98.5 (70.8-131.8) min, p < 0.001], and number of attempts to reach proficiency [14 (12-15) vs. 23 (19-32.75), p < 0.001). Seventeen students (11.0%) scored significantly much worse than the rest on median weighted time [202.2 (182.5-221.0) min vs. 84.3 (65.7-114.4) min, p < 0.001], and number of attempts [42 (40-48) vs. 22 (17.25-28), p < 0.001]. Low correlation between simulator scores and extracurricular activities, like videogames and musical instruments, was found. The test successfully identified two groups straddling the large cohort with average innate aptitude for psychomotor skills: (i) innately gifted and (ii) with scarce level. Hence, exercises on a virtual simulator are a valid test of innate manual dexterity and can be considered to complement the selection process for a surgical training program, primarily to identify individuals with low innate aptitude for surgery and advise them to consider specialization in other (non-craft) medical specialties.