Date of Award
MD (Medical Doctor)
Mr Paul Neary
Professor Oscar Traynor
Surgical Procedures, Minimally Invasive, Education, Clinical Competence
Background: Minimally invasive surgery (MIS) is an evolving area of surgery which is becoming more main-stream. However, when compared to the traditional open surgical approach MIS techniques have been demonstrated to be associated with a longer learning curve for the trainee surgeon.
Aim: The overall objective of this thesis was to investigate and evaluate those factors that could influence the length of the learning curve and the capacity of a trainee to become a proficient minimally invasive surgeon.
Materials & Methods: We evaluated three different areas; psychometric aptitude (visual spatial, depth perception & psychomotor), personality traits and non-technical skills (musical ability, playing sport & video games) and how these factors impacted on the surgical novice, junior and senior trainees ability to perform in both basic minimally invasive skills (laparoscopy, endoscopy & endovascular) and more advanced skills (laparoscopic colectomy) in a simulated setting.
Results: The results demonstrated that there is a relationship between psychometric aptitude and MIS performance. This association was greatest in frequency and most consistent amongst the surgical novices with its effect decreasing with increasing surgical experience. However, the results also demonstrated that in trainees with significant surgical experience psychometric aptitude was associated with performance in an advanced MIS task (laparoscopic colectomy). Certain personality traits were also found to be associated with MIS performance (distractibility, confidence & energy). Finally, musical ability in particular was found to have the greatest association with MIS performance in contrast to the other nontechnical skills measured.
Conclusion: We have shown that certain attributes influence the learning curve and the fundamental ability of the trainee surgeon in MIS techniques. These findings have relevance in the design of training curricula and when ensuring the optimum learning pathway for the individual trainee.
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Nugent E. The evaluation of fundamental ability in acquiring minimally invasive surgical skill sets [MD Thesis]. Dublin: Royal College of Surgeons in Ireland; 2012.