Video Game Skills May Make Better Surgeons

IRA FLATOW: Did you ever play that board game Operation, where you carefully take the tweezers, try to remove the patient’s funny bone without bumping the sides. Almost got it, [BUZZ] rats! There goes the clown nose.

OK. Maybe it’s not such a great method of surgical training after all. But video games might be useful in training surgeons, according to a recent article published in the journal Surgery. Arnav Gupta is a third year medical student at the University of Ottawa and was co-author on that survey of video games. Welcome to Science Friday.

ARNAV GUPTA: Hi, I’m super glad to be here.

IRA FLATOW: Nice to have you. Now as I understand it, you surveyed the literature for studies on video games and medical studies and what did you find?

ARNAV GUPTA: So pretty much we did a systematic review where we went through about 2,000 to 3,000 articles related to A, surgery, B, video games, and C, specifically surgery types such as laparoscopy or robotic surgery. So essentially what came out of it was that we managed to get 16 studies related to both surgery, surgical training and medical students, and video games.

And we had about a total of 575 participants across those 16 studies. And what we essentially found was that, if you were a video gamer in the past, you most likely were going to be better at robotic surgery training as a medical student, and if you did something like a video game-based training. So specifically sort of a training module or a training regimen that uses video games to enhance certain skills, you’d see the most benefit in terms of laparoscopic surgery, laparoscopic surgery training.

We also looked at other interventional procedures, such as arthroscopy. So putting a camera in your knee, or bronchoscopy, so putting a camera in your airway, and we found that there wasn’t much evidence supporting the use of video games in terms of training for those skills.

IRA FLATOW: What do you think the difference was? Is there a certain kind of skill that’s better trained by video than other?

ARNAV GUPTA: The interesting thing is that, with robotic surgery, the whole console itself, while it’s never going to be exactly like using a joystick and a controller, the skills that you need are very similar to using a joystick. So the theory is that, because of that familiarity, it translates better into the idea of robotic surgery. Now, with laparoscopic surgery, it’s a lot more complex.

You don’t have a lot of the, I guess you could say, quality of life adjustments that robotic surgery may afford you. So, for example, in the robotic surgery console, if you look through the screen, it essentially gives you 3D vision. It has a certain sensitivity to your movements. So it’s very precise in that sense.

So you don’t have the luxury of those in laparoscopic surgery. So perhaps, with the video games, we think that that might not be sufficient to essentially make a difference. However, if you were to make training which specifically focuses on skills that you may see on laparoscopic surgery, that might be more beneficial.

So one example I can give you is that, when you play video games, you’re essentially translating three dimensional movements onto a two dimensional screen. Laparoscopic surgery is very much the same way. You have 3D movements, but you’re looking at it on a 2D screen. So, in theory, if you make a system that takes advantage of those movements, you’ll be essentially directly training those. And in a shorter term it will be more beneficial to do video game-based training in laparoscopic surgery.

IRA FLATOW: This is Science Friday from WNYC Studios. Talking with Arnav Gupta about whether video games can help in surgical training. Do you think that the benefit comes more from, well, the fine muscle movements that you do in surgery and working the joystick in video games? Or could it come from your mental focus, where when you play a video game you’re really playing it intensely, and maybe you have to do that in surgery also?

ARNAV GUPTA: We mainly saw that the benefits of video games came from the movements themselves. So we used various outcome measures, including something called economy of motion, which is essentially how efficient are you with your movements. Or we used other metrics to really see how accurate your movements were, how many errors did you make, how many times did your instruments collide. And it really seems that the video games really do have some benefit in the right context, with respect to those metrics.

The mental aspect may be related as well. But I think it might just be a transfer effect.

IRA FLATOW: Can you give us a name of a game or two that you think improves surgical skills?

ARNAV GUPTA: Ooh, I wish I could say, I wish I could say many. But a couple of the games that we came across in our study was Super Monkey Ball, Call of Duty, Resident Evil 4 Half Life. They even did some tests such as like Chessmaster or New Blood and a racing game like Need for Speed. So it seems like a lot of the researchers try and tend towards something like a first person shooter just because, once again, that kind of works on a scale of translating three dimensional movements onto a 2D screen.

But there still needs to be more research done on various types of genres, because I think different games have different mechanics, that can really be capitalized on if appropriately addressed, and may have value as adjunctive training for surgical skills.

IRA FLATOW: What kind of games would those be, if you’re going to do additional research?

ARNAV GUPTA: I think honestly everything and anything. I think right now there really is, not a bias, but there really is a focus towards those FPS games, because, once again, that 3D to 2D translation. But I’d really like to see studies in the future looking at stuff like, once again, those racing games, looking at puzzle games, looking at games that force you to make decisions, RPGs, because RPGs, role playing games, are very popular these days.

And I’d like to really see them in newer consoles as well. One limitation of our study, you’ll notice, is that it’s been done on very outdated consoles. Like the one console that they really, really focused on for laparoscopic surgery was the Wii U. But the Wii U is pretty much a console of the past in this day and age.

We have stuff like the Nintendo Switch, the PS 5, the Xbox Series X, and infinitely expanding PC power. So I totally imagine that there’s new games for it, with more powerful capabilities due to their hardware and software. So the sky’s the limit in terms of what kind of games we can really use.

IRA FLATOW: Do you see yourself conducting any more research in this field?

ARNAV GUPTA: Oh, I would absolutely love to. Pretty much this research study started off when I was mainly interested in urology, which really has a great combination of laparoscopic surgery and robotic surgery. However, now my own medical interests have shifted towards ophthalmology, where you’ll see a lot of microscopic surgery, so surgeries on even smaller planes and requiring even more precise movements.

Hopefully, if all things going well with residency, then I would love to take the skill set and apply it to ophthalmology, maybe some sort of video game study to see how we can improve cataract surgery training, or other difficult ophthalmologic surgeries. I have a friend who’s in ophthalmology PGY-1. We constantly joke about the fact that if and whenever I get the chance to do ophthalmology, we’ll be playing Call of Duty on resident half days, just to train for cataract surgery or something like that.

IRA FLATOW: Well, I wish you great luck.

ARNAV GUPTA: Thank you, appreciate it.

IRA FLATOW: Arnav Gupta is a third year medical student at the University of Ottawa. Thanks for being with us today. And as I say, good luck on your exams, too.

ARNAV GUPTA: Thank you so much. Hopefully those go well.

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