Early exposure to haptic feedback enhances performance in surgical simulator training:: a prospective randomized crossover study in surgical residents

Background: In the literature of skill acquisition and transfer of skills, it often is assumed that the rate of skill acquisition depends on what has been learned in a similar context (i.e., surgical simulators providing haptic feedback). This study aimed to analyze whether the addition of haptic feedback early in the training phase for imageguided surgical simulation improves performance. Methods: A randomized crossover study design was used, in which 38 surgical residents were randomized to begin a 2-h simulator training session with either haptic or nonhaptic training followed by crossover after 1 h. The graphic context was a virtual upper abdomen. The residents performed two diathermy tasks. Two validated tests were used to control for differences in visual-spatial ability: the BasIQ general cognitive ability test and Mental Rotation Test A (MRT-A). Results: After 2 h of training, the group that had started with haptic feedback performed the two diathermy tasks significantly better (p < 0.05, unpaired t-test). Only the (group that had started with haptic training significantly improved during the last 1-h session) (p < 0.01, paired t-test). Conclusion: The findings indicate that haptic feedback could be important in the early training phase of skill acquisition in image-guided Surgical simulator training.