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January 4, 2011

Video Game Surgeons

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Video games have been linked to problems like bad grades and violent behavior. But as this ScienCentral News video reports, a new study suggests that video games might also make surgeons better at their jobs.

"The Nintendo Surgeon"

Step into the training room of Butch Rosser's laparoscopic surgery department at Beth Israel Medical Center in New York, and one thing immediately catches your eye: video games.

"Mine is a interesting lab," he says. "Where along with the laparoscopic training instruments, virtual reality training instruments and all this other research technology all in one place, you have an X-Box, a Playstation 2, side by side with these medical-related items."

He put them there because of the unique skills needed for the modern minimally-invasive surgery known as laparoscopic surgery. Also known as "keyhole surgery," it is performed by inserting instruments through very small incisions. One instrument has a camera and fiber-optic light, while other instruments are the surgical tools used to operate.

Trainees manipulating "joysticks" during a laparoscopic training course Rosser created called "Top Gun."
"You look at a television screen and you hold these instruments that are two feet long just like joysticks, and [you're] performing these operations from the outside while manipulating the body's internal organs on the inside," says Rosser. He adds, "This environment is more like navigating through a video game environment than traditional surgery."

The similarities really hit Rosser several years ago when a journalist watched a laparoscopic case of his and then referred to him as "the Nintendo surgeon."

"Now that just hit me when I read that," he recalls. "And I said, 'Well I am a gamer, all the way back to the days of pong. Is that why I can do this a little better than the average bear? Is that why this seems so natural to me?'"

Wanting to know just how much video game experience affects laparoscopic performance, Rosser led a study of surgeons and surgical residents who took a laparoscopic training course he created called Top Gun. He compared surgeons who said they played video games at least three hours a week to those who never played.

Rosser reported that in training tasks like this one, the video gamers made 37% fewer errors and worked 27% faster.
As he and others reported in the journal Archives of Surgery, the gamers performed significantly better. They made 37% fewer errors, worked 27% faster, and scored 42% higher overall on the training task.

With only 33 surgeons involved, the study was a small one. Also, an "invited critique" of the study notes, "This study does not indicate that good Top Gun scores decrease deaths or increase patient safety."

But Rosser thinks the results are profound enough to recommend that surgeons start using video games the way athletes use a weight room.

"The results were really astounding ... even more than I thought from an intuitive standpoint," Rosser says. "The ones that [played video games] three hours a week, they did well. The ones that did not play, they struggled. Now these are still surgeons and surgical residents though!"

Tempered Enthusiasm

While Rosser and his co-authors are encouraged by the results, they also point out in their paper that "indiscriminate video game play is not a panacea." They point out that there have been plenty of other studies on the negative impact of video games, which have been linked to poor performance in school, obesity, and even aggressive behavior in kids. One of Rosser's co-authors, psychologist Douglas Gentile of Iowa State University, has conducted several of the studies mentioned on the negative impacts of video games.

Butch Rosser, Beth Israel Medical Center, NY
"Most kids play for much more than 3 hours a week, and several studies demonstrate that increased time playing games predicts poorer school performance," Gentile says. "That's taking away time from their reading, it's taking away time from their homework, it's taking away time from exploring or creating, or any of a number of other things that might be useful for their academic achievement." He notes that the American Academy of Pediatrics recommends no more than one to two hours per day of total "screen time" -- including TV, video games, movies/DVDs, and recreational computer use. "So parents should not view this study as a reason to allow children to spend a lot of time with video games," he says.

Rosser agrees that while video games might help make him a better surgeon, he still needed good grades to become one in the first place.

"I say to the kids out there that Butch Rosser would not be here in this capacity if he played video games and did not have good grades, did not develop perseverance," Rosser says. "And I would say to that child out there that thinks that they've got a free pass to play video games carte blanche, I say 'No, sadly mistaken!'"

But he hopes studies like his will help people realize that video games can be put to good use.

"I would tell the parents and the politicians alike that it's their responsibility to not let this be a visceral response to a grassroots issue," he says. "That we all should prepare ourselves to understand the entire world of video games so we don’t create a 21st century witch hunt. And remember this: all video games are not created equal."

The study was published in the February 2007 edition of Archives of Surgery; no outside funding was provided.

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