Effect of distraction on simulated anterior segment surgical performance

J Cataract Refract Surg. 2011 Aug;37(8):1517-22. doi: 10.1016/j.jcrs.2011.01.031.


Purpose: To determine the effect of distraction on anterior segment surgical performance using a virtual reality simulator in expert and novice surgeons.

Setting: Horizon Suite Simulation Centre, South Devon Foundation NHS Trust, Devon, England.

Design: Cohort study.

Methods: Expert and novice ophthalmic surgeons completed a standardized and validated surgical task 10 times on a virtual reality simulator (EyeSi). They then completed a cognitive task (arithmetic questions), after which they completed 10 attempts on the simulator module while also completing the cognitive task.

Results: For experts (n = 7), the distracting cognitive task had no statistically significant effect on operating scores. The rate of correctly answered questions decreased from 12.3 per minute ± 2.1 (SD) while single tasking to 8.6 ± 3.1 per minute while dual tasking (P=.018). For novices (n = 14), the distracting cognitive task had no effect on any operating score except a small reduction in the penalty odometer score. The rate of correctly answered questions decreased from 11.5 ± 4.1 per minute while single tasking to 7.0 ± 3.2 per minute while dual tasking (P=.001).

Conclusion: A distractive cognitive task reduced the ability of novice surgeons and expert surgeons to deal with that cognitive task, although their simulated surgical performance was not overtly compromised.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Attention / physiology*
  • Clinical Competence*
  • Cognition / physiology*
  • Cohort Studies
  • Computer Simulation*
  • Humans
  • Middle Aged
  • Ophthalmology / education
  • Phacoemulsification*
  • Specialization
  • Students, Medical
  • Task Performance and Analysis*
  • User-Computer Interface
  • Young Adult