A randomised trial of observational learning from 2D and 3D models in robotically assisted surgery

Surg Endosc. 2018 Nov;32(11):4527-4532. doi: 10.1007/s00464-018-6203-3. Epub 2018 May 14.


Background: Advances in 3D technology mean that both robotic surgical devices and surgical simulators can now incorporate stereoscopic viewing capabilities. While depth information may benefit robotic surgical performance, it is unclear whether 3D viewing also aids skill acquisition when learning from observing others. As observational learning plays a major role in surgical skills training, this study aimed to evaluate whether 3D viewing provides learning benefits in a robotically assisted surgical task.

Methods: 90 medical students were assigned to either (1) 2D or (2) 3D observation of a consultant surgeon performing a training task on the daVinci S robotic system, or (3) a no observation control, in a randomised parallel design. Subsequent performance and instrument movement metrics were assessed immediately following observation and at one-week retention.

Results: Both 2D and 3D groups outperformed no observation controls following the observation intervention (ps < 0.05), but there was no difference between 2D and 3D groups at any of the timepoints. There was also no difference in movement parameters between groups.

Conclusions: While 3D viewing systems may have beneficial effects for surgical performance, these results suggest that depth information has limited utility during observational learning of surgical skills in novices. The task constraints and end goals may provide more important information for learning than the relative motion of surgical instruments in 3D space.

Keywords: 3D; Observational learning; Robotically assisted surgery; Stereoscopic; Surgical training.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Competence*
  • Computer Simulation*
  • Education, Medical, Graduate / methods*
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Laparoscopy / education*
  • Learning
  • Male
  • Robotic Surgical Procedures / education*
  • Surgeons / education*
  • Young Adult