Video Games and Surgical Performance: What the Research Shows
Background and Rationale
High-paced, action-oriented video games demand skills like hand–eye coordination, visuospatial attention, and quick decision-making, which are also critical in surgery. This overlap has sparked numerous studies exploring whether surgeons who play video games exhibit better surgical performance – particularly fewer errors and faster, more efficient operations. Below we summarize key peer-reviewed studies (across various surgical specialties and game types) and their findings, including study design, sample size, and outcomes.
Early Evidence: Laparoscopic Skills and Gaming
One of the first seminal studies was a 2007 cross-sectional analysis by Rosser et al. involving 33 surgeons (residents and attendings) in a laparoscopic training course. Participants reported their gaming habits and also played video games during the study:
Design: Cross-sectional study at a surgical skills training program (Top Gun laparoscopic skills/suturing course). Surgeons completed video game exercises and a laparoscopic skill test.
Key Findings: Surgeons with a history of gaming >3 hours per week committed 37% fewer errors and were 27% faster in laparoscopic suturing drills than non-gamers (significant at P<.05). Overall performance scores on the laparoscopic tasks were 33–42% higher for past gamers (highest for those playing >3 h/wk). Even current gamers (those still playing at the time of study) made 32% fewer errors and scored significantly better than non-players. Moreover, video game skill level itself (as measured by game performance during the study) was a strong predictor: the top one-third of gamers (highest game scores) performed 47% better with 39% faster times on surgical tasks than the bottom third.
Conclusion: This study was among the first to quantify the gaming advantage in surgery – suggesting that action video game experience correlates with superior laparoscopic skills (fewer errors, faster execution). The authors even posited that integrating video games into training could help “thin the interface” between surgeons and minimally invasive surgical systems.
“Warm-Up” with Video Games to Reduce Errors
Building on that idea, a 2012–2013 study by Rosser’s team tested whether using video games as a pre-surgery warm-up could improve performance. In this quasi-experimental study (303 surgeons):
Design: Surgeons were split into experimental (n=123) and control (n=180) groups. The experimental group played video games for 6 minutes immediately before performing standardized laparoscopic tasks (the “Cobra Rope” drill and intracorporeal suturing), whereas controls did not warm up with games.
Key Findings: Those who “warmed up” with a fast-paced video game were significantly faster from the first trial of the task and maintained faster times across all 10 trials. They also scored higher on suturing tasks; the warm-up group had better overall suturing scores (P<.05). In terms of errors, the study notes the warm-up group was faster and made fewer errors than the no-warm-up group. The overall composite surgical skill score (“Top Gun” score) trended higher in the gaming warm-up group as well.
Conclusion: A short burst of video game play immediately before surgery acted like a “warm-up”, enhancing speed and reducing errors in laparoscopic drills. This suggests that action video games might temporarily prime or tune a surgeon’s sensorimotor skills, leading to better operative performance right afterward.
Specialized Game Training: Genre Matters
Not all games are equal. A 2016 randomized controlled trial by Araujo et al. examined whether different video game genres differ in their impact on surgical skill development:
Design: 20 medical student novices were randomized to 3 weeks of training with either a first-person shooter (FPS) game, a racing game, a surgery simulation game, or to a no-gaming control group. All participants also underwent standard lessons in knot-tying and suturing.
Key Findings: After training, the FPS group and the surgery-game group outperformed the control group in surgical skill tests. By week 3, the FPS players had the highest surgical performance scores – significantly better than controls (P = 0.002). The surgery simulation gamers also scored higher than controls (P = 0.022). However, the racing game group showed no significant difference from controls (their improvement was on par with no gaming). Interestingly, the study noted that the complexity of the game might be key: games with more complex, diverse challenges (even if non-medical, like action shooters) improved surgical skill more than simpler driving games.
Conclusion: High-paced action games, especially those requiring targeting and spatial navigation (like FPS), and surgical simulation games can significantly boost surgical dexterity in novices. In contrast, simpler genres (e.g. racing) may offer less benefit. This RCT underscores that game content/genre matters – the more transferable skills a game exercises, the greater the potential surgical benefit.
Robotic Surgery and Video Games
With the rise of robot-assisted surgery, researchers have also looked at whether gaming helps in this domain (which similarly involves consoles and screen-mediated instruments). The evidence here is a bit mixed:
Harper et al. (2007): An early study of robotic surgical performance (in urology residents) found no overall advantage from prior gaming experience. In that study, experienced gamers did not significantly outperform non-gamers in robotic suturing tasks on most metrics. (Notably, gamers actually tied fewer knots on a robotic suturing drill than non-gamers – 5.8 vs 9.0 knots on average, P = 0.04 – suggesting they gave up sooner or struggled on that specific task.) The authors concluded that prior gaming alone did not enhance robotic surgery skills in their sample.
Hvolbek et al. (2019): A more recent prospective study looked at 32 participants (30 med students, 2 interns) on a RobotiX robotic surgery simulator. They compared “gamers” (≥6 hours/week of action video games) vs. “non-gamers” (<6 hours/week):
Findings: The gamers significantly outperformed non-gamers in 3 of 24 metrics measured by the simulator (P < 0.05). For the other metrics, gamers still trended better on most (7 of the remaining 21 measures showed a non-significant trend favoring gamers). Areas of improvement included things like instrument handling efficiency and targeting accuracy.
Conclusion: Even in robotic surgery simulations, there is evidence that experienced action gamers have an edge in certain performance aspects. The advantage isn’t across the board, but it’s notable in metrics requiring coordination and precision.
Bottom line: In robotic surgery simulations, gaming history appears to confer some benefits (better metrics on simulators). However, not all studies agree, and more work (especially in real clinical settings) is needed to clarify how gaming translates to actual robotic OR performance.
Laparoscopic Simulation and Training: Recent Trials
A number of randomized trials in the 2010s have reinforced the idea that video games can be used as a training adjunct for minimally invasive surgery:
Harrington et al. (2018) – “Playing to Your Skills” RCT: 20 medical students (no laparoscopic experience, minimal gaming background) were divided into two groups. Group A had to play 5 hours per week of an action–puzzle laparoscopic video game (“Underground” on the Nintendo Wii U, which uses a laparoscopic-like tool controller), whereas Group B refrained from gaming. After 4 weeks, all participants were tested on a laparoscopic simulator:
Results: Both groups improved (simply from some exposure to the simulator), but the gaming group improved significantly more on a majority of metrics. Specifically, the gaming group showed significant gains in 31 performance metrics (including faster task times, more precise instrument movements, and better economy of motion). In direct comparison, the gaming group was significantly better than controls on 5 key measures (e.g. non-dominant hand efficiency, path length, etc.) after the training. Despite less-than-perfect adherence to the full 5 hours/week (some participants didn’t play as much as instructed), the difference in skill acquisition was clear.
Conclusion: A dedicated surgical video game improved novices’ laparoscopic simulator performance more than no extra training. The authors suggest this “serious game” could be a valuable at-home training tool for surgeons in training.
Jalink et al. (2014) – Review of multiple studies: This review examined all studies (up to 2013) on video games and laparoscopic simulators. It concluded that, generally, video game experience correlates with higher baseline laparoscopic skill (better initial scores on simulators). Furthermore, controlled experiments show video games can improve basic laparoscopic skills in surgical novices. An interesting application mentioned is using games as a “temporary warm-up” before surgery to boost performance, which aligns with Rosser’s findings. (Note: The lack of a standard way to quantify “gaming experience” was cited as a challenge in comparing studies.)
Sammut et al. (2017) – “Benefits of Being a Video Gamer” observational study: This study (Malta, 32 participants) looked at surgical trainees’ performance on a laparoscopic simulator relative to their gaming history. In line with others, it found that those with regular video gaming experience performed better on laparoscopic tasks than non-gamerspubmed.ncbi.nlm.nih.gov. Gamers were typically faster and made fewer errors in tasks like object transfers and precision cutting. The implication is that long-term gaming may develop a psychomotor skill reservoir that surgeons can tap intopubmed.ncbi.nlm.nih.gov.
Broader Systematic Reviews and Meta-Analyses
To get a high-level view, several systematic reviews have synthesized these individual studies:
Ou et al. (2013) – Best Evidence Review: This review identified 7 best evidence papers on the question. It concluded that both surgical trainees and experienced surgeons who are video gamers outperform their non-gaming peers on laparoscopic simulators – with faster completion times, greater efficiency, and fewer errorspubmed.ncbi.nlm.nih.gov. The likely reason cited is superior psychomotor skills among gamerspubmed.ncbi.nlm.nih.gov. However, the review noted the need for research on whether these simulator advantages translate to the actual operating room (a crucial point that direct evidence was still limited on)pubmed.ncbi.nlm.nih.gov.
Glassman et al. (2016) – Systematic Review: This review sifted through studies up to 2014 (5 RCTs made the cut) to see if gaming improves laparoscopic performance. The findings were mixed:
Two RCTs showed significantly fewer errors in the gaming group than controls (P = 0.002 and P = 0.045).
One study found faster completion time on one task for gamers (P = 0.037) – but when the groups crossed over (controls later got to play, etc.), that time advantage disappeared, suggesting a learning effect more than a permanent gaming advantage.
Two RCTs found no significant differences between gamers and non-gamers on the surgical tasks.
Conclusion: Given the small number of high-quality trials and some conflicting results, they found limited evidence to strongly support video games enhancing surgical simulation performance. In other words, some positive trends exist (especially in error reduction), but it’s not universally proven across all metrics and studies.
Gupta et al. (2021) – Contemporary Systematic Review: This review focused on medical students and included 16 studies (575 total participants) spanning various surgical domainspubmed.ncbi.nlm.nih.gov. Key takeaways:
For laparoscopy and robotic surgery, evidence favored gamers. Having a gaming history was linked to better robotic surgery metrics, and video-game-based training led to improved laparoscopic performancepubmed.ncbi.nlm.nih.gov.
By contrast, in fields like arthroscopy or bronchoscopy, video game skills did not show a clear benefitpubmed.ncbi.nlm.nih.gov.
Notably, studies that used the Nintendo Wii or the “Underground” laparoscopic game showed significant improvements in overall laparoscopic scores for those interventionspubmed.ncbi.nlm.nih.gov.
Conclusion: Video games have potential as an adjunct training tool for surgical skillspubmed.ncbi.nlm.nih.gov. The authors echoed that due to variations in study methods and quality, we need larger, standardized trials to make firm conclusionspubmed.ncbi.nlm.nih.gov. But overall, this 2021 review affirms positive associations – especially for fast-paced video gaming improving laparoscopic and robotic surgery-related skillspubmed.ncbi.nlm.nih.gov.
Summary of Key Findings
Bringing it all together, surgeons (and trainees) who play action video games tend to show better performance in simulated surgical tasks compared to non-gamers, as evidenced by multiple studies:
Fewer errors: Several studies found gamers make significantly fewer surgical errors. For example, 37% fewer errors in laparoscopic drills for surgeons with gaming habits, and error reduction was confirmed in certain RCTs (P = 0.002 in one trial).
Speed and efficiency: Gamers often complete tasks faster – 27% faster in the 2007 study – and with more economical instrument movements. In surgical simulations, faster completion without added errors is a sign of greater efficiency.
Overall skill scores: Composite scores (combining time, errors, precision) are higher in video game players. E.g. Rosser’s study saw a 42% higher overall score for those playing >3 hours/week.
Training transfer: Action games (especially FPS) appear to improve surgical skill acquisition in trainees. Even short-term play can give a boost (as a warm-up or over a few weeks of practice).
Limitations: Not all studies show a benefit – some found no difference in certain metrics or in certain specialties (no clear gains in arthroscopy/bronchoscopy taskspubmed.ncbi.nlm.nih.gov). Also, most evidence is based on simulator performance, which, while correlating with real skills, is not the same as actual OR patient outcomes. Direct studies of video gaming and real surgical outcomes are scarce due to practical and ethical constraints.
Conclusion
On balance, the peer-reviewed literature suggests a positive relationship between playing high-paced video games and surgical performance in minimally invasive procedures. Surgeons and trainees who are gamers tend to perform better on laparoscopic and robotic simulators – making fewer errors, completing tasks faster, and scoring higher on technical proficiency scalespubmed.ncbi.nlm.nih.gov. Action-oriented games (like first-person shooters) and bespoke surgical games seem particularly effective in sharpening relevant skills. Some researchers even advocate incorporating video games into surgical training curricula or pre-surgery warm-ups to leverage these benefits.
However, experts also caution that video games are not a magic bullet. While simulation studies are promising, we need more research to confirm that these gaming-related advantages translate to actual operating room performance and improved patient outcomespubmed.ncbi.nlm.nih.gov. Future studies with larger samples, long-term follow-ups, and focus on real surgical error rates will help solidify how (and how much) video gaming can augment surgical expertise.
Sources (Peer-Reviewed Studies & Reviews)
Rosser JC Jr. et al. (2007). “The impact of video games on training surgeons in the 21st century.” Archives of Surgery, 142(2):181-186.
Badurdeen S et al. (2010s, published 2013). “The Effect of Video Game ‘Warm-up’ on Performance of Laparoscopic Surgery Tasks.” Surgical Endoscopy / JSLS – Quasi-experimental study on 303 surgeons.
Araujo TB et al. (2016). “Impact of video game genre on surgical skills development: a RCT.” J Surg Res, 201(1):235-243. (FPS and surgery games improved skills; racing did not).
Harper JD et al. (2007). “Prior video game exposure does not enhance robotic surgical performance.” J Endourol, 21(10):1207-1210. (Found no clear gaming benefit in robotic surgery; gamers tied fewer knots, implying no advantage).
Hvolbek AP et al. (2019). “Effect of video games on robotic surgery skills: a prospective study.” Adv Med Educ Pract, 10:627-634. (Gamers vs non-gamers on RobotiX simulator; gamers better on some metrics).
Harrington CM et al. (2018). “Playing to your skills: RCT of a dedicated video game for MIS training.” Surgical Endoscopy, 32(9):3813-3821. (Wii U “Underground” game training improved laparoscopic simulator performance).
Sammut M et al. (2017). “The benefits of being a video gamer in laparoscopic surgery.” Int J Surg, 45:42-46. (Observational study; surgeons with gaming experience had better laparoscopic sim scores).
Ou Y et al. (2013). “Does playing video games improve laparoscopic skills?” Int J Surg, 11(5):365-369. (Review of best evidence; concludes gamers have superior laparoscopic simulator skills)pubmed.ncbi.nlm.nih.gov.
Glassman D et al. (2016). “Effect of Playing Video Games on Laparoscopic Skills: A Systematic Review.” J Endourol, 30(2):146-152. (Mixed RCT results; limited evidence for gaming benefit, though some error reduction noted).
Gupta A et al. (2021). “Can video games enhance surgical skills acquisition in medical trainees? A systematic review.” Surgery, 169(4):821-829. (16 studies, 575 participants; gaming history beneficial in laparoscopy & robotics, not in some other fields)pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov.
*This research was conducted, analyzed, and summarized using AI. We do not use AI to generate all of our content, but are open about when and where we do.
