Does screen time really affect medical students’ surgery skills?

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A surgeon uses the robotic surgery system da Vinci, which is used in more than 70 hospitals in the UK

Medical students are losing the dexterity to stitch up their patients because they are spending too much time in front of screens.

That’s the claim from one professor of surgery who says trainee doctors are “less competent”, compared to their older colleagues, at using their hands.

Professor Roger Kneebone, from Imperial College London, says young people have so little experience of craft skills that they struggle with practical tasks.

It’s a worrying thought – but how true is it? Does screen time impact dexterity?

Professor Kneebone argues that a decline in the manual dexterity of medical students is due to a lack of experience in handling materials, and that “a lot of things are reduced to swiping on a two-dimensional flat screen”.

But his view is being challenged by doctors and health professionals, who say the facts, and their personal experiences, don’t back him up.

Physiotherapist Ashley James said there is “very, very little evidence” to suggest the widespread use of smartphones by students affects their manual dexterity.

“There’s not that research out there,” he said. “I’m not saying he [Professor Kneebone] doesn’t have a point, but the likelihood is the authority and certainty of which he speaks is probably not based on fact or any evidence.”

Mr James pointed to a study of 100 medical students, half of whom were frequent mobile phone texters, and half light users.

“The researchers didn’t find anything different in terms of dexterity,” says Mr James. “But another thing they tested in that study was reaction time.

“Mobile phone frequent texters had improved reaction time.”

He added: “It’s just one small study. I wouldn’t hang my hat on it but I wouldn’t be as forthright on my conclusion as the surgeon is.”

‘Video games boosted my dexterity’

Trainee surgeon Saied Froghi, from London, who played video games like Age of Empire and Halo in his spare time during medical school, said time spent in front of a screen helped his surgery skills.

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Saied Froghi

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Saied Froghi, right, with his brother Farid Froghi, a surgery research fellow, who joked “all those years of gaming paid off”

“If you take the example of keyhole surgery, your eyes focus on a screen and your hands move synchronously with what you are doing,” he said.

“That’s a similar scenario to when you are playing football with a games console. Your hands know where the buttons are and how to rotate the instrument.”

Another former video games player – Rajin Chowdhury, a registrar in anaesthetic and intensive care at Sheffield Teaching Hospital – said he was “more dextrous” because of his hobby.

Video games, he said, improved hand-eye coordination because they trained the surgeon to perform the surgery remotely from a screen.

“For example in an appendicectomy, because of the way the camera is inserted in the abdomen, when you move it down [in the body] you move it up on the image. When I want to move right you have to move it left.

“It’s not intuitive.”

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Rajin Chowdhury says games which require decent hand-eye co-ordination can help with some procedures

One consultant surgeon in Leeds tweeted a story he was told of how a junior doctor got the job done during an operation, citing his Nintendo skills as a help.

‘Skills can be taught’

Meanwhile Susan Hill, vice president of the Royal College of Surgeons, said: “I have not noticed any great difference in the dexterity of the medical students or junior doctors I come into contact with, when compared to other generations.

“In fact, I can recall finding some surgical techniques extremely difficult to master myself even though I trained well before the IT revolution,” she said.

“Although it may be useful for a surgeon to be naturally dexterous, the skills required to operate can be taught.

“Much of surgical training is about practising skills such as cutting and sewing over and over until they are perfected.”

Professor Steve Wigmore, a professor of surgery from the University of Edinburgh. said research is showing that playing computer games “is a good warm up” to performing keyhole, or laparoscopic surgery.

“I think the quality of the trainees is down to the quality of the training,” he said.

NHS surgeon and surgery professor Peter Brennan is the chairman of the MRCS exam for the UK and Ireland – the exam which junior doctors need to pass to become surgeons.

He said: “We are not going to let people pass that exam if we don’t think they have the skills”.

And he added medical students who want to become surgeons often may choose that career path because they are “good with their hands”.

Many surgeons said practice is one of the top ways to improve their stitching and suturing skills – a rule which applies for both the current medical students – and older generations.

As surgeon Mr Froghi joked, as the doctors of today get older, “do you think gardening will contribute to the acquisition and maintenance of new skills?”

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