Flying Aptitude TestFlying Aptitude Testfor the Selection of for the Selection of Surgical TraineesSurgical Trainees

Principal Investigator:Principal Investigator: Mrs Hyun-Mi Carty Mrs Hyun-Mi Carty Teaching FellowTeaching Fellow

Chief Investigator:Chief Investigator: Mr Charles Maxwell-Armstrong Mr Charles Maxwell-Armstrong Consultant SurgeonConsultant Surgeon

Queens Medical Centre NottinghamQueens Medical Centre Nottingham

IntroductionIntroduction Surgical AptitudeSurgical Aptitude

Technical SkillsTechnical Skills

Aptitude Testing in military pilotsAptitude Testing in military pilots

Flying Aptitude Test for the Flying Aptitude Test for the selection of surgical traineesselection of surgical trainees

Surgeon’s AttributesSurgeon’s Attributes A Gallagher, G Leonard & O. Traynor (RCSI)A Gallagher, G Leonard & O. Traynor (RCSI)

• Technical skillsTechnical skills• Fundamental abilitiesFundamental abilities

Psychomotor skillsPsychomotor skills Visuospatial abilityVisuospatial ability Depth perceptionDepth perception

Cuschieri (Am J Surg)Cuschieri (Am J Surg)• Spatial perceptionSpatial perception• Hand-eye coordinationHand-eye coordination• AimingAiming• Multilimb coordinationMultilimb coordination• Hand-arm steadinessHand-arm steadiness• Interpret and manipulate from imagesInterpret and manipulate from images

Laparoscopic Laparoscopic Simulator Simulator

performance: performance: Harrier pilots vs Harrier pilots vs Medical StudentsMedical Students

Harrier pilots n=8Med Students n=25

4 laparoscopic box trainer tasks

Appendicectomy taskMed students 95.5 sHarrier pilots 28.7 s

Evolution of the RAF Aptitude TestingEvolution of the RAF Aptitude Testing

Before WWIIBefore WWII

‘right type’

UK Tri-service aircrew selectionUK Tri-service aircrew selection

Part 1Part 1• Aptitude testingAptitude testing• MedicalMedical• Generic fitness testGeneric fitness test• InterviewInterview

Part 2Part 2• Practical situational exercisesPractical situational exercises

Aptitude DomainsAptitude Domains

Verbal Reasoning (VR)Verbal Reasoning (VR) Numerical Reasoning (NR)Numerical Reasoning (NR) Spatial Reasoning (SR)Spatial Reasoning (SR) Attentional Capability (AC)Attentional Capability (AC) Work Rate (WR)Work Rate (WR) Psychomotor Coordination (PC)Psychomotor Coordination (PC)

Test developmentTest development

1)1) Job/task analysisJob/task analysis

2)2) Test battery designTest battery design

3)3) ValidationValidation

Job / task analysisJob / task analysis

1)1) Identification of training elements & Identification of training elements & competences required for successcompetences required for success

2) Development of aptitude profiles2) Development of aptitude profiles

3) Assistance from Subject Matter Experts 3) Assistance from Subject Matter Experts (experienced flying instructors)(experienced flying instructors)

ValidationValidation

Correlation between test results and Correlation between test results and training data:training data:

• Ground SchoolGround School• Overall GradingOverall Grading• PracticalPractical

Our StudyOur Study

Flying aptitude Test for the Selection of Flying aptitude Test for the Selection of Surgical TraineesSurgical Trainees

MoD Ethical Ref: 1002/299MoD Ethical Ref: 1002/299

NHS Ethics Ref: 10/H0401/43 NHS Ethics Ref: 10/H0401/43

NUH R&D Ref: 10GS002NUH R&D Ref: 10GS002

HypothesisHypothesis

1.1. RAF Aircrew Selection test (AST): RAF Aircrew Selection test (AST): Identify participants with good Identify participants with good

Spatial, Verbal & Numerical Reasoning, Attentional Spatial, Verbal & Numerical Reasoning, Attentional Capability, Work Rate & Psychomotor Ability. Capability, Work Rate & Psychomotor Ability.

2.2. AST result = LAP & ENDO & VR SIM AST result = LAP & ENDO & VR SIM

3.3. SIM Test results = Intra-operative SIM Test results = Intra-operative Procedure Based Assessments (PBA) Procedure Based Assessments (PBA) done as part of ongoing training.done as part of ongoing training.

MethodMethod Participants take part in the following tests:Participants take part in the following tests:

1.1. RAF Aircrew Selection Test at RAF CranwellRAF Aircrew Selection Test at RAF Cranwell

2.2. Simulated laparoscopic and endoscopic tests at Simulated laparoscopic and endoscopic tests at the Trent simulation Centre, QMCthe Trent simulation Centre, QMC

3.3. Psychometric questionnaires Psychometric questionnaires

4.4. Optional participation into prospective study Optional participation into prospective study analysing Procedure Based Assessments resultsanalysing Procedure Based Assessments results

Participant numbersParticipant numbers Total N= 450Total N= 450

Medical students (n=200)Medical students (n=200)

Surgical and Medical Core Training (CT) year 1 Surgical and Medical Core Training (CT) year 1 and 2 (n=100)and 2 (n=100)

Specialty Registrars in years 3 to 8 (n=100)Specialty Registrars in years 3 to 8 (n=100)

Forces doctors in training (n=50)Forces doctors in training (n=50)

Flying Aptitude Test for SurgeonsFlying Aptitude Test for Surgeons

Aptitude Domain Domain Weight Tests

Perceptual   20 VISS

Short Term Memory/Capacity 10 ACT

Spatial Reasoning 20 SIT

Psychomotor   40 RTT, SMA

Central Information Processing 10 VIGsp

Results so farResults so far

RAF Flying aptitude test: n=108RAF Flying aptitude test: n=108 LAP SIM tests: n=38LAP SIM tests: n=38

Mean Score: 52.37%Mean Score: 52.37% Median: 51%Median: 51% Lowest score: 17%Lowest score: 17% Highest score: 87%Highest score: 87%

Results of the first 28 participantsResults of the first 28 participants

Flying Aptitude Test and Lap Sim correlation

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30405060

708090

0 500 1000 1500 2000 2500

Total time lap sim tests

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Series2

SummarySummary Identify a computer based selection test

based on the current RAF selection test

Tailored to select those candidates who possess the technical abilities necessary for successful postgraduate training where the use of minimally invasive tools are used.

This test can be used to assist the already existing selection process of surgical trainees in the UK