1. Flying Aptitude Test for the Selection of Surgical Trainees Principal Investigator: Mrs Hyun-Mi Carty Teaching Fellow Chief Investigator: Mr Charles Maxwell-Armstrong Consultant Surgeon Queens Medical Centre Nottingham

2. Introduction  Surgical Aptitude  Technical Skills  Aptitude Testing in military pilots  Flying Aptitude Test for the selection of surgical trainees

3. Surgeon’s Attributes  A Gallagher, G Leonard & O. Traynor (RCSI) Technical skillsTechnical skills Fundamental abilitiesFundamental abilities  Psychomotor skills  Visuospatial ability  Depth perception  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

4. Laparoscopic Simulator performance: Harrier pilots vs Medical Students Harrier pilots n=8 Med Students n=25 4 laparoscopic box trainer tasks Appendicectomy task Med students 95.5 s Harrier pilots 28.7 s

5. Evolution of the RAF Aptitude Testing  Before WWII ‘right type’

6. UK Tri-service aircrew selection  Part 1 Aptitude testingAptitude testing MedicalMedical Generic fitness testGeneric fitness test InterviewInterview  Part 2 Practical situational exercisesPractical situational exercises

7. Aptitude Domains  Verbal Reasoning (VR)  Numerical Reasoning (NR)  Spatial Reasoning (SR)  Attentional Capability (AC)  Work Rate (WR)  Psychomotor Coordination (PC)

8. Test development 1)Job/task analysis 2)Test battery design 3)Validation

9. Job / task analysis 1)Identification of training elements & competences required for success 2) Development of aptitude profiles 3) Assistance from Subject Matter Experts (experienced flying instructors)

10. Validation  Correlation between test results and training data: Ground SchoolGround School Overall GradingOverall Grading PracticalPractical

11. Our Study Flying aptitude Test for the Selection of Surgical Trainees  MoD Ethical Ref: 1002/299  NHS Ethics Ref: 10/H0401/43  NUH R&D Ref: 10GS002

12. Hypothesis 1. RAF Aircrew Selection test (AST): Identify participants with good  Spatial, Verbal & Numerical Reasoning, Attentional Capability, Work Rate & Psychomotor Ability. 2. AST result = LAP & ENDO & VR SIM 3. SIM Test results = Intra-operative Procedure Based Assessments (PBA) done as part of ongoing training.

13. Method  Participants take part in the following tests: 1. RAF Aircrew Selection Test at RAF Cranwell 2. Simulated laparoscopic and endoscopic tests at the Trent simulation Centre, QMC 3. Psychometric questionnaires 4. Optional participation into prospective study analysing Procedure Based Assessments results

14. Participant numbers  Total N= 450  Medical students (n=200)  Surgical and Medical Core Training (CT) year 1 and 2 (n=100)  Specialty Registrars in years 3 to 8 (n=100)  Forces doctors in training (n=50)

15. Flying Aptitude Test for Surgeons Aptitude DomainDomain WeightTests Perceptual 20VISS Short Term Memory/Capacity10ACT Spatial Reasoning20SIT Psychomotor 40RTT, SMA Central Information Processing10VIGsp

16. Results so far  RAF Flying aptitude test: n=108  LAP SIM tests: n=38  Mean Score: 52.37%  Median: 51%  Lowest score: 17%  Highest score: 87%

17. Results of the first 28 participants

18. Summary   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