APPLIED COGNITIVE PSYCHOLOGY Appl. Cognit. Psychol. 20: 487–503 (2006) Published online 12 April 2006 in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/acp.1198 Learning a Spatial Skill for Surgery: How the Contributions of Abilities Change With Practice MADELEINE KEEHNER 1 *, YVONNE LIPPA 2 , DANIEL R. MONTELLO 1 , FRANK TENDICK 3 and MARY HEGARTY 1 1 University of California, Santa Barbara, USA 2 Miami University, Ohio, USA 3 University of California, San Francisco, USA SUMMARY We examined changes in performance as people learned to use an angled laparoscope, a challenging spatial skill that must be mastered by surgeons who perform minimally invasive techniques. In Experiment 1, novices took tests of spatial and general reasoning ability, and then learned to operate an angled laparoscope, simulated in a virtual environment, over 12 learning sessions. Initial performance showed considerable variability among learners, with performance related to general and spatial abilities. As learning progressed, interindividual variability diminished and all learners attained proficiency; the correlation with general ability diminished but the correlation with spatial ability remained significant. In Experiment 2, performance by highly experienced surgeons on the simulation was excellent from the first session, confirming its ecological validity. The findings contribute to theories of skill acquisition. They also have practical implications for the selection of surgeons and for the potential use of virtual environments in surgical training. Copyright # 2006 John Wiley & Sons, Ltd. The question of how cognitive abilities predict task performance at different stages of learning has been a classic issue in psychology (Ackerman, 1987; Reed, 1931; Thorndike, 1908). Abilities such as spatial visualization are correlated with many real-world tasks, such as piloting aircraft and mechanical reasoning. But does this relationship change over time, as skill is acquired? One domain in which this issue is currently relevant is surgery. Skill learning is an important aspect of surgical training, in which medical students must learn to perform complex procedures. Research has indicated that spatial ability is a key predictor of performance in surgical procedures. Scores on tests of spatial relations (Bennet, Seashore, & Wesman, 1981), which measure the ability to recognize a correspondence between two objects at differing spatial orientations, have been shown to predict the performance of surgical trainees on a microsurgery task (Murdoch, Bainbridge, Fisher, & Webster, 1994). Copyright # 2006 John Wiley & Sons, Ltd. *Correspondence to: Madeleine Keehner, School of Psychology, Curtin University of Technology, GPO Box U 1987, Perth 6845, Western Australia. E-mail: m.keehner@curtin.edu.au Contract/grant sponsor: National Science Foundation; contract/grant numbers: 9980122; 0313237.