The effect of a three-dimensional instructional video on performance of a spatially complex procedure in surgical residents in relation to their visual-spatial abilities

K. Bogomolova*, J.J.G. van Merrienboer, J.E. Sluimers, J. Donkers, T. Wiggers, S.E.R. Hovius, J.A. van der Hage

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: The effect of three-dimensional (3D) vs. two-dimensional (2D) video on performance of a spatially complex procedure and perceived cognitive load were examined among residents in relation to their visual-spatial abilities (VSA).Methods: In a randomized controlled trial, 108 surgical residents performed a 5-Flap Z-plasty on a simulation model after watching the instructional video either in a 3D or 2D mode. Outcomes included perceived cognitive load measured by NASA-TLX questionnaire, task performance assessed using Observational Clinical Human Reliability Analysis and the percentage of achieved safe lengthening of the scar.Results: No significant differences were found between groups. However, when accounted for VSA, safe lengthening was achieved significantly more often in the 3D group and only among individuals with high VSA (OR = 6.67, 95%CI: 1.23-35.9, p = .027).Conclusions: Overall, 3D instructional videos are as effective as 2D videos. However, they can be effectively used to enhance learning in high VSA residents. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (
Original languageEnglish
Pages (from-to)739-745
Number of pages7
JournalAmerican Journal of Surgery
Issue number4
Publication statusPublished - 1 Oct 2021


  • Surgical education
  • Visual-spatial abilities
  • Three-dimensional visualization technology
  • Instructional video
  • Surgical procedural learning

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