SURGSMART HEMOSTASIS CHALLENGE: A SERIOUS GAME FOR BUILDING CONFIDENCE AND COMPETENCE IN LAPAROSCOPIC BLEEDING CONTROL

Background: Intraoperative bleeding is one of the most common and critical complications in minimally invasive surgery (MIS), requiring precise and timely management to prevent adverse outcomes. However, conventional surgical training methods are often constrained by limited resources, a lack of real-time feedback, and insufficient opportunities for deliberate practice, particularly in high-stress bleeding scenarios. To address this gap, we developed a mobile serious game, "Surgsmart Hemostasis Challenge", in improving surgeons' competency and self-confidence in managing laparoscopic bleeding scenarios.

Methods: A prospective single-arm intervention study was conducted with 40 medical participants. Participants engaged in a structured training program using a touchscreen based serious game that simulated laparoscopic bleeding scenarios using authentic surgical videos and an artificial intelligence(AI)-driven real-time scoring and feedback system. The primary outcome was the change in participants' self-reported confidence levels, measured using a Likert scale before and after training. Secondary outcomes included in-game performance metrics such as hemorrhage control time, precision, success rates, and participant satisfaction with the training system.

Results: The study included 25 completely inexperienced medical students and 15 surgeons with prior surgical experience. Post-training self-confidence scores significantly increased (Median = 3.50, IQR: 3.00-4.00) from baseline (Median = 3.00, IQR: 2.00-3.00), with a median improvement of 1.00 (IQR: 0.00-2.00; p < 0.001), with 62.5% of participants reporting heightened confidence. Especially, novice learners demonstrated statistically significant improvements in self-confidence following the intervention with Wilcoxon signed-rank test revealing a substantial increase in confidence scores from a median of 2.0 (IQR: 1.0-2.0) to 3.0 (IQR: 3.0-4.0), with a median improvement of 1.0 (IQR: 0.0-2.0; p < 0.001).Besides, game performance metrics also improved significantly, with final scores markedly higher than initial scores (60.0 vs. 53.8, p = 0.018). Furthermore, high satisfaction was reported with the training experience, underscoring its value as an accessible and realistic tool for building clinical competency.

Conclusion: SurgSmart Hemostasis Challenge is an effective and scalable training tool for enhancing both confidence and technical performance in managing laparoscopic bleeding scenarios. Its engaging design and AI-driven feedback make it particularly valuable for less experienced practitioners, serving as a readily accessible and effective complement to conventional surgical simulation training.