The influence of music on technical skill in robotic surgery among general surgery residents: a simulation-based experimental study

Music is commonly played in operating rooms, but its effect on the acquisition of robotic surgical skills is unclear, particularly when the music is chosen by the trainee. This study evaluated whether a personalized musical intervention influences the technical performance of general surgery residents on a robotic surgery simulator. Thirty-two residents with no previous robotic experience performed three exercises (Pick and Place, Ring and Rail 1 and Energy Dissection 1) on the RobotiX Mentor simulator in three consecutive runs: run 1 without music, run 2 with self-selected preferred music and run 3 under a condition allocated by sealed envelope for each exercise (no music, preferred music or random music). The effect of music was assessed only in run 3, using the Kruskal-Wallis test with Bonferroni correction for 26 comparisons and epsilon-squared effect sizes. No comparison reached statistical significance after correction; the lowest unadjusted p values were observed for instrument collisions in Pick and Place (p = 0.045) and inappropriately applied energy in Energy Dissection 1 (p = 0.029). Effect sizes were mostly small, although some were moderate. Execution time decreased from run 1 to run 2 in all exercises (p ≤ 0.003), with larger reductions in more complex tasks, a pattern attributable to task repetition; because these runs were not randomized, they cannot support causal inferences about music. Under the conditions evaluated, personalized music was not associated with a significant improvement in technical performance during early robotic simulator training. Larger, fully randomized studies are warranted.