  Teleoperated robotic systems have introduced more intuitive control for
minimally invasive surgery, but the optimal method for training remains
unknown. Recent motor learning studies have demonstrated that exaggeration of
errors helps trainees learn to perform tasks with greater speed and accuracy.
We hypothesized that training in a force field that pushes the operator away
from a desired path would improve their performance on a virtual reality
ring-on-wire task.
  Forty surgical novices trained under a no-force, guidance, or
error-amplifying force field over five days. Completion time, translational and
rotational path error, and combined error-time were evaluated under no force
field on the final day. The groups significantly differed in combined
error-time, with the guidance group performing the worst. Error-amplifying
field participants showed the most improvement and did not plateau in their
performance during training, suggesting that learning was still ongoing.
Guidance field participants had the worst performance on the final day,
confirming the guidance hypothesis. Participants with high initial path error
benefited more from guidance. Participants with high initial combined
error-time benefited more from guidance and error-amplifying force field
training. Our results suggest that error-amplifying and error-reducing haptic
training for robot-assisted telesurgery benefits trainees of different
abilities differently.
