Background:
It has been suggested that certain nonsurgical skills can be used to predict endoscopic surgical skills. This study aimed to conclusively determine whether nonsurgical skills are associated with endoscopic surgical skills before and after surgical training.

Material and Methods:
We recruited 58 medical students into this study, and assessed their endoscopic surgical skills using the Hiroshima University Endoscopic Surgical Assessment Device (HUESAD). The participants performed 10 runs of HUESAD tasks before training. After they underwent box training and virtual reality simulator training , they performed 10 additional runs of the tasks. Finally, the participants responded to a questionnaire about their involvement in nonsurgical skills, including playing computer games, typing, sewing, playing musical instruments, and using chopsticks. Correlation coefficients were calculated for assessing the relationships between the nonsurgical skills and the HUESAD assessment scores.

Result
No significant correlation was found between any of the nonsurgical skills and initial endoscopic surgical skills. However, there was a significant correlation between the participants’ ability to use chopsticks, scissors, ride a bicycle and playing games, and post-training endoscopic surgical skills. Several of the nonsurgical skills queried in this study did not correlate with pre- and post- training endoscopic surgical skills.

Conclusion:
This is the clear demonstration that those certain nonsurgical skills predict endoscopic surgical skills not before but after training. This approach can be useful for predicting the improvement in endoscopic surgical skills. The ability to predict endoscopic surgical skills would be important for designing custom training programs to ensure safety and high-quality operation in endoscopic surgery.