Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: Results of a randomized controlled trial

RESUMENEl éxito de una cirugía depende de las competencias quirúrgicas y académicas del cirujano, del control de las variables propias del ambiente quirúrgico (estrés e incertidumbre) y de habilidades cognitivas avanzadas que permitan integrar lo anterior e impactar sobre el resultado. Las técnicas cognitivas de entrenamiento propias de atletas y músicos han sido utilizadas en los cirujanos para mejorar su desempeño quirúrgico, dada la similar naturaleza de su actividad, técnicamente demandante, con altos niveles de estrés y una permanente exigencia de resultados positivos. Una de estas estrategias es el Entrenamiento Mental o Cognitivo (EM) que consiste en la realización del acto quirúrgico en la mente previo a la cirugía, sin la necesidad del movimiento físico. Su efectividad en el desempeño quirúrgico ha permitido comprobar que las habilidades no técnicas juegan un papel relevante en la formación profesional. Es decir, la efectividad del cirujano reside en su destreza quirúrgica aunada a su destreza mental, y se relaciona directamente con la capacidad integradora de estas dos variables.El propósito de esta revisión es generar un marco conceptual del EM como una estrategia de mejoramiento para el desempeño del cirujano, considerando su metodología y sus potenciales beneficios para el cirujano, mejorando su desempeño quirúrgico en las salas de cirugía.

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“…El cirujano que realiza EM utiliza su mente como un simulador (17,18), que le permite mejorar su desempeño en diferentes situaciones y contextos:…”

Section: Em En Cirugíaunclassified

“…• Manejo del estrés e incertidumbre El EM propicia el fortalecimiento de las habilidades mentales y facilita el adecuado control del ambiente quirúrgico, creando un esquema mental claro que mejora la toma de decisiones (6,17).…”

Section: Em En Cirugíaunclassified

El entrenamiento mental y los cirujanos: una estrategia de mejoramiento

Ramírez-Sánchez

Vega-Peña

Domínguez-Torres

et al. 2018

iatreia

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“…Although physical practice is essential for the mastery of complex motor skills, MP has been found to be a promising adjunct to facilitate skill learning and performance (Taktek, 2004) [3]. This technique has been employed successfully in teaching and rehearsing complex psychomotor tasks in several domains, including sports (Feltz DL, 1983;Martin K., 1999) [4], [5]; music education [2], [6] and recently, in perceptuo-motor professional skills such as in surgery (Anton NE, et al, 2017) [7] and nursing (Bachman K., 1990) [8]. Recent upsurge in fundamental and behavioural science have established e cacy of MP and has resulted in widespread use of this technique.…”

Section: Introductionmentioning

confidence: 99%

Immediate Effect of Mental Practice on Performance of a Neurodynamic Skill in Physiotherapy Students: A Randomized Control Trial.

Chheda

Akulwar-Tajane

2020

Preprint

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Background Mental Practice (MP), "the cognitive rehearsal of a task in the absence of overt physical movement," has been used successfully in teaching and rehearsing complex psychomotor tasks in several domains, including sports; music; and recently, in surgical skills acquisition. This study investigates the implementation of MP on performance of a neurodynamic skill in third year undergraduate Physiotherapy students. Method: It was a randomized control trial (single-blind) conducted in a Physiotherapy institute. A convenient sample of 40 III year undergraduate students who were novice for the topic were recruited. Some important preliminary steps involved development and validation of the tools used in the study viz. an audio script to guide mental imagery practice and an OSPE checklist to assess the outcome. The OSPE checklist was procedural specific for ULNT-1 and included stations for cognitive, psychomotor and affective domains. A neurodynamic skill (ULNT-1 Median nerve) was taught to all the students (n = 38, 2 drop outs) by a teacher as a didactic lecture followed by physical practice which was supervised and guided by the same teacher. After randomization, the intervention group (n = 19) received MP guided by a structured audio script as a single session for 20 minutes delivered to all the participants together in a group. The control group participants (n = 19) intended to serve as a basis of comparison and received no intervention. Pre- and post-intervention assessment was done by a set of examiners who were blinded to the intervention. Comparative analysis was done within the group using Wilcoxon sign rank test and between the groups using unpaired t test. Results MP group showed significant improvement in cognitive, psychomotor, affective domain and total score of OSPE post intervention whereas the control group did not show significant difference except for the total score. Between group comparison showed significant differences in all the domains and total score in favor of the MP group. Also, the extent of improvement (effect size calculated using Cohen’s d) was more in the mental practice group than in the control group. Conclusion MP as an adjunct to physical practice is a time-and cost-effective strategy to augment traditional training and enhance performance of a neurodynamic skill in Physiotherapy students. This preliminary evidence supported by robust scientific base and ease of integration should facilitate adoption of MP in Physiotherapy education. We recommend future studies to further explore the potential of this promising tool.

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“…10 Accordingly, we sought to ameliorate this dearth in surgical education by 3 developing a novel and comprehensive mental skills curriculum (MSC) and have implemented it with diverse learners. [11][12][13][14] Initially, our group implemented our MSC with surgical novices in a pilot study of its effectiveness during their laparoscopic skills training. 11 From baseline to post-test, we observed significant increases in novices' use of mental skills (i.e., overall use of mental skills in practice and performance settings, attention, and mental imagery) and significantly increased laparoscopic performance.…”

Section: Introductionmentioning

confidence: 99%

“…In a randomized-controlled trial with surgical novices, we implemented our MSC with participants concurrently with laparoscopic skills training, whereas the control group only participated in laparoscopic skills training. 13 Participants completed two transfer tests of laparoscopic skill, an initial test immediately after training, and a retention test of skill after two to three months of no training. We observed that MSC-trained novices displayed significantly enhanced surgical skill retention compared to controls.…”

Section: Introductionmentioning

confidence: 99%

Mental skills training limits the decay in operative technical skill under stressful conditions: Results of a multisite, randomized controlled study

Anton

Mizota

Whiteside

et al. 2019

Surgery

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Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: Results of a randomized controlled trial

Abstract: Introduction-We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress.

Cited by 55 publications

References 29 publications

El entrenamiento mental y los cirujanos: una estrategia de mejoramiento

El entrenamiento mental y los cirujanos: una estrategia de mejoramiento

Immediate Effect of Mental Practice on Performance of a Neurodynamic Skill in Physiotherapy Students: A Randomized Control Trial.

Mental skills training limits the decay in operative technical skill under stressful conditions: Results of a multisite, randomized controlled study

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