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Surgical Endoscopy

Published in:

01-01-2010

Development and validation of mental practice as a training strategy for laparoscopic surgery

Authors: Sonal Arora, Rajesh Aggarwal, Nick Sevdalis, Aidan Moran, Pramudith Sirimanna, Roger Kneebone, Ara Darzi

Published in: Surgical Endoscopy | Issue 1/2010

Abstract

Background

Concerns for patient safety have accelerated the need for alternative training strategies outside the operating room. Mental practice (MP: the use of mental imagery to rehearse a task symbolically before performance) has been used successfully in sports and music to enhance skill. This study aimed to develop and validate a MP training strategy for laparoscopic surgery.

Methods

A cognitive “walk through” was conducted for a laparoscopic cholecystectomy (LC) to identify key visual, cognitive, and kinesthetic cues for the procedure. This was used to develop a MP training protocol featuring an “MP script” to enhance mental imagery of a LC. The script was validated by asking each subject to rehearse mentally a LC within 30 min. Ability to practice this procedure mentally was assessed before and after MP training with a modified version of a validated questionnaire (minimum score, 8; maximum score, 56).

Results

The study was completed by 20 subjects (10 experienced surgeons >100 LCs, 10 novice surgeons <10 LCs). Reliability testing of the questionnaire gave it a Cronbach alpha of 0.984 (n = 20) before MP training and 0.879 (n = 20) after MP training, indicating internal consistency. The construct validity of the questionnaire is supported by the fact that the experienced surgeons scored higher on all the questions than the novices both before and after training. Significant improvement in global imagery score after MP was shown by both experienced (48 before MP vs. 53 after MP; p = 0.007) and novice (15 before MP vs. 42 after MP; p = 0.005) surgeons, suggesting both face and content validity.

Conclusions

This is the first study to develop and validate MP as a novel training approach for laparoscopic surgery. Mental practice may be a time- and cost-effective strategy that improves surgeons’ ability to visualize themselves performing a LC, increasing both their knowledge and confidence.

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Title: Development and validation of mental practice as a training strategy for laparoscopic surgery
Authors: Sonal Arora
Rajesh Aggarwal
Nick Sevdalis
Aidan Moran
Pramudith Sirimanna
Roger Kneebone
Ara Darzi
Publication date: 01-01-2010
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 1/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-009-0624-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Development and validation of mental practice as a training strategy for laparoscopic surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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