title: Implicit motor learning promotes neural efficiency during laparoscopy.
abstract: BACKGROUND
  An understanding of differences in expert and novice neural behavior can inform surgical skills training. Outside the surgical domain, electroencephalographic (EEG) coherence analyses have shown that during motor performance, experts display less coactivation between the verbal-analytic and motor planning regions than their less skilled counterparts. Reduced involvement of verbal-analytic processes suggests greater neural efficiency. The authors tested the utility of an implicit motor learning intervention specifically devised to promote neural efficiency by reducing verbal-analytic involvement in laparoscopic performance.
  
  
  METHODS
  In this study, 18 novices practiced a movement pattern on a laparoscopic trainer with either conscious awareness of the movement pattern (explicit motor learning) or suppressed awareness of the movement pattern (implicit motor learning). In a retention test, movement accuracy was compared between the conditions, and coactivation (EEG coherence) was assessed between the motor planning (Fz) region and both the verbal-analytic (T3) and the visuospatial (T4) cortical regions (T3-Fz and T4-Fz, respectively).
  
  
  RESULTS
  Movement accuracy in the conditions was not different in a retention test (P = 0.231). Findings showed that the EEG coherence scores for the T3-Fz regions were lower for the implicit learners than for the explicit learners (P = 0.027), but no differences were apparent for the T4-Fz regions (P = 0.882).
  
  
  CONCLUSIONS
  Implicit motor learning reduced EEG coactivation between verbal-analytic and motor planning regions, suggesting that verbal-analytic processes were less involved in laparoscopic performance. The findings imply that training techniques that discourage nonessential coactivation during motor performance may provide surgeons with more neural resources with which to manage other aspects of surgery.
authors: Institute of Human Performance, The University of Hong Kong, Pokfulam, Hong Kong, People's Republic of China. ffzhu@hku.hk
authors: Frank F
authors: FF
authors: Zhu
authors: Jamie M
authors: JM
authors: Poolton
authors: Mark R
authors: MR
authors: Wilson
authors: Yong
authors: Y
authors: Hu
authors: Jon P
authors: JP
authors: Maxwell
authors: Rich S W
authors: RS
authors: Masters
mesh_terms: D000328:Adult; D001364:Awareness; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D004526:Efficiency; D004569:Electroencephalography; D058407:Electroencephalography Phase Synchronization; D005625:Frontal Lobe / Q000502:physiology; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D007858:Learning; D059032:Learning Curve; D009048:Motor Skills; D012153:Retention, Psychology; D013037:Spatial Behavior; D013647:Task Performance and Analysis; D013702:Temporal Lobe / Q000502:physiology; D055815:Young Adult