title: Using the mind as a simulator: a randomized controlled trial of mental training.
abstract: OBJECTIVE
  Laparoscopic simulators have been introduced as safe and effective methods of developing basic skills. Mental training is a novel training method likened to using the mind as a simulator to mentally rehearse the movements of a task or operation. It is widely used by professional athletes and musicians and has been suggested as a technique that could be used by surgical trainees. The purpose of this study was to assess the use of mental training in developing basic laparoscopic skills in novices.
  
  
  METHODS
  Sixty-four medical students without laparoscopic experience were randomized into 4 groups. The first 3 groups were trained to cut a circle on a box trainer. Group 1 received no additional training (BT), Group 2 received additional virtual reality training (BT + VRS), and Group 3 received additional mental training (BT + MT). The fourth group was trained on a virtual reality simulator with additional mental training (box-free). The following 4 assessment criterias: time, accuracy, precision and overall performance were measured on both the box-trainer and virtual simulator.
  
  
  RESULTS
  The mental training group (BT + MT) demonstrated improved laparoscopic skills over both assessments. The improvement in skills in the VRS group (BT + VRS) was limited to VRS assessment and not observed in the box assessment. The fourth group (box-free) had the worst performance on both methods of assessment.
  
  
  CONCLUSIONS
  The addition of mental training led to improved laparoscopic skills development. It is a flexible technique and has the potential to challenge VRS as a more cost-effective training method associated with lower capital investment. Given the benefits of mental training with further research, it could be considered for inclusion in training curricula.
authors.affiliation: King's College London, London, UK. eldredevans@doctors.org.uk
authors.forename: David
authors.initials: D
authors.lastname: Eldred-Evans
authors.forename: Philippe
authors.initials: P
authors.lastname: Grange
authors.forename: Adrian
authors.initials: A
authors.lastname: Cheang
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Salma
authors.initials: S
authors.lastname: Ayis
authors.forename: Mubashir
authors.initials: M
authors.lastname: Mulla
authors.forename: Marc
authors.initials: M
authors.lastname: Immenroth
authors.forename: Davendra
authors.initials: D
authors.lastname: Sharma
authors.forename: Gabriel
authors.initials: G
authors.lastname: Reedy
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D008606:Mental Processes; D011597:Psychomotor Performance; D013647:Task Performance and Analysis; D014584:User-Computer Interface