title: Hypnosis-induced mental training improves performance on the Fundamentals of Laparoscopic Surgery (FLS) simulator.
abstract: BACKGROUND
  Mental training (MT) is used extensively by musicians and athletes to improve their performance. Recently, it has been suggested as a training method for surgical trainees. We assessed the influence of MT, induced by hypnosis, on the performance of simulated tasks on a laparoscopic simulator, as compared to a non-specific relaxing intervention.
  
  
  METHODS
  11 surgeons completed a proficiency-based training program on the Fundamentals of Laparoscopic Surgery (FLS) simulator, until they reached performance plateau of the peg transfer task. Thereafter, they received a single music session, as a relaxing intervention, followed by repeating of the peg transfer task. Then they went through a hypnosis session guided by an experienced psychologist, with suggestions of smooth flow of pegs from one position on the board to another, and re-performed the task.
  
  
  RESULTS
  Plateau performance was 51.1 ± 6.9 s. After the music session performance improved by 6.3% to 47.9 ± 5.4 s (p = 0.86). After the MT session performance further improved by 15.3% to 40.1 ± 5.8 s (p = 0.009), which was a 21.6% improvement from baseline (p < 0.001). Subject's satisfaction from their performance, without knowledge of the task scores, was 6.0 ± 2.9 on 0-10 VAS after the music and reached as high as 8.5 ± 1.7 after the hypnotic session (p = 0.01).
  
  
  CONCLUSIONS
  Hypnosis-induced MT significantly improves performance on the FLS simulator, which cannot be attributed to its relaxing qualities alone. This study contributes evidence to the effectiveness of MT in surgical skills acquisition and suggests that hypnotic techniques should be used in mental preparation processes. There is a need to further study these effects on operating room performance.
authors.affiliation: Department of General Surgery, Bnai-Zion Medical Center, 47 Golomb Street, Haifa, Israel, gideon.sroka@gmail.com.
authors.forename: Gideon
authors.initials: G
authors.lastname: Sroka
authors.forename: Zahi
authors.initials: Z
authors.lastname: Arnon
authors.forename: Monica
authors.initials: M
authors.lastname: Laniado
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Matter
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D010535:Laparoscopy / Q000193:education*; D008297:Male; D008875:Middle Aged; D013647:Task Performance and Analysis