title: A Randomized Control Trial Exploring the Effect of Mental Rehearsal and Cognitive Visualization on Microsurgery Skills.
abstract: Background Many factors are known to influence the performance of surgeons within the operating theater, including tiredness, previous experience, and stress levels. The effects of mental rehearsal and cognitive visualization on microsurgical skills have not been assessed. Methods Thirty-six subjects recruited from the Northwick Park Microsurgery Skills Course were randomized into three groups; (1) a control group (C) with no mental rehearsal script, (2) a visual anastomosis group (VA), with a detailed rat anastomosis script, and (3) a visual relaxation (VR) group with a relaxation script, unrelated to the anastomosis. Participants ran through relevant scripts from day 2 to 5 and were assessed through recorded arterial rat anastomosis, scored using the structured assessment of microsurgery skills. Results Results were analyzed by double-blinded assessors. No statistical significance was found on Monday and Tuesday (first day post intervention), p = 0.326 (VA vs. C) and p = 0.283 (VR vs. C). A statistically significant difference was noted at the end of day 4; p < 0.001 (VA vs. VR) and p = 0.001 (VA vs. C). Further analysis demonstrated that domains within the global rating scoring system showed statistical significance for (1) dexterity: VA versus VR, p = 0.001, (2) visuospatial skills: VA versus VR, p = 0.001, and VA versus C, p = 0.002, and (3) operative flow: VA versus VR, p = 0.044, and VA versus C, p = 0.026. Conclusion The benefits of cognitive visualization and mental rehearsal in microsurgery may result in fewer complications from errors and thus lead to enhanced patient safety and better operative outcomes.
authors.affiliation: Department of Plastic Surgery, SHO, Guys and St Thomas' Hospital, London, United Kingdom.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Chadha
authors.affiliation: Department of Plastic Surgery, The Royal Free Hospital, London, United Kingdom.
authors.forename: Nadine
authors.initials: N
authors.lastname: Hachach-Haram
authors.affiliation: Department of Surgical Research, NPIMR, Northwick Park and St Marks' Hospital, London, United Kingdom.
authors.forename: Sandra
authors.initials: S
authors.lastname: Shurey
authors.affiliation: Department of Plastic Surgery, SHO, Guys and St Thomas' Hospital, London, United Kingdom.
authors.forename: Pari-Naz
authors.initials: PN
authors.lastname: Mohanna
mesh_terms: D000818:Animals; D002983:Clinical Competence / Q000592:standards*; D004195:Disease Models, Animal; D004503:Education, Medical, Graduate; D006801:Humans; D008606:Mental Processes; D008866:Microsurgery / Q000193:education / Q000379:methods* / Q000523:psychology* / Q000592:standards; D051381:Rats; D000066908:Simulation Training; D013647:Task Performance and Analysis; D014656:Vascular Surgical Procedures / Q000193:education / Q000379:methods* / Q000523:psychology* / Q000592:standards; D014741:Video Recording