title: Cognitive training: How can it be adapted for surgical education?
abstract: BACKGROUND
  There is a need for new approaches to surgical training in order to cope with the increasing time pressures, ethical constraints, and legal limitations being placed on trainees. One of the most interesting of these new approaches is "cognitive training" or the use of psychological processes to enhance performance of skilled behaviour. Its ability to effectively improve motor skills in sport has raised the question as to whether it could also be used to improve surgical performance. The aim of this review is to provide an overview of the current evidence on the use of cognitive training within surgery, and evaluate the potential role it can play in surgical education.
  
  
  METHODS
  Scientific database searches were conducted to identify studies that investigated the use of cognitive training in surgery. The key studies were selected and grouped according to the type of cognitive training they examined.
  
  
  RESULTS
  Available research demonstrated that cognitive training interventions resulted in greater performance benefits when compared to control training. In particular, cognitive training was found to improve surgical motor skills, as well as a number of non-technical outcomes. Unfortunately, key limitations restricting the generalizability of these findings include small sample size and conceptual issues arising from differing definitions of the term 'cognitive training'.
  
  
  CONCLUSIONS
  When used appropriately, cognitive training can be a highly effective supplementary training tool in the development of technical skills in surgery. Although further studies are needed to refine our understanding, cognitive training should certainly play an important role in future surgical education.
authors.affiliation: Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, London, England, SE1 1UL, United Kingdom. Electronic address: lauren.h.wallace@kcl.ac.uk.
authors.forename: Lauren
authors.initials: L
authors.lastname: Wallace
authors.affiliation: Division of Transplantation, Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, London, England, SE1 1UL, United Kingdom. Electronic address: nicholas.raison@kcl.ac.uk.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Raison
authors.affiliation: Department of Urology, Medway Maritime Hospital, Gillingham, Kent, ME7 5NY, United Kingdom. Electronic address: safari1616@hotmail.com.
authors.forename: Faisal
authors.initials: F
authors.lastname: Ghumman
authors.affiliation: School of Psychology, University College Dublin, D04 V1W8, Ireland. Electronic address: aidan.moran@ucd.ie.
authors.forename: Aidan
authors.initials: A
authors.lastname: Moran
authors.affiliation: Division of Transplantation, Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, London, England, SE1 1UL, United Kingdom. Electronic address: prokar.dasgupta@kcl.ac.uk.
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.affiliation: Division of Transplantation, Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, London, England, SE1 1UL, United Kingdom. Electronic address: kamran.ahmed@kcl.ac.uk.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
mesh_terms: D002983:Clinical Competence; D003071:Cognition; D006801:Humans; D007092:Imagination; D009048:Motor Skills; D000066908:Simulation Training / Q000379:methods; D013043:Specialties, Surgical / Q000193:education*; D013514:Surgical Procedures, Operative / Q000193:education* / Q000523:psychology*
keywords: Cognitive training; Mental rehearsal; Surgical education; Surgical skills training