Development and Validation of a Mental Practice Tool for Total Abdominal Hysterectomy.
OBJECTIVE
Total abdominal hysterectomy (TAH) is a common operation performed by obstetrician-gynecologists. Training opportunities for this procedure are declining. Mental practice (MP), the use of mental imagery to rehearse a task symbolically before performance, has been used successfully in sports and music to enhance skill. This strategy demonstrates benefit in existing surgical education literature. We aimed to develop and validate a MP tool (MPT) for resident training in TAH.


METHODS
A prospective survey study was performed in a large, urban, academic medical center in Philadelphia, Pennsylvania, USA. A MPT was developed by guiding expert surgeons through a cognitive walk-through of TAH to identify key procedural cues. For validation, a convenience sample of 22 residents and attendings (N = 11 per group) mentally rehearsed TAH. Motivation, confidence, quality of imagery, and utility of the activity were assessed with a previously validated Mental Imagery Questionnaire (MIQ) before and after exposure to the MPT.


RESULTS
Residents, but not attendings, found MP to be useful in preparation for surgery (residents, p = 0.01; attendings, p = 0.34) and had increased confidence following this exercise (residents, p = 0.01; attendings, p = 0.08). Significant improvement in global imagery score after use of the tool was shown by residents (p = 0.01) but not by the attendings (p = 0.08), with residents having lower imagery skills than attendings both pre-MP and post-MP. Reliability testing of the MIQ indicated internal consistency (pre-MPT, 0.91; post-MPT, 0.90).


CONCLUSIONS
MP may serve as a potentially effective, portable, and inexpensive resident surgical training tool in preparation for TAH. Attendings may benefit from certain aspects of MP. The MIQ may serve as a measure of imagery skills in future experiments of MP in preparation for surgery.
Department of OBGYN, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Said S
SS
Saab
Department of OBGYN, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Jamie
J
Bastek
Department of OBGYN, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Sandra
S
Dayaratna
Wellness Within LLC, Wilmington, Delaware.
Ellyn
E
Hutton
Department of OBGYN, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: catherine.salva@uphs.upenn.edu.
Catherine R
CR
Salva
D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006176:Gynecology / Q000193:education; D006785:Hospitals, University; D006801:Humans; D007044:Hysterectomy / Q000193:education* / Q000523:psychology*; D019018:Imagery, Psychotherapy / Q000193:education*; D007396:Internship and Residency / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008297:Male; D008606:Mental Processes; D057234:Preoperative Period; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014481:United States
Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; abdominal hysterectomy; gynecology; imagery; mental practice; surgical education