give advice on improving trainees' posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limbs posture during laparoscopic training like the expert but leads to a lower increment in the workload.Methods: A 9-axis Inertial Measurement Unit (IMU) was used to compute the upper limbs posture, and a Detection Reaction Time (DRT) device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limbs posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli.Results: We found that subliminal visual stimulation is a valid method to improve trainees' upper limbs posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level.
Conclusions:We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limbs posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: subliminal persuasion improved upper limbs posture of trainees, with a smaller increase on the overall workload.