Mental practice in postgraduate training: A randomized controlled trial in mastoidectomy skills

Abstract

BackgroundMental practice, the cognitive rehearsal of a task in the absence of overt physical movement, has been successfully used in teaching complex psychomotor tasks including sports and music, and recently, surgical skills.The objectives of this study were, 1) To develop and evaluate a mental practice protocol for mastoidectomy 2) To assess the immediate impact of mental practice on a mastoidectomy surgical task among senior Otolaryngology─Head & Neck Surgery (OHNS) residents.MethodThree expert surgeons were interviewed using verbal protocol analysis to develop a mastoidectomy mental practice script. Twelve senior Residents from Canadian training programs were randomized into two groups. All Residents were video-recorded performing a baseline mastoidectomy in a temporal bone lab. The intervention group received mental practice training, while the control group undertook self-directed textbook study. All subjects were then video-recorded performing a second mastoidectomy. Changes in pre- and post-test scores using validated expert ratings, the Task Specific Evaluation of Mastoidectomy and the Global Evaluation of Mastoidectomy, were statistically analyzed.ResultsA mental practice script was successfully developed based on interviews of three expert surgeon-educators. Task Specific Evaluation and Global Evaluation scores increased in both the mental practice and textbook study groups; there was no significant difference between the two groups in the change in scores post-intervention. There was a high and statistically signficant correlation between evaluators on the outcome measures.ConclusionsWe were not able to demonstrate a significant difference for the benefits of mental practice in mastoidectomy, possibly due to the sample size. However, mental practice is a surgical education tool which is portable, accessible, inexpensive and safe.Electronic supplementary materialThe online version of this article (doi:10.1186/s40463-016-0162-2) contains supplementary material, which is available to authorized users.

Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial

“…Differences in the handling of instruments might be caused by differences in mental practice. Mental practice utilizes the systemic use of mental imagery to rehearse an action before the actual performance without the need for physical movement [ 27 , 28 ]. Mental practice has been validated as an efficient training method in teaching laparoscopic surgery [ 27 ], as well as in learning basic surgical skills [ 29 ].…”

“…In addition, mental practice has been successfully implemented in teaching and rehearsing complex psychomotor tasks in several domains such as sports or music [ 28 ]. Our data indicated that sports activity positively correlates with operative performance.…”

Effect of motor imagery and actual practice on learning professional medical skills

“…In general, the beginner showed a tendency to omit key points, thus decreasing mental representation duration. [27] During the third session, actual practice duration decreased due to skill execution improvement while that of MI increased, thus attesting that the exp group took into account most elements of the script and that the quality of mental representation improved. This resulted in better congruence between actual and imagined execution times, close to isochrony, thus confirming that both tasks share similar processes.…”

“…The exp group performed significantly better than the ctrl group from the second training session showing that MI is quickly effective. During initial learning where a high volume of knowledge was to be learnt, [27] MI better concretized the operations to be carried out and made possible to segment them into several sub-objectives. The association of MI with real practice led to better efficiency than in the ctrl group.…”

“…in surgical techniques. [26,27] Experienced surgeons view MI as the most effective procedure for preparing for complex and stressful situations [9,13,26].…”